Sexual violence affects adolescents’ health and prosocial behaviour beyond other violence exposure

ABSTRACT

Background: Sexual violence is a public health issue among adolescents globally but remains understudied in Sub-Saharan Africa.

Objective: The present study focused on the association of cumulative exposure to different types of sexual violence with mental and physical health problems and prosocial behaviour.

Method: We conducted a survey with a regionally representative sample of both in-school and out-of-school adolescents, aged 13–17 years, living in south-western Nigeria. Self-reported exposure to sexual violence, behavioural problems, physical complaints, and prosocial behaviour were assessed.

Results: About three quarters of the participants reported the experience of sexual violence (74.6%). Multiple regression models revealed that the more types of sexual violence an individual reported, the more mental and physical health problems, and the fewer prosocial behaviours they reported when controlling for other forms of violence exposure. Latent class analysis revealed three severity classes of sexual violence. Symptoms of mental and physical health indicators were significantly higher as exposure increased by group whereas prosocial behaviours were non-significantly fewer in the opposite direction.

Conclusion: This study revealed a consistent and unique relation between sexual violence exposure and negative health outcomes among adolescents. Further research on sexual violence in Sub-Saharan Africa and its associations is needed.

HIGHLIGHTS

• Sexual violence is associated with health problems and prosocial behaviour among in- and out-of-school youth in Nigeria.

• Mental and physical health is particularly affected among youth who experience the highest levels of sexual violence. Yet, lower exposure levels are highly prevalent and are related to health issues, too.

• Prosocial behaviour is negatively related to sexual violence exposure indicating effect on social well-being.

Antecedentes: La violencia sexual es un problema de salud pública entre los adolescentes a nivel mundial, pero aún no se ha estudiado lo suficiente en el África subsahariana.

Objetivo: El presente estudio se centró en la asociación de la exposición acumulativa a diferentes tipos de violencia sexual con problemas de salud física y mental y conducta prosocial.

Método: Realizamos una encuesta con una muestra regionalmente representativa de adolescentes escolarizados y no escolarizados, de entre 13 y 17 años, que viven en el suroeste de Nigeria. Se evaluó la exposición autoinformada a violencia sexual, problemas de conducta, quejas físicas y comportamiento prosocial.

Resultados: Alrededor de tres cuartas partes de los participantes informaron experiencias de violencia sexual (74,6%). La regresión múltiple reveló que cuantos más tipos de violencia sexual reportaba un individuo, más problemas de salud física y mental, y menos conductas prosociales reportaba cuando se controló para otras formas de exposición a la violencia. El análisis de clases latentes reveló tres clases de gravedad de la violencia sexual. Los síntomas de los indicadores de salud física y mental fueron significativamente mayores a medida que aumentaba la exposición por grupo, mientras que los comportamientos prosociales no fueron significativamente menores en la dirección opuesta.

Conclusión: Este estudio reveló una relación consistente y única entre exposición a violencia sexual y resultados negativos de salud entre los adolescentes. Es necesario realizar más investigaciones sobre violencia sexual en el África subsahariana y sus asociaciones.

背景：性暴力是全球青少年的一个公共卫生问题，但在撒哈拉以南非洲地区仍然没有得到充分研究。

目的：本研究重点关注不同类型性暴力的累积暴露与身心健康问题和亲社会行为的关系。

方法：我们对居住在尼日利亚西南部的 13 至 17 岁在校和失学青少年进行了区域代表性样本调查。对自我报告的性暴力暴露、行为问题、身体不适和亲社会行为进行了评估。

结果：大约四分之三的参与者报告了性暴力的经历（74.6%）。多元回归显示，一个人报告的性暴力类型越多，心理和身体健康问题就越多，在控制其他形式的暴力暴露时，他们报告的亲社会行为就越少。 潜在类别分析揭示了三个性暴力的严重程度等级。随着群体暴露程度的增加，心理和身体健康指标的症状显著升高，而亲社会行为则相反。

结论：本研究揭示了青少年性暴力暴露与负面健康结果之间存在一致且独特的关系。需要对撒哈拉以南非洲地区的性暴力及其关联进行进一步研究。

KEYWORDS:

• Sexual violence
• adolescents
• mental health
• prosocial behaviour
• health

PALABRAS CLAVE:

• Violencia sexual
• salud mental
• salud
• conducta prosocial
• adolescentes

关键词:

• 性暴力
• 心理健康
• 健康
• 亲社会行为
• 青少年

Acknowledgements

The authors wish to express their sincere thanks to the participants, the caregivers and the school staff for their contribution to their study. They are also grateful to their highly engaged research team, especially to Daramola Akinyemi, Sherifat Adeniyi and Abolade Irenitemi. Special thanks to the Institute of Medical Biometry and Statistics (IMBI), Faculty of Medicine – University Medical Centre Freiburg, Freiburg, Germany, namely Matthias Sehlbrede and Jörg Sahlmann, for their statistical consult. They also thank Justin Preston for proofreading the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by the Alexander von Humboldt Foundation. We acknowledge support for the publication costs by the Open Access Publication Fund of Bielefeld University and the Deutsche Forschungsgemeinschaft (DFG).