Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K34, Atlanta, GA 30341, USA.
Child Abuse Negl. 2013 May;37(5):310-9. doi: 10.1016/j.chiabu.2012.10.005. Epub 2013 Jan 4.
Little is known about the magnitude and consequences of violence against children for those living outside family care. We sought to estimate the frequency of childhood abuse and examine its association with lifetime pregnancy involvement (LPI) and past year suicide ideation among orphaned youth.
We analyzed data collected via cross-sectional interviewer-administered surveys completed by 293 orphaned youth aged 16-23 years living outside of family care in St. Petersburg, Russia. We used multivariable logistic regression to estimate adjusted odds ratios (AORs) of LPI and past year suicide ideation associated with childhood physical and sexual abuse. Other risk factors were also examined (e.g., social vulnerability, sexual and substance use behaviors), and characteristics of orphaned youth with LPI and past year suicide ideation were described.
The prevalence of childhood abuse was higher among females than among males (23.3% versus 15.6% for physical abuse, and 20.3% versus 5.6% for sexual abuse), as was the prevalence of LPI and past year suicide ideation among those with histories of abuse. Experiences of childhood abuse were strong risk factors for both LPI and past year suicide ideation, with significant variation by gender. While both types of abuse were significantly associated with LPI and past year suicide ideation among females, physical abuse was significantly associated with LPI and sexual abuse was associated with suicide ideation for males. Of the other characteristics examined, strong modifiable risk factors included having no one to turn to for help and no involvement in activities outside of class. Among those with LPI (n=36), nearly 20% had been pregnant or gotten someone pregnant ≥2 times, most (61.8%) reported at least one induced abortion, and current use of effective contraception was nearly non-existent. Among those with past year suicide ideation (n=30), nearly half (44.8%) reported attempting suicide.
There is an urgent need for interventions to prevent and mitigate the negative influence of childhood abuse experiences. Programs providing services to orphaned youth should increase access to sexual education, effective contraceptives, and mental health counseling.
对于生活在家庭关怀之外的儿童，我们对针对他们的暴力行为的严重程度和后果知之甚少。本研究旨在评估儿童虐待的频率，并研究其与孤儿青年的终生怀孕参与（LPI）和过去一年自杀意念之间的关联。
我们分析了通过在俄罗斯圣彼得堡进行的 293 名年龄在 16-23 岁之间、生活在家庭关怀之外的孤儿青年的横断面访谈者管理的调查收集的数据。我们使用多变量逻辑回归来估计与儿童期身体和性虐待相关的 LPI 和过去一年自杀意念的调整后优势比（AOR）。还检查了其他风险因素（例如，社会脆弱性，性行为和物质使用行为），并描述了具有 LPI 和过去一年自杀意念的孤儿青年的特征。
在女性中，儿童虐待的发生率高于男性（身体虐待为 23.3％对 15.6％，性虐待为 20.3％对 5.6％），在有虐待史的人群中，LPI 和过去一年自杀意念的发生率也更高。儿童虐待经历是 LPI 和过去一年自杀意念的强烈危险因素，且在性别上存在显著差异。尽管身体虐待和性虐待都与女性的 LPI 和过去一年自杀意念显著相关，但身体虐待与 LPI 显著相关，性虐待与男性自杀意念相关。在所检查的其他特征中，强有力的可改变风险因素包括无人求助和没有课外活动参与。在具有 LPI（n=36）的人群中，近 20％的人怀孕或使某人怀孕≥2 次，大多数（61.8％）报告至少有一次人工流产，当前有效避孕的使用率几乎不存在。在过去一年有自杀意念的人群（n=30）中，近一半（44.8％）报告曾试图自杀。
迫切需要采取干预措施来预防和减轻儿童虐待经历的负面影响。为孤儿青年提供服务的计划应增加获得性教育，有效避孕药具和心理健康咨询的机会。
