Does a history of sexual and physical childhood abuse contribute to HIV infection risk in adulthood? A study among post-natal women in Harare, Zimbabwe

Abstract

BackgroundSexual and physical abuse in childhood creates a great health burden including on mental and reproductive health. A possible link between child abuse and HIV infection has increasingly attracted attention. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women.MethodsA cross sectional survey was conducted among 2042 postnatal women (mean age=26y) attending six public primary health care clinics in Harare, Zimbabwe within 6 weeks post-delivery. Clinic records were reviewed for mother’s antenatal HIV status. Participants were interviewed about childhood abuse including physical or sexual abuse before 15 years of age, forced first sex before 16, HIV risk factors such as age difference at first sex before age 16. Multivariate analyses assessed the associations between mother’s HIV status and child physical and sexual abuse while controlling for confounding variables.ResultsMore than one in four (26.6%) reported abuse before the age of 15: 14.6% physical abuse and 9.1% sexual abuse,14.3% reported forced first sex and 9.0% first sex before 16 with someone 5+ years older. Fifteen percent of women tested HIV positive during the recent antenatal care visit. In multivariate analysis, childhood physical abuse (aOR 3.30 95%CI 1.58- 6.90), sexual abuse (3.18 95%CI: 1.64-6.19), forced first sex (aOR 1.42, 95%CI: 1.00-2.02), and 5+ years age difference with first sex partner (aOR 1.66 95%CI 1.09-2.53) were independently associated with HIV infection.ConclusionThis study confirms that child physical and/or sexual abuse increases risk for HIV acquisition. Further research is needed to assess the pathways to HIV acquisition from childhood to adulthood. Prevention of child abuse must form part of the HIV prevention agenda in Sub-Saharan Africa.

Factors associated with past year physical and sexual intimate partner violence against women in Zimbabwe: results from a national cluster-based cross-sectional survey

“…Similar studies in Africa have found male dominance and sexual entitlement influencing such relations [37]. Although HIV status is not always related or does not always reach significance levels with violent experiences [38], the fact that having an STI, it being a strong risk factor for HIV shows that sexual factors are strongly related to intimate partner violence [39,40]. STIs which signify non-use of protection during sex illustrate women's failure or inability to negotiate safe sex with their partners due to fear of several things including being blamed by the partner, being rejected or a clear use of male force during sex.…”

Prevalence and Forms of Intimate Partner Violence among People Living with HIV/AIDS in Sokoto State, Nigeria

“…Findings from this study indicated that being in a monogamous marriage was the only factor associated with the risk of IPV amongst our respondents. In contrast to this finding, the study from Uganda showed that the sociodemographic status of being married was associated with a higher risk of IPV [74], while another type of marital status, such as being divorced, was also associated with IPV in another context [75,76]. This calls for concerted efforts including improving public awareness and providing family counselling aimed at stemming the tide of IPV regardless of marital status and marriage settings.…”

Attributes of HIV infection over decades (1982–2018): A systematic review and meta‐analysis

“…Anal rape, particularly in children, is associated with a multiplied risk of infection because anal tissues can be easily damaged (Murray, Nguyen, & Cohen, 2014). Victims of sexual violence during childhood are more likely to engage in an array of behaviours later in life that put them at greater risk of HIV acquisition, including substance abuse, homosexuality, having multiple partners, and participating in sex work (Miltz et al., 2019; Mimiaga et al., 2009; Shamu et al., 2019). Furthermore, sexual coercion among adolescents and adults is associated with low self‐esteem and depression, factors that perpetuate many of the risk behaviours for HIV infection (Richter et al., 2014).…”