AEGiS-15IAC: The impact of childhood trauma on HIV risk behaviours of young women in South Africa.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

The impact of childhood trauma on HIV risk behaviours of young women in South Africa.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrC1121)

Jewkes RK, Nduna M, Levin JB, Jama PN, Khuzwayo N, Duvvury N, Koss MP
Medical Research Council, Pretoria, South Africa

Introduction: Experiences of sexual violence in childhood have been shown to influence HIV risk behaviours but there is limited evidence of links between other forms of childhood trauma and HIV risk behaviours. This paper seeks to describe the impact of childhood trauma on HIV risk behaviours of South African youth.

METHODS: This cross-sectional study of 1044 sexually active women aged 17-23 years. They were volunteers recruited for participation in a RCT of the Stepping Stones behavioural intervention for HIV from 70 rural villages in the Eastern Cape province of South Africa. Each completed a questionnaire and gave a blood sample. A 25 item South African adaptation of the short form of the Childhood Trauma Questionnaire was used. A multiple regression model was constructed for each risk behaviour showing the relationship between the behaviours and the childhood trauma score (as well as the separate dimensions) in each case after adjusting for age, socio-economic status, education, alcohol use, depression and clusters.

RESULTS: 90.4% reported physical violence, 77.4% physical hardship, 97.6% emotional abuse, 78.6% emotional neglect, 42.8% sexual abuse and 34.8% loss of one or both parents. Childhood trauma was significantly associated with or risk of having 4 or more sexual partners (OR1.07 95%CI 1.04-1.11), not using a condom correctly on last sex (OR 1.03 95%CI 1.01-1.06), any transactional sex (OR1.02 95%CI 1.0-1.05), and experiencing more than one episode of physical and/or sexual violence (OR1.11 95%CI 1.09-1.14). Having four or more partners was most strongly associated with HIV status (OR 1.89, 95%CI 1.26-2.84) and experiences of physical violence in childhood, sexual abuse and parental loss were significantly associated with this.

CONCLUSIONS: Experience of childhood trauma is strongly associated with HIV risk behaviours. HIV prevention activities need to encompass identification of and support for children and youth who have experienced this.

Keywords: AEGIS, HIV, Risk-Taking, Acquired Immunodeficiency Syndrome, HIV Seropositivity, HIV Infections, Sexual Behavior, Condoms, Substance-Related Disorders, Cross-Sectional Studies, Crime Victims, HIV-1, Sex Offenses, Violence, South Africa, Humans, Female, Child, injuries

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