Department of Pediatrics, Stanford University School of Medicine, Stanford, California;
UJAMAA Africa, Nairobi, Kenya;
Pediatrics. 2014 May;133(5):e1226-32. doi: 10.1542/peds.2013-3414. Epub 2014 Apr 14.
Sexual assault is a major cause of injury, unplanned pregnancy, HIV infection, and mental health problems worldwide. In parts of sub-Saharan Africa, sexual assault has reached epidemic proportions. This study evaluated the efficacy of an empowerment and self-defense intervention for adolescent girls to decrease the incidence of sexual assault and harassment in Nairobi's large informal settlements.
A prospective cohort of 1978 adolescents from 4 neighborhoods near Nairobi were taught empowerment, deescalation, and self-defense skills in six 2-hour sessions. The standard-of-care (SOC) group (n = 428) received a life skills class. Self-reported, anonymous survey data were collected at baseline and 10.5 months after intervention.
Annual sexual assault rates decreased from 17.9/100 person-years at baseline to 11.1 at follow-up (rate ratio = 1.61; 95% confidence interval [CI], 1.26-1.86; P < .001); there was no significant change in the SOC group (14.3 to 14.0, rate ratio = 1.02; 95% CI, 0.67-1.57, P = .92). Sexual assault disclosure in the intervention group increased from 56% to 75% (P = .006), compared with a constant incidence of disclosure (53%) in the SOC group. The majority (52.3%) of adolescents in the intervention group reported using skills learned to stop an assault.
This intervention decreased sexual assault rates among adolescent girls in Kenya. The intervention was also associated with an increase in the disclosure of assaults, thereby enabling survivors to seek care and support and possibly leading to the identification and prosecution of perpetrators. This model should be adaptable to other settings both in Africa and globally.
性侵犯是全球范围内导致伤害、意外怀孕、HIV 感染和心理健康问题的主要原因之一。在撒哈拉以南非洲部分地区，性侵犯已达到流行程度。本研究评估了一项针对少女的赋权和自卫干预措施的效果，以减少内罗毕大型非正规住区性侵犯和性骚扰的发生率。
对来自内罗毕附近 4 个社区的 1978 名青少年进行了前瞻性队列研究，他们接受了 6 个 2 小时的赋权、降级和自卫技能培训。对照组（n=428）接受了生活技能课程。在干预前和干预后 10.5 个月收集了自我报告的匿名调查数据。
性侵犯的年发生率从基线时的 17.9/100 人年降至随访时的 11.1（率比=1.61；95%置信区间[CI]，1.26-1.86；P<.001）；对照组没有显著变化（14.3 至 14.0，率比=1.02；95%CI，0.67-1.57，P=0.92）。干预组的性侵犯披露率从 56%增加到 75%（P=0.006），而对照组的披露率保持不变（53%）。干预组的大多数（52.3%）青少年报告说，她们使用了所学技能来阻止攻击。
该干预措施降低了肯尼亚少女的性侵犯率。该干预措施还与性侵犯报告的增加相关，从而使幸存者能够寻求护理和支持，并可能导致肇事者的识别和起诉。这种模式在非洲和全球其他地区都应该具有适应性。
