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Understanding sexual violence: Perspectives from an adolescent HIV prevention study
Nadia Ahmed1,2, Emily Webb3, Richard Muhumuza4
1Department of Genito-Urinary Medicine, Central North West London NHS Trust, London, United Kingdom.
Background:
Sub-Saharan Africa has a high prevalence of sexual violence in young women, with less data on young men.
Aim:
We investigated the prevalence of forced sex among adolescents and young people and described factors putting them at risk of sexual violence.
Setting:
The study was conducted in South Africa, Uganda and Zimbabwe.
Methods:
We conducted a cross-sectional, structured survey among 1330 13-24-year-old male and female participants. Logistic regression models were used to estimate odds ratios for associations with forced sex, adjusting for site, sex and age. Sixty in-depth interviews and 24 group discussions were also conducted. Data were transcribed, translated and analysed using thematic framework analysis.
Results:
Seventy-six out of 1326 participants (6%) reported forced sex in the last 6 months. Forced sex was most commonly reported in Entebbe versus other sites, female than male participants, and 18-24 years than 13-18 years. Associations were seen with younger sexual debut (adjusted odds ratio [aOR]: 0.89; 95% confidence interval [CI]: 0.81, 0.98), ever having transactional sex (aOR: 2.18; 95% CI: 1.19, 4.02), risk-taking (aOR: 3.51; 95% CI: 1.99, 6.19), depression (aOR: 3.20; 95% CI: 1.69, 6.06), anxiety (aOR: 2.07; 95% CI: 1.08, 3.96) and binge drinking (aOR: 2.66; 95% CI: 1.33, 5.36), and strong association with forcing someone to have sex (aOR: 7.54; 95% CI: 3.68, 15.46). Qualitative data support these results.
Conclusion:
Our findings identify risks similar to those for sexual violence.
Contribution:
We suggest protection strategies to police times and places of risk are developed, and addressed in economic and legal country specific guidance.
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