Zhang Jie, Tang Bo-Wen, Liu Ming-Wei, Yuan Shuai, Yu Hong-Jie, Zhang Rui, Huang Xiao-Chang, Nzala Selestine H, Chikoya Mpundu, Wang Pei-Gang, He Qi-Qiang
School of Health Sciences, Wuhan University, Donghu Rd, No. 185, Wuhan, 430071, Hubei Province, People's Republic of China.
School of Medicine, University of Zambia, Lusaka, Zambia.
Int J Behav Med. 2020 Aug;27(4):400-405. doi: 10.1007/s12529-020-09863-y.
Adverse childhood experiences (ACEs) have been linked to long-term health outcomes, while the impact of such experience has not been investigated among Zambian youth. This study examined the associations of ACEs with individual and clusters of health risk behavior among college students in Zambia.
A total of 624 college students participated in this cross-sectional study. A self-administered questionnaire was used to collect information on their ACEs and health risk behaviors.
There were 58.3% (364) reporting some forms of ACEs, with 27.6% (172), 16.3% (102), and 14.4% (90) being exposed to 1, 2, and ≥ 3 ACEs, respectively. The prevalence of health risk behaviors ranged from 6.0 to 34.2%. Overall, ACEs were associated with increased risk of smoking, binge drinking, suicide attempt, risky sexual behaviors, and illicit drug use. Logistic regression suggested that participants with ≥ 3 ACEs (OR, 3.62; 95% CI, 2.14-6.13) were more likely to engage in the unhealthy cluster, characterized by the presence of any health risk behavior, than those without ACE.
ACEs were associated with individual and clustering of health risk behaviors among Zambia college students. Our study suggests that early intervention is needed to prevent long-term adverse health consequences in this population.
童年不良经历（ACEs）与长期健康结果相关，但此类经历对赞比亚青年的影响尚未得到研究。本研究调查了赞比亚大学生中ACEs与个体及健康风险行为集群之间的关联。
共有624名大学生参与了这项横断面研究。采用自填式问卷收集他们的ACEs和健康风险行为信息。
58.3%（364人）报告有某种形式的ACEs，其中分别有27.6%（172人）、16.3%（102人）和14.4%（90人）曾经历1次、2次及≥3次ACEs。健康风险行为的患病率在6.0%至34.2%之间。总体而言，ACEs与吸烟、暴饮、自杀未遂、危险性行为及非法药物使用风险增加相关。逻辑回归分析表明，与无ACEs者相比，经历≥3次ACEs的参与者（比值比，3.62；95%置信区间，2.14 - 6.13）更有可能出现以存在任何健康风险行为为特征的不健康行为集群。
ACEs与赞比亚大学生个体及健康风险行为集群相关。我们的研究表明，需要进行早期干预以预防该人群长期的不良健康后果。
