Abstract This systematic review examined 140 outcome evaluations of primary prevention strategies for sexual violence perpetration. The review had two goals: 1) to describe and assess the breadth, ...quality, and evolution of evaluation research in this area; and 2) to summarize the best available research evidence for sexual violence prevention practitioners by categorizing programs with regard to their evidence of effectiveness on sexual violence behavioral outcomes in a rigorous evaluation. The majority of sexual violence prevention strategies in the evaluation literature are brief, psycho-educational programs focused on increasing knowledge or changing attitudes, none of which have shown evidence of effectiveness on sexually violent behavior using a rigorous evaluation design. Based on evaluation studies included in the current review, only three primary prevention strategies have demonstrated significant effects on sexually violent behavior in a rigorous outcome evaluation: Safe Dates ( Foshee et al., 2004 ); Shifting Boundaries (building-level intervention only, Taylor, Stein, Woods, Mumford, & Forum, 2011); and funding associated with the 1994 U.S. Violence Against Women Act (VAWA; Boba & Lilley, 2009). The dearth of effective prevention strategies available to date may reflect a lack of fit between the design of many of the existing programs and the principles of effective prevention identified by Nation et al. (2003).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Globally 1 billion children are exposed to violence every year. The Violence Against Children Surveys (VACS) are nationally representative surveys of males and females ages 13-24 that are intended to ...measure the burden of sexual, physical and emotional violence experienced in childhood, adolescence and young adulthood. It is important to document the methodological approach and design of the VACS to better understand the national estimates that are produced in each country, which are used to drive violence prevention efforts.
This study describes the surveys' target population, sampling design, statistical considerations, data collection process, priority violence indicators and data dissemination.
Twenty-four national household surveys have been completed or are being planned in countries across Africa, Asia, the Caribbean, Central and South America, and Eastern Europe. The sample sizes range from 891 to 7912 among females (72%-98% response rate) and 803-2717 among males (66%-98% response rate). Two face-to-face interviews are conducted: a Household and an Individual Questionnaire. A standard set of core priority indicators are generated for each country that range from prevalence of different types of violence, contexts, risk and protective factors, and health consequences. Results are disseminated through various platforms to expand the reach and impact of the survey results.
Data obtained through VACS can inform development and implementation of effective prevention strategies and improve health service provision for all who experience violence. VACS serves as a standardised tool to inform and drive prevention through high-quality, comprehensive data.
Compared to young men, Ugandan young women are disproportionately impacted by HIV. Childhood transactional sex may contribute to this disparity. Using data from the 2015 Uganda Violence Against ...Children Survey, we used logistic regression models to assess the association between childhood transactional sex and negative outcomes. Among 18-24-year-old young women who had sex prior to 18 (n = 982), those who ever engaged in transactional sex had 5.9 times adjusted odds ratio (AOR); confidence interval (CI): 1.6-22.2 higher odds of having multiple sexual partners in the past year; 5.2 times (AOR; CI: 2.1-12.9) higher odds of infrequent condom use in the past year; 3.0 times (AOR; CI: 1.2-7.9) higher odds of hurting themselves intentionally; and 3.2 times (AOR; CI: 1.3-7.7) higher odds of having attitudes justifying spousal abuse than young women who never engaged in transactional sex. Interventions for transactional sex and HIV in Uganda should consider prioritizing prevention, harm-reduction and continued investment in adolescent girls' and young women's futures.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Most coronavirus disease 2019 (COVID-19) deaths occur among adults, not children, and attention has focused on mitigating COVID-19 burden among adults. However, a tragic consequence of adult deaths ...is that high numbers of children might lose their parents and caregivers to COVID-19-associated deaths.
We quantified COVID-19-associated caregiver loss and orphanhood in the United States and for each state using fertility and excess and COVID-19 mortality data. We assessed burden and rates of COVID-19-associated orphanhood and deaths of custodial and coresiding grandparents, overall and by race and ethnicity. We further examined variations in COVID-19-associated orphanhood by race and ethnicity for each state.
We found that from April 1, 2020, through June 30, 2021, >140 000 children in the United States experienced the death of a parent or grandparent caregiver. The risk of such loss was 1.1 to 4.5 times higher among children of racial and ethnic minority groups compared with non-Hispanic White children. The highest burden of COVID-19-associated death of parents and caregivers occurred in Southern border states for Hispanic children, in Southeastern states for Black children, and in states with tribal areas for American Indian and/or Alaska Native populations.
We found substantial disparities in distributions of COVID-19-associated death of parents and caregivers across racial and ethnic groups. Children losing caregivers to COVID-19 need care and safe, stable, and nurturing families with economic support, quality child care, and evidence-based parenting support programs. There is an urgent need to mount an evidence-based comprehensive response focused on those children at greatest risk in the states most affected.
Objectives This study assessed associations between recent transactional sex (TS) and potential determinants and variations in patterns across two geographic regions with high HIV burden compared to ...the rest of Uganda, among adolescent girls and young women (AGYW). Methods In 2015, a nationally representative cross-sectional household survey was conducted in Uganda. A stratified multi-stage cluster sample design produced nationally representative estimates and sub-national estimates for AGYW in two high HIV burden regions, DREAMS Central 1 (Bukomansimbi, Ssembabule, and Rakai districts) and DREAMS Central 2 (Mubende, Mityana, Gomba, and Mukono districts), and the rest of Uganda. To identify associations between recent TS (defined as sex in the past 12 months in exchange for material support or help) and risk factors, multivariable logistic regressions were conducted. Interaction terms assessed the associations between violence and recent TS across geographic regions. Results Nationally, 14.2% of sexually active AGYW engaged in recent TS. Region-specific significant associations emerged between recent TS and marriage, family wealth, friendship, orphanhood, and sexual debut. In DREAMS Central 1 and 2, AGYW who witnessed violence in the home or community, or experienced sexual, physical, or emotional violence had higher odds of recent TS than AGYW who did not experience that form of violence (adjusted odds ratio ranged between 2.10 (95% CI, 1.07, 4.13) and 8.25 (95% CI, 3.40, 20.06)). The magnitude of association between recent TS and types of violence varied by region. Conclusions Violence is strongly and consistently associated with recent TS, and patterns in prevalence and risk factors vary across regions in Uganda. Given the high risk of HIV association with recent TS, HIV epidemic control efforts may benefit from focus on comprehensive violence prevention and target persons who engage in TS. Comprehensive HIV prevention programming aimed at keeping AGYW HIV-negative should incorporate prevention of violence and TS as key components to facilitate HIV epidemic control in this vulnerable population.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Purpose: Adverse childhood experiences (ACEs) are a global public health concern. Little research exists on the prevalence and health consequences of ACEs in Zambia. The current study examined ...associations between individual and cumulative ACEs, mental distress, and suicide risk among Zambian youth. Methods: Data from Zambia Violence Against Children and Youth Survey were used (18-24 years old, n=1034). Bivariate and adjusted logistic models were performed with independent variables (i.e., experienced physical violence (PV), sexual violence (SV), and emotional violence (EV); witnessed intimate partner violence (IPV) and community violence (CV); orphan status; cumulative ACE exposure) and dependent variables (i.e., mental distress and suicide risk). Adjusted models controlled for demographic and social characteristics. Results: 76.8% of Zambian youth experienced one or more ACEs, and more than 30% witnessed CV (38.4%) or IPV (30.2%), or experienced PV (35.1%), prior to age 18. 27.5% were orphans, and less than 20% experienced EV (17.3%) or SV (15.4%) in childhood. 42.4% experienced mental distress in the past 30 days, and 12.5% reported lifetime suicidal thoughts or suicide attempts. PV, EV, cumulative ACE exposure, older age, being single, and stronger friendships were significantly related to experiencing mental distress. Cumulative ACEs exposure was associated with significantly higher suicide risk. Conclusions: Preventing ACEs can reduce mental distress and suicide risk among Zambian youth. Youth with cumulative ACE exposure can be prioritized for mental health intervention. More research is warranted to investigate the broad-based prevention of ACEs, especially PV and EV, and protective factors that can promote resilience among youth who have experienced ACEs.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
The US Centers for Disease Control and Prevention have released a report with sufficient evidence, showing that a majority of cancers in younger people are associated to excessive weight and obesity. ...Recommendations from the US Preventive Services Task Force (USPSTF) includes screening for obesity and intensive behavioural interventions as well as weight counselling for preventive care in clinical care settings.
Adverse Childhood Experiences (ACEs) are potentially traumatic childhood events associated with negative health outcomes. Limited data on ACEs exists from low- and middle-income countries (LMICs). No ...ACEs studies have been done in Honduras.
This study assessed the prevalence of ACEs in Honduras and associated health risks and risk behaviors among young adults.
Data from the 2017 Honduras Violence Against Children and Youth Survey (VACS) were used. Analyses were restricted to participants ages 18−24 years (n = 2701).
This study uses nationally representative VACS data to estimate the weighted prevalence of ACEs (physical, emotional, and sexual violence; witnessing violence; parental migration). Logistic regression analyses assessed the relationship between individual ACEs, cumulative ACEs, and health risks and risk behaviors (psychological distress; suicide ideation or self-harm; binge drinking; smoking; drug use; STIs; early pregnancy). Chi-square tests examined differences by sex.
An estimated 77 % of 18−24 year olds in Honduras experienced at least 1 ACE and 39 % experienced 3+ ACEs. Women experienced significantly more sexual, emotional, and physical violence compared to men. Compared to youth with no ACEs, those with 1−2 ACEs and 3+ ACEs had 1.8 and 2.8 increased odds for psychological distress, 2.3 and 6.4 increased odds for suicidal ideation and self-harm, and 1.7 and 1.9 increased odds for smoking, respectively, adjusting for age, education, and food insecurity. Physical violence victimization and witnessing violence in the community were associated with increased odds of all health risks and risk behaviors.
The high prevalence of ACEs and associated negative health risks and risk behaviors in this population support the need for prevention and early intervention for ACEs.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Data on adverse childhood experiences (ACEs) are key to understanding their burden and informing prevention programs and strategies. Population-based surveys that collect ACEs data may be affected by ...item non-response. This study examines differences in non-response to the optional Behavior Risk Factor Surveillance System (BRFSS) ACEs module overall, by sociodemographic characteristics, year, and question.INTRODUCTIONData on adverse childhood experiences (ACEs) are key to understanding their burden and informing prevention programs and strategies. Population-based surveys that collect ACEs data may be affected by item non-response. This study examines differences in non-response to the optional Behavior Risk Factor Surveillance System (BRFSS) ACEs module overall, by sociodemographic characteristics, year, and question.The study used BRFSS ACEs Module data from 21 states in 2019 and 16 states in 2021. Weighted proportions and 95% confidence intervals (95% CI) of responders and non-responders to the ACEs module by year and sociodemographic characteristics, and percentages of non-responders for each question were calculated. Chi-square tests were used to assess statistically significant (p<0.05) differences. Analyses were conducted in 2023.METHODSThe study used BRFSS ACEs Module data from 21 states in 2019 and 16 states in 2021. Weighted proportions and 95% confidence intervals (95% CI) of responders and non-responders to the ACEs module by year and sociodemographic characteristics, and percentages of non-responders for each question were calculated. Chi-square tests were used to assess statistically significant (p<0.05) differences. Analyses were conducted in 2023.In 2019 and 2021, 1.2% (95% CI=1.1, 1.4) and 2.4% (95% CI=2.2, 2.5) of BRFSS participants were non-responders to the ACEs Module, respectively (p<0.01). Compared with responders, non-responders were more likely to be non-Hispanic Black (p=0.01) or non-Hispanic Asian (p=0.01), unemployed (p<0.01), have income <$15,000 (p<0.01), or report poor health (p<0.01). Non-response by question increased as the module progressed, and non-response was highest for sexual abuse questions.RESULTSIn 2019 and 2021, 1.2% (95% CI=1.1, 1.4) and 2.4% (95% CI=2.2, 2.5) of BRFSS participants were non-responders to the ACEs Module, respectively (p<0.01). Compared with responders, non-responders were more likely to be non-Hispanic Black (p=0.01) or non-Hispanic Asian (p=0.01), unemployed (p<0.01), have income <$15,000 (p<0.01), or report poor health (p<0.01). Non-response by question increased as the module progressed, and non-response was highest for sexual abuse questions.Overall, findings demonstrate that individuals are willing to respond to the ACEs module questions. Although low, non-response to the module increased from 2019 to 2021. Higher non-response for sexual abuse questions may be due to their sensitivity or potential survey fatigue due to placement at the end of the module. Higher non-response among racial/ethnic minorities and economically disadvantages groups highlight opportunities to improve existing surveillance systems.CONCLUSIONSOverall, findings demonstrate that individuals are willing to respond to the ACEs module questions. Although low, non-response to the module increased from 2019 to 2021. Higher non-response for sexual abuse questions may be due to their sensitivity or potential survey fatigue due to placement at the end of the module. Higher non-response among racial/ethnic minorities and economically disadvantages groups highlight opportunities to improve existing surveillance systems.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Violence is associated with health-risk behaviors, potentially contributing to gender-related HIV incidence disparities in sub-Saharan Africa. Previous research has demonstrated that violence, ...gender, and HIV are linked via complex mechanisms that may be direct, such as through forced sex, or indirect, such as an inability to negotiate safe sex. Accurately estimating violence prevalence and its association with HIV is critical in monitoring programmatic efforts to reduce both violence and HIV. We compared prevalence estimates of violence in youth aged 15-24 years from two Ugandan population-based cross-sectional household surveys (Uganda Violence Against Children Survey 2015 VACS and Uganda Population-based HIV Impact Assessment 2016-2017 UPHIA), stratified by gender. UPHIA violence estimates were consistently lower than VACS estimates, including lifetime physical violence, recent intimate partner physical violence, and lifetime sexual violence, likely reflecting underestimation of violence in UPHIA. Multiple factors likely contributed to these differences, including the survey objectives, interviewer training, and questionnaire structure. VACS may be better suited to estimate distal determinants of HIV acquisition for youth (including experience of violence) than UPHIA, which is crucial for monitoring progress toward HIV epidemic control.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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