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

• Published in: PloS one Vol. 14; no. 1; p. e0198866
• Main Authors: Shamu, Simukai, Shamu, Patience, Zarowsky, Christina, Temmerman, Marleen, Shefer, Tamara, Abrahams, Naeemah
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 04-01-2019; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Age; Age differences; Analysis; Biology and Life Sciences; Child abuse & neglect; Child Abuse, Sexual; Childhood; Children; Children & youth; Clinics; Cross-Sectional Studies; Domestic violence; Families & family life; Female; Gender; Girls; Health aspects; Health care; Health risks; Health services; HIV; HIV infections; HIV Infections - epidemiology; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Infections; Medical research; Medicine and Health Sciences; Mental health; Middle Aged; Mothers; Multivariate analysis; Pedophilia; People and Places; Physical Abuse; Pregnancy; Prevention; Primary care; Public health; Rape; Reproductive health; Risk analysis; Risk Factors; Schools; Sex; Sex crimes; Sex differences; Sexual abuse; Sexual assault; Sexual Behavior; Sexual Partners; Sexually transmitted diseases; Social Sciences; STD; Studies; Trauma; Women; Womens health; Zimbabwe - epidemiology; Zimbabwe; South Africa; Harare Zimbabwe; Africa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0198866

Sexual 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.
A 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.
More 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.
This study highlights that child physical and/or sexual abuse may increase 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.