Sponsor
This study was funded by the National Institute of Child Health and Development [5R01HD046345-04].
Published In
AIDS Care
Document Type
Article
Publication Date
2016
Subjects
Orphans, Post-traumatic stress disorder -- Social aspects, Potentially traumatic experiences, Sexual health
Abstract
Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in sub-Saharan Africa and Asia. Over 153 million children worldwide have lost one or both parents, including 17 million orphaned by AIDS, and millions more have been separated from their parents. As younger orphans enter adolescence, their sexual health and HIV-related risk behaviors become key considerations for their overall health. Importantly, their high prevalence of exposure to potentially traumatic events (PTEs) may put OSC at additional risk for adverse sexual health outcomes. The Positive Outcomes for Orphans study followed OSC randomly sampled from institution-based care and from family-based care, as well as a convenience sample of non-OSC, at six sites in five low-and middle-income countries. This analysis focused on the 90-month followup, during which adolescents 16 and older were assessed for sexual health, including age at sexual debut, past-year sex, past-year condom use, and perceptions of condom use. We specifically examined the relationship between PTEs and sexual health outcomes. Of the 1258 OSC and 138 non-OSC assessed, 11% reported ever having sex. Approximately 6% of participants reported recent sex and 5% reported having recent unprotected sex. However, 70% of those who had recent sex reported that they did not use a condom every time, and perceptions of condom use tended to be unfavorable for protection against sexual risk behavior. Nearly all (90%) of participants reported experiencing at least one lifetime PTE. For those who experienced “any” PTE, we found increased prevalence of recent sex (PR = 1.39 [0.47, 4.07]) and of recent unprotected sex (PR = 3.47 [0.60, 19.91]). This study highlights the need for caregivers, program managers, and policymakers to promote condom use for sexually active OSC and identify interventions for trauma support services. Orphans living in family-based care may also be particularly vulnerable to early sexual debut and unprotected sexual activity.
DOI
10.1080/09540121.2016.1147013
Persistent Identifier
http://archives.pdx.edu/ds/psu/17727
Citation Details
Christine L. Gray, Kathryn Whetten, Lynne C. Messer, Rachel A. Whetten, Jan Ostermann, Karen O'Donnell, Nathan M. Thielman & Brian W. Pence (2016) Potentially traumatic experiences and sexual health among orphaned and separated adolescents in five low- and middle-income countries, AIDS Care, 28:7, 857-865, DOI: 10.1080/09540121.2016.1147013
Included in
Child Psychology Commons, Family, Life Course, and Society Commons, Mental and Social Health Commons, Social Welfare Commons
Description
© 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.