Associations between childhood adversity and depression, substance abuse and HIV and HSV2 incident infections in rural South African youth

Jewkes, Rachel K.; Dunkle, Kristin; Nduna, Mzikazi; Jama, P. Nwabisa; Puren, Adrian

doi:10.1016/j.chiabu.2010.05.002

Cited by 269Child Abuse and TraumaIntimate Partner and Family ViolenceAdolescent Sexual and Reproductive Health

Associations between childhood adversity and depression, substance abuse and HIV and HSV2 incident infections in rural South African youth

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Jewkes, Rachel K., Dunkle, Kristin, Nduna, Mzikazi, Jama, P. Nwabisa, Puren, Adrian·2010·Child Abuse & Neglect

DOI 10.1016/j.chiabu.2010.05.002PMC PMC2981623

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Abstract

Objectives To describe prevalence of childhood experiences of adversity in rural South African youth and their associations with health outcomes.Methods We analyzed questionnaires and blood specimens collected during a baseline survey for a cluster randomized controlled trial of a behavioral intervention, and also tested blood HIV and herpes simplex type 2 virus at 12- and 24-month follow up; 1,367 male and 1,415 female volunteers were recruited from 70 rural villages.Results Both women and men before 18 had experienced physical punishment (89.3% and 94.4%), physical hardship (65.8% and 46.8%), emotional abuse (54.7% and 56.4%), emotional neglect (41.6% and 39.6%), and sexual abuse (39.1% and 16.7%). Incident HIV infections were more common in women who experienced emotional abuse (IRR 1.96, 95% CI 1.25, 3.06, p=.003), sexual abuse (IRR 1.66 95% CI 1.04, 2.63, p=.03), and physical punishment (IRR 2.13 95% CI 1.04, 4.37, p=.04). Emotional neglect in women was associated with depression (aOR 1.82, 95% CI 1.15, 2.88, p=.01), suicidality (aOR 5.07, 95% CI 2.07, 12.45, p<.0001), alcohol abuse (aOR 2.17, 95% CI .99, 4.72, p=.05), and incident HSV2 infections (IRR 1.62, 95% CI 1.01, 2.59, p=.04). In men emotional neglect was associated with depression (aOR 3.41, 95% CI 1.87, 6.20, p<.0001) and drug use (aOR 1.98, 95% CI 1.37, 2.88, p<.0001). Sexual abuse was associated with alcohol abuse in men (aOR 3.68, 95% CI 2.00, 6.77, p<.0001) and depression (aOR 2.16, 95% CI 1.34, 3.48, p=.002) and alcohol abuse in women (aOR 3.94, 95% CI 1.90, 8.17, p<.0001).Practice implications Childhood exposure to adversity is very common and influences the health of women and men. All forms of adversity, emotional, physical and sexual, enhance the risk of adverse health outcomes in men and women. Prevention of child abuse need to be included as part of the HIV prevention agenda in sub-Saharan Africa. Interventions are needed to prevent emotional, sexual, and physical abuse and responses from health and social systems in Africa to psychologically support exposed children must be strengthened.

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Evidence suggests that adverse childhood experiences are associated with substance abuse, mental illness, and HIV risk in low-income, high-violence settings.
“However, evidence suggests that ACEs are associated with substance abuse, mental illness, and HIV risk in such settings. 52”
From The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. (2017) · cites this paper as [52]

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Authors: Jewkes, R. K., Dunkle, K., Nduna, M., Jama, P. N., & Puren, A.
Affiliations: South African Medical Research Council (ZA)
Emory University (US)
University of the Witwatersrand (ZA)
National Institute for Communicable Diseases (ZA)
Corresponding author: Jewkes, Rachel K.
ORCID: Jewkes, Rachel K.
Dunkle, Kristin
Nduna, Mzikazi
Puren, Adrian
Venue: Child Abuse & Neglect
Publisher: Elsevier BV
Published: 2010-11
Volume: 34
Issue: 11
Pages: 833-841
ISSN: 0145-2134 (ISSN-L)
DOI: 10.1016/j.chiabu.2010.05.002
PMC: PMC2981623
OpenAlex: W2004998274
Cited by: 269
References: 35
Citations by year: 2026: 9 · 2025: 12 · 2024: 12 · 2023: 18 · 2022: 26 · 2021: 20 · 2020: 23 · 2019: 21 · 2018: 23 · 2017: 26 · 2016: 18 · 2015: 16 · 2014: 14 · 2013: 12 · 2012: 10
FWCI: 10.51
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Child Abuse & Neglect (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (MH 64882-01, MH 64882‐04S1A1, R01MH064882)
Topics: Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Health › Intimate Partner and Family Violence
Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
Keywords: childhood adversity, depression, substance abuse, HIV incidence, rural youth, emotional neglect, emotional abuse, corporal punishment, sexual abuse, suicidality, alcohol abuse, drug use, gender differences, South Africa, behavioral interventions, HIV prevention, mental health promotion, violence against children
MeSH terms: Adolescent, Adult, Child Abuse, Depressive Disorder, Enzyme-Linked Immunosorbent Assay, Female, Herpes Genitalis, Humans, Male, Surveys and Questionnaires, Rural Population, South Africa, HIV-1, HIV Infections, Prevalence, Cluster Analysis, Sex Distribution, Herpesvirus 2, Human, Substance-Related Disorders, Alcohol-Related Disorders, Young Adult

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Associations between childhood adversity and depression, substance abuse and HIV and HSV2 incident infections in rural South African youth

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