Assessing the relationship between adverse childhood experiences (ace) and high hiv risk behaviours among male and female adolescents: a cross sectional study in Balaka, Malawi
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Date
2020-12-01
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Kamuzu University of Health Sciences
Abstract
Human Immunodeficiency Virus (HIV) remains a burden in Malawi with high incidences among
adolescents (0.23% per year). Adverse childhood experiences (ACEs) are a range of events (that
children can experience early in their life that leads to stress and can result in trauma and
unhealthy behaviours eg sexual immorality, indulging in substance abuse. There are a number of
behaviours that exposes one to high HIV risks eg multiple sexual partners and infrequent
condom use. The study assessed the relationship between reported adverse childhood
experiences and sexual risk behaviours among adolescents’ in Balaka district. This was a crosssectional study design. It used secondary data from the Malawi Longitudinal Study of Families
and Health (MLSFH) study. This study used data from the 2017/2018 data collection wave
which interviewed adolescents aged between 10-19. Logistic regression analysis was performed
in STATA v14 to assess the association between ACEs and HIV risk behaviours (multiple sexual
partners and infrequent condom use). Adolescents who reported having exposed to physical
abuse were 1.5771 times likely to have multiple sexual partners as compared to those who were
not exposed to reported physical abuse (OR=1.5771, Cl = 0.7879 – 3.1566 at 95%) and AOR
was 1.4245 among the exposed. Adolescents exposed to physical abuse and sexual abuse had
1.3019 and 1.4048 respectively risk of not Infrequently use condoms amongst the exposed than
in the non-exposed. No association was found between reported emotional abuse and infrequent
condom use (OR=1). The study revealed that there was an association between ACEs and sexual
risk behaviours. There is a need to institutionalise comprehensive sexuality education from lower
primary age groups, not confined to the limited coverage of life skills as at present.
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Keywords
Adverse childhood experiences, sexual risk behaviours’, HIV, adolescents, Balaka, Malawi