Prevalence, Type, and Correlates of Trauma Exposure Among Adolescent Men and Women in Soweto, South Africa: Implications for HIV Prevention

Resource type
Date created
2016-11-25
Authors/Contributors
Author: Closson, K.
Author: Nkala, B.
Author: Musuku, A.
Author: Cui, Z.
Author: Chia, J.
Author: Gray, G.
Author: Miller, C.L.
Abstract
BACKGROUND: Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. METHODS: Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS), prevalence of "ever" experiencing a traumatic event among adolescents (aged 14-19) was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C) scale (19 items, study alpha = 0.63). We assessed self-reported number of potentially traumatic events (PTEs) experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of 'high PTE score' (≥7 PTEs). RESULTS: Overall, 767/830 (92%) participants were included (58% adolescent women). Nearly all (99.7%) reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19). Adolescent men reported more violent PTEs (e.g., "seen an act of violence in the community") whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., "family member or someone close died of HIV/AIDS"). High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively). For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63); and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76). Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03,) and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37). CONCLUSION: Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with depression and inconsistent condom use suggest pathways for HIV risk. HIV prevention interventions targeting adolescents must address the syndemics of trauma and HIV through the scale-up of gender-transformative, youth-centred, trauma-informed integrated HIV and mental health services.
Document
Published as
Closson K, Dietrich JJ, Nkala B, Musuku A, Cui Z, Chia J, Gray G,Lachowsky NJ, Hogg RS, Miller CL, Kaida A. Prevalence, type, and correlatesof trauma exposure among adolescent men and women in Soweto, South Africa:implications for HIV prevention. BMC public health. 2016 Nov 25;16(1):1191. https://dx.doi.org/10.1186/s12889-016-3832-0
Publication title
BMC public health
Document title
Prevalence, Type, and Correlates of Trauma Exposure Among Adolescent Men and Women in Soweto, South Africa: Implications for HIV Prevention
Date
2016
Volume
16
Issue
1
Publisher DOI
10.1186/s12889-016-3832-0
Copyright statement
Copyright is held by the author(s).
Scholarly level
Peer reviewed?
Yes
Language
Member of collection
Attachment Size
art3a10.11862fs12889-016-3832-0.pdf 485.85 KB