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Adverse childhood experiences: prevalence and associated factors among South African young adults.

ABSTRACT: While adverse childhood experiences (ACEs), as described by the CDC-Kaiser Permanente Study, are reportedly common in both high and low-income settings, evidence on the epidemiology of ACEs in low-income settings is scarce. This study aimed to determine the prevalence of ACEs reported in young adulthood and assess their association with childhood maternal, household and community factors. We used data from the 22-23 year wave of the Birth to Twenty Plus (Bt20+) study in South Africa, the largest and longest running birth cohort in Africa. With ACEs as the main outcome measure, their association with childhood factors was assessed using regression models. As demonstrated in high-income settings, ACEs are highly prevalent in this young adult population in a middle income country. Both household and community socio-economic status in childhood was associated with the experience of ACEs and the likelihood of experiencing multiple ACEs. The attenuation of significance in adjusted models suggested that individual ACEs are correlated and may exert their effects through other ACEs. Interventions for the prevention of ACEs need to be directed not only at individuals but households as well as communities.

SUBMITTER: Manyema M

PROVIDER: S-EPMC6926197 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Adverse childhood experiences: prevalence and associated factors among South African young adults.

Manyema Mercy M Richter Linda M LM

Heliyon 20191212 12

While adverse childhood experiences (ACEs), as described by the CDC-Kaiser Permanente Study, are reportedly common in both high and low-income settings, evidence on the epidemiology of ACEs in low-income settings is scarce. This study aimed to determine the prevalence of ACEs reported in young adulthood and assess their association with childhood maternal, household and community factors. We used data from the 22-23 year wave of the Birth to Twenty Plus (Bt20+) study in South Africa, the largest ...[more]

PMID: 31890957

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Project description:BackgroundAdverse childhood experiences (ACEs) are traumatic and stressful events that occur in childhood. These experiences at home, school, or in the community may damage the cognitive health and emotional skills of children and adolescents.ObjectiveThe present study examines the association between Adverse childhood experiences and risky health behaviour indicators while controlling other background characteristics among boys and girls. This study also assesses outcomes in the aggregate to estimate the impact of cumulative adversity on various risky health behavioural factors among boys and girls among adolescents and young adults (age group 13-23) in India.Data and methodsData were drawn from the second wave of the "Understanding the lives of adolescents and young adults (2018-2019)" survey. Bivariate and logistic regression analysis were conducted to fulfill the objective.ResultsThe findings show that nearly 30% of boys and 10% of girls had violent behaviour. Substance use prevalence was much higher among boys (34.11%) than girls (6.65%). More boys had negative gender attitudes. The majority of the study participants had multiple ACEs. Boys who experienced more than three or more childhood adversity had two times higher odds (OR: 2.04; CI: 1.01-4.16) of the early sexual debut, while the same figure for girls was thirteen times (OR: 13.13; CI: 3.95-43.69) than their male counterparts.ConclusionThe study findings underlined the need for implementing outcome-oriented approaches to adolescents' health care and behavioural risks. Therefore, identifying and intervening with adolescents and young adults who are at the highest risk of engaging in risky behaviors early in life may reduce the risk of these behaviors persisting into adulthood. In order to avoid health risk behavior in later stages among adolescents and young adults, policymakers need to focus on ACEs as risk factors and take action to reduce this burden. A potential model could be to create awareness among family members, caregivers, and communities to be more empathetic toward the children.

Project description:BackgroundMany people are now living longer with HIV due to access to antiretroviral treatment. In turn, there has been an increase in the burden of hypertension and diabetes. The paucity of data on the burden of hypertension and diabetes in adults living with HIV in South Africa is a public health concern. The paper aimed to describe the prevalence and factors associated with hypertension and diabetes among adults living with HIV (ALHIV).MethodsThis was a secondary data analysis of the population based on the South African National HIV Prevalence, Incidence, Behaviour and Communication surveys for 2005, 2008 and 2017. Descriptive statistics were used to summarise the characteristics of the study sample. Bivariate and multivariate logistic regression analyses were used to determine factors associated with hypertension and diabetes.ResultsThe total study population of ALHIV aged 25 years and older was 978, 1023 and 2483 for 2005, 2008 and 2017. The prevalence of hypertension showed an increasing trend at 11.8% in 2005, 9.5% in 2008 and 14.3% in 2017. The prevalence of diabetes was 3.3% in 2005, 2.8% in 2008 and 3.2% in 2017. Increased odds of hypertension among adults living with HIV were consistently associated with being female and the age group 45 years older across all the survey years, including pensioners and the sick, living in urban areas, high risk of hazardous alcohol consumption, diabetes and heart disease. Increased odds of diabetes were consistently associated with hypertension across all the survey years, including age group 45 years and older, and poor health. While having a secondary level of education and above was protective against diabetes.ConclusionThe study showed that the prevalence of hypertension is high and has increased over time among adults living with HIV while the prevalence of diabetes has remained constant. Findings identified factors consistently associated with the prevalence of both diseases overtime, including contemporary risk factors that should be targeted in the integrated management of chronic disease and HIV care model.

Project description:Background: HIV-infected individuals have increased risk of developing obstructive lung disease (OLD). Studies from developed countries report high viral load, low CD4 counts, and anti-retroviral therapy (ART) to be associated with OLD; but these findings may not be generalizable to populations in resource-limited settings.Methods: We conducted a prospective cohort study of lung function in 730 HIV-infected black South African adults. Pre-bronchodilator spirometry was performed at enrollment and repeated annually for three years. Logistic regression models were used to identify factors associated with OLD, defined as FEV1/FVC<0.70, at enrollment. Excess annual declines in FEV1 and FVC were modelled as the product-term of follow-up time and exposures using random effects regression.Results: Median (IQR) age at enrollment was 36 (32-41) years, 85% were female and 30% ever-smoked with a median (IQR) exposure of 3 (1-6) pack-years. Median (IQR) CD4 count and viral load at enrollment were 372 (261-518) cells/mm3 and 2655 (91-13,548) copies/mL respectively. Overall, 25% were receiving ART at enrollment, 16% of whom reported at least 6 months of ART receipt. OLD was found in 35 (5%) at enrollment. Increasing age (aOR = 2.08 per 10-years [95%CI 1.22-3.57], p = 0.007), current smoking (aOR = 3.55 [95%CI 1.20-10.53], p = 0.02), and CRP (aOR = 1.01 per unit-increase [95%CI 1.00-1.03], p = 0.04) were significantly associated with OLD at enrollment; while increasing CD4 count (aOR = 1.02 per-100 cells/mm3 [95%CI 0.85-1.22], p = 0.82), viral load (aOR = 0.67 per log-increase [95%CI 0.43-1.10], p = 0.12) and receipt of ART (aOR = 0.57 [95%CI 0.18-1.75], p = 0.32) were not. The median (IQR) follow-up time was 18 (12-24) months. Participants with a history of tuberculosis (TB) had a 35 mL (95%CI 2-68, p = 0.03) and 57 mL (95%CI 19-96, p = 0.003) per year excess loss of FEV1 and FVC respectively.Conclusion: Prevalent OLD was associated with older age, current smoking and higher CRP levels, but not CD4 counts and ART, in HIV-infected South African adults. Better understanding of the long-term effects of TB, smoking and inflammation on lung function in HIV-infected populations is urgently needed.

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Adverse childhood experiences: prevalence and associated factors among South African young adults.

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Adverse childhood experiences: prevalence and associated factors among South African young adults.

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