Background

Estimates on sexual violence (SV) among adolescents are rarely disaggregated by key indicators.

Objective

We examine the independent effects of sex, age, HIV status and mode of HIV acquisition on the exposure to SV using generalised estimating equations models and proportional hazard model.

Participant and setting

Data from a 4-year prospective cohort study of 1447 adolescents (ages 10–19, 57% girls, 76% living with HIV) in South Africa.

Methods

We describe the lifetime prevalence of three forms of SV: non-contact (unwanted showing of private parts), contact (coerced sexual debut, attempted and completed forced penetrative or oral sex,) and exploitative (sex in exchange for goods/money).

Results

Overall, 23.9% (95%CI = 21.7%–26.1%) reported exposure to SV at some point in their lives: non-contact = 5.7%, contact = 9.0% and exploitative = 15.8%. While girls reported higher rates of exploitative (18.4% vs 12.3%; p < 0.001) and contact SV (12.3% vs 4.6%; p < 0.001), there were no differences in levels of non-contact SV by sex (6.5% vs 4.6%; p = 0.086). Exposure to any SV doubled in late adolescence (10–14 years = 7.0% vs ≥15 years = 31.7%; aIRR = 2.07; 95%CI = 1.82–2.37). Though level of SV were comparable between those living with HIV and those HIV-uninfected (22.9% vs 26.2%; p = 0.182), adolescents who recently acquired HIV were twice as likely to experience SV compared to adolescents who perinatally acquired HIV (42.3% vs 15.7%; aIRR = 2.03; 95%CI = 1.73–2.39). This association persisted when analysis was restricted to incidence SV during follow-up (aIRR = 1.53; 95%CI = 1.23–2.10).

Conclusion

Exposure to SV was high for both sexes, increased with age and more prevalent among adolescents who recently acquired HIV. SV prevention and response services must also be offered to boys and strengthened in HIV care services.

中文翻译：

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哪些群体最容易受到性暴力的影响？对南非青少年的性别、年龄和艾滋病毒感染状况进行分类分析

背景

对青少年性暴力（SV）的估计很少按关键指标进行分类。

客观的

我们使用广义估计方程模型和比例风险模型研究了性别、年龄、HIV 状况和 HIV 感染方式对 SV 暴露的独立影响。

参与者和设置

数据来自对南非 1447 名青少年（10-19 岁，57% 女孩，76% 艾滋病毒感染者）进行的 4 年前瞻性队列研究。

方法

我们描述了三种形式的 SV 的终生流行率：非接触（不想要的私处展示）、接触（强迫首次性行为、尝试并完成强迫插入或口交）和剥削（以性换取商品/金钱）。

结果

总体而言，23.9% (95%CI = 21.7%–26.1%) 的人报告在其一生中的某个时刻接触过 SV：非接触 = 5.7%，接触 = 9.0%，剥削 = 15.8%。虽然女孩报告的剥削率较高（18.4% vs 12.3%；p  < 0.001），接触性 SV 率较高（12.3% vs 4.6%；p < 0.001），但不同性别的非接触性 SV 水平没有差异（6.5% vs 6.5%）。 4.6%；p  = 0.086）。在青春期后期，任何 SV 的接触率都会增加一倍（10-14 岁 = 7.0% vs ≥15 岁 = 31.7%；aIRR = 2.07；95%CI = 1.82-2.37）。尽管 HIV 感染者和未感染 HIV 的人的 SV 水平相当（22.9% vs 26.2%；p = 0.182），最近感染 HIV 的青少年发生 SV 的可能性是围产期感染 HIV 的青少年的两倍（42.3% vs 15.7%；aIRR = 2.03；95%CI = 1.73–2.39）。当分析仅限于随访期间 SV 的发生率时，这种关联仍然存在（aIRR = 1.53；95% CI = 1.23–2.10）。

结论

男性和女性的 SV 接触率都很高，并且随着年龄的增长而增加，并且在最近感染 HIV 的青少年中更为普遍。还必须向男孩提供性暴力预防和应对服务，并加强艾滋病毒护理服务。