Orphanhood vulnerabilities for violence and HIV by education, sex, and orphan type among 18-24-year-old youth: findings from the 2018 Lesotho violence against children and youth survey

ABSTRACT

HIV and violence among orphans are key measures of vulnerability in low-resource settings. Although Lesotho has the second highest HIV adult prevalence rate (21.1%) in the world, and the prevalence of orphanhood (44.2%) and violence exposure (67.0%) is high, little research exist on orphanhood vulnerabilities for violence and HIV in Lesotho. Using data from 4,408 youth (18–24 years old) from Lesotho’s 2018 Violence Against Children and Youth survey, a nationally representative cross-sectional household survey, the study examined associations among orphan status, violence, and HIV and assessed how associations differed by education, sex, and orphan type, using logistic regression. Orphans had higher odds of violence (aOR, 1.21; 95% CI, 1.01–1.46) and HIV (aOR, 1.69; 95% CI, 1.24–2.29). Having primary education or less (aOR, 1.43; 95% CI, 1.02–2.02), male sex (aOR, 1.74; 95% CI, 1.27–2.36), and being a paternal orphan (aOR, 1.43; 95% CI, 1.14–1.80) were significant interaction terms for violence. Orphans who completed primary school or less (aOR, 1.61; 95% CI, 1.09–2.39), female (aOR, 3.08; 95% CI, 2.14–4.42) and double orphans (aOR, 2.54; 95% CI, 1.56–4.13) had higher odds of HIV. These relationships highlight the importance of comprehensive strategies to support education and family strengthening for orphans as core violence and HIV prevention efforts.

KEYWORDS:

• Lesotho
• youth
• orphanhood
• violence
• HIV, education

Acknowledgments

The authors thank all partnering organizations who made this survey possible and the children and youth who participated in the survey. Concept and design: NaeHyung Lee, Greta Massetti, Shannon Self-Brown. Acquisition, analysis, or interpretation of data: NaeHyung Lee, Greta Massetti, Shannon Self-Brown. Statistical analysis: NaeHyung Lee. Drafting of the manuscript: NaeHyung Lee, Greta Massetti, Shannon Self-Brown. Critical revision of the manuscript for important intellectual content: All authors. Extensive literature search: Jack F. (Rick) Colbert from Stephen B. Thacker CDC Library.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.