Adverse childhood experiences, sexual debut and HIV testing among adolescents in a low-income high HIV-prevalence context.

OBJECTIVES To investigate whether adverse childhood experiences (ACEs) are important determinants of sexual debut and HIV testing. DESIGN Adolescents (age 10-16; N = 2,089) from rural Malawi were interviewed in 2017-2018 for the baseline wave of a longitudinal study of childhood adversity and HIV risk. METHODS Respondents were interviewed in their local language. Surveys captured 13 lifetime childhood adversities (using the ACE - International Questionnaire); sexual debut; and previous HIV testing. We used multivariate regression models to test whether adversity, measured both cumulatively and separately, predicted HIV risk. RESULTS For each additional adversity, there was a significant rise in the odds of sexual debut (OR 1.13, CI 1.07-1.20) and HIV testing (OR 1.10, CI 1.04-1.16). CONCLUSIONS Preventing HIV among all young people necessitates a paradigm shift that recognizes the importance of early life social determinants in structuring HIV risk.

• Publication year

  2019

• Venue

  AIDS (London)

• Publication date

  2019-08-22

• Fields of study

  Medicine, Sociology

• Identifiers
  DOI 10.1097/QAD.0000000000002352PMID 31449094PMCID PMC6832840
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Psychometric evaluation of the Adverse Childhood Experience International Questionnaire (ACE-IQ) in Malawian adolescents.

  2019cited by this paper
• Adverse Childhood Experiences: Prevalence and Association With Adolescent Health in Malawi.

  2019cited by this paper
• Does free schooling affect pathways from adverse childhood experiences via mental health distress to HIV risk among adolescent girls in South Africa: a longitudinal moderated pathway model

  2019cited by this paper
• Adverse Childhood Experiences and HIV Sexual Risk-Taking Behaviors Among Young Adults in Malawi

  2018influential reference
• Childhood traumas as a risk factor for HIV-risk behaviours amongst young women and men living in urban informal settlements in South Africa: A cross-sectional study

  2018cited by this paper
• An analysis of retrospective and repeat prospective reports of adverse childhood experiences from the South African Birth to Twenty Plus cohort

  2017cited by this paper
• The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis.

  2017cited by this paper
• INSPIRE: Seven Strategies for Ending Violence Against Children

  2016cited by this paper
• Cohort Profile: The Malawi Longitudinal Study of Families and Health (MLSFH).

  2015cited by this paper
• Reported Physical and Sexual Abuse in Childhood and Adult HIV Risk Behaviour in Three African Countries: Findings from Project Accept (HPTN-043)

  2013cited by this paper
• Is Early Sexual Debut a Risk Factor for HIV Infection Among Women in Sub‐Saharan Africa? A Systematic Review

  2013cited by this paper
• A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa

  2013cited by this paper
• Prevalence of Psychological Trauma and Association with Current Health and Functioning in a Sample of HIV-infected and HIV-uninfected Tanzanian Adults

  2012cited by this paper
• Voluntary counseling and testing (VCT) for changing HIV-related risk behavior in developing countries.

  2012cited by this paper
• HIV infection and sexual risk behaviour among youth who have experienced orphanhood: systematic review and meta-analysis

  2011cited by this paper
• Building a framework for global surveillance of the public health implications of adverse childhood experiences.

  2010cited by this paper
• Associations between childhood adversity and depression, substance abuse and HIV and HSV2 incident infections in rural South African youth.

  2010cited by this paper
• Adverse childhood experiences (ACE) and health-risk behaviors among adults in a developing country setting.

  2010cited by this paper
• Adverse childhood experiences: origins of behaviors that sustain the HIV epidemic.

  2009cited by this paper
• Are female orphans at risk for early marriage, early sexual debut, and teen pregnancy? Evidence from sub-Saharan Africa.

  2009cited by this paper
• HIV Voluntary Counseling and Testing and Behavioral Risk Reduction in Developing Countries: A Meta-analysis, 1990–2005

  2008cited by this paper
• An examination of risky sexual behavior and HIV in victims of child abuse and neglect: a 30-year follow-up.

  2008cited by this paper
• Coerced first sex among adolescent girls in sub-Saharan Africa: prevalence and context.

  2007cited by this paper
• HIV Voluntary Counseling and Testing Service Preferences in a Rural Malawi Population

  2005cited by this paper
• Conceptualizing and Identifying Cumulative Adversity and Protective Resources: Implications for Understanding Health Inequalities.

  2005cited by this paper
• Conceptualizing and identifying cumulative adversity and protective resources: implications for understanding health inequalities.

  2005cited by this paper
• The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction.

  2004cited by this paper
• The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900.

  2003cited by this paper
• Adverse childhood experiences and sexual risk behaviors in women: a retrospective cohort study.

  2001cited by this paper
• Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.

  1998cited by this paper
• Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study.

  1998cited by this paper

• Field validation and application of the luminex triplex HIV assay to estimate HIV prevalence and HIV-1 incidence in Nigeria

  2025cites this paper
• Relationship between high adverse childhood experience score, HIV risk behavior, and previous HIV testing in the South Carolina behavioral risk factor surveillance system

  2025influential citation
• Sustainable Human Development Across the Life Course

  2023cites this paper
• Adverse childhood experiences and human immunodeficiency virus testing among adults with human immunodeficiency virus risk behaviours.

  2023cites this paper
• Strong Father–Child Relationships and Other Positive Childhood Experiences, Adverse Childhood Experiences, and Sexual Risk Factors for HIV among Young Adults Aged 19–24 Years, Namibia, 2019: A Cross-Sectional Study

  2023cites this paper
• Exploring adverse childhood experiences (ACEs) among Ugandan university students: its associations with academic performance, depression, and suicidal ideations

  2023cites this paper
• Adverse childhood experiences, HIV and sexual risk behaviors - Five sub-Saharan countries, 2018-2020.

  2023cites this paper
• A prospective study on adverse childhood experiences and HIV-related risk among adolescents in Malawi

  2022cites this paper
• Sexual Risk Behavior and Lifetime HIV Testing: The Role of Adverse Childhood Experiences

  2022cites this paper
• Sexual partnership concurrency and age disparities associated with sexually transmitted infection and risk behavior in rural communities in Kenya and Uganda

  2022cites this paper
• The Relationship Between Adverse Childhood Experiences and Utilization of Different HIV Testing Strategies Among Young Men Who Have Sex with Men in Texas

  2022cites this paper
• Adverse Childhood Experiences among a Sample of Youth Living with HIV in the Deep South

  2022cites this paper
• Risky sexual behaviours among Ugandan university students: A pilot study exploring the role of adverse childhood experiences, substance use history, and family environment

  2022cites this paper
• The Association of Recurrent and Multiple Types of Abuse with Adverse Mental Health, Substance Use, and Sexual Health Outcomes among Out-of-School Adolescent Girls and Young Women in Cape Town, South Africa

  2021cites this paper
• Sexual consent self-efficacy and sexual health communication for STI/HIV prevention among college students

  2020cites this paper
• Factors Influencing Adolescents’ Sexually Risky Behaviors in Botswana

  2020cites this paper