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Psychology, Health & Medicine

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reporting forced sex during their first sexual intercourse. A recent review by Lalor (2004) cites a study in Kenya by the African Medical and Research Foundation’s survey of over 10,000 females finding that 23.8% reported being ‘‘forced’’ and another 18% ‘‘tricked’’ into their first instance of sexual intercourse. Sexual abuse affects the lives of boys as well as girls. A study of street children in Mwanza in northern Tanzania indicated that a majority of boys had experienced anal sex as a ‘‘rite of passage’’ (Lalor, 2004). In this manner, particularly in regions with high HIV prevalence, young people, particularly young women are at great risk of contracting the virus as soon as they become sexually active. Recent estimates indicate that half of all new HIV infections – approximately 7000 every day – are among young people between the ages of 15 to 24 (UNAIDS et al., 2004). Sexual violence and HIV/AIDS Strong links exist between childhood sexual abuse and a number of risky behaviors which can increase vulnerability to HIV/AIDS. These include early age at first intercourse, frequent, short-term relationships, multiple partners, prostitution, drug, alcohol abuse, and unprotected sex (Cunningham, Stiffman, Dore, & Earls, 1994; Greenberg, 2001; Stock, Bell, Boyer, & Connell, 1997). A review of the literature on child sexual abuse in sub-Saharan African (Lalor, 2004) noted the lack of national surveys documenting the problem. The few studies available indicate that 5% of respondents report penetrative sexual abuse during childhood, but this number is likely to be an underestimate due to underreporting of sexual violence (Lalor, 2004). Reviews of the literature on the epidemiology of childhood sexual abuse in North American countries indicates lifetime prevalence estimates ranging from seven to 36% in females and three to 29% in males (Finkelhor, 1994). The little research that is available on sexual abuse and violence in subSaharan Africa points to similar mechanisms linking childhood sexual abuse and risk of HIV infection. For instance, a cross-sectional survey of women attending antenatal clinics in Soweto, South Africa correlated childhood sexual assault or forced first intercourse with increased sexual risk behaviors and earlier onset of physical/sexual partner violence as well as adult sexual assault by a non-partner (Dunkle et al., 2004). In Tanzania, Maman et al. (2002) found that HIV-positive women were much more likely to have experienced sexual violence and/or physical violence in their lifetime compared to their HIV-negative peers. Community violence Witnessing violence is associated with a number of emotional and behavioral consequences ranging from anxiety and depression to an increased tendency of delinquency (Buka, Stichick, Birdthistle, & Earls, 2001). In parts of the world that carry a large burden from HIV, from South African townships to Brazilian favellas, problems associated with the AIDS pandemic are compounded by violence and insecurity. When faced with such insecurity, children do not all remain passive victims. As their capacities evolve, children facing insecurity fashion their own survival or coping strategies. Negative survival strategies ultimately feed cycles of risky behavior and disadvantage. When a young person’s impulse to exert a sense of control cannot be fed via more positive alternatives

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Children affected by HIV/AIDS: SAFE, a model ...  

Children affected by HIV/AIDS: SAFE, a model for promoting their security, health, and development Authors: Theresa S. Betancourt, Mary K.S...

Children affected by HIV/AIDS: SAFE, a model ...  

Children affected by HIV/AIDS: SAFE, a model for promoting their security, health, and development Authors: Theresa S. Betancourt, Mary K.S...

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