MMWR Morb Mortal Wkly Rep. 2019 Apr 19;68(15):350-355. doi: 10.15585/mmwr.mm6815a3.
Violence is a major public health and human rights concern, claiming over 1.3 million lives globally each year (1). Despite the scope of this problem, population-based data on physical and sexual violence perpetration are scarce, particularly in low-income and middle-income countries (2,3). To better understand factors driving both children becoming victims of physical or sexual violence and subsequently (as adults) becoming perpetrators, CDC collaborated with four countries in sub-Saharan Africa (Malawi, Nigeria, Uganda, and Zambia) to conduct national household surveys of persons aged 13-24 years to measure experiences of violence victimization in childhood and subsequent perpetration of physical or sexual violence. Perpetration of physical or sexual violence was prevalent among both males and females, ranging among males from 29.5% in Nigeria to 51.5% in Malawi and among females from 15.3% in Zambia to 28.4% in Uganda. Experiencing physical, sexual, or emotional violence in childhood was the strongest predictor for perpetrating violence; a graded dose-response relationship emerged between the number of types of childhood violence experienced (i.e., physical, sexual, and emotional) and perpetration of violence. Efforts to prevent violence victimization need to begin early, requiring investment in the prevention of childhood violence and interventions to mitigate the negative effects of violence experienced by children.
暴力是一个主要的公共卫生和人权问题，每年在全球造成超过 130 万人死亡（1）。尽管这个问题的范围很广，但基于人口的身体和性暴力实施数据却很少，特别是在低收入和中等收入国家（2,3）。为了更好地了解导致儿童成为身体或性暴力受害者以及随后（作为成年人）成为施害者的因素，疾病预防控制中心与撒哈拉以南非洲的四个国家（马拉维、尼日利亚、乌干达和赞比亚）合作，对 13-24 岁的人进行了全国性的家庭调查，以衡量儿童时期遭受暴力侵害的经历以及随后实施身体或性暴力的情况。男性和女性都普遍存在实施身体或性暴力的行为，男性中从尼日利亚的 29.5%到马拉维的 51.5%不等，女性中从赞比亚的 15.3%到乌干达的 28.4%不等。在儿童时期经历身体、性或情感暴力是实施暴力的最强预测因素；在经历的童年暴力类型（即身体、性和情感）数量与暴力实施之间出现了逐渐增强的剂量反应关系。预防暴力侵害的努力需要尽早开始，需要投资预防儿童时期的暴力，并采取干预措施减轻儿童所经历的暴力的负面影响。
