Perry Elizabeth W, Culbreth Rachel, Swahn Monica, Kasirye Rogers, Self-Brown Shannon
School of Public Health, Georgia State University, Atlanta, GA, USA.
Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA.
Child Youth Serv Rev. 2020 Dec;119. doi: 10.1016/j.childyouth.2020.105587. Epub 2020 Oct 13.
Psychological distress is a priority health issue in low- and middle-income countries; however, it is inadequately addressed among vulnerable youth living in extremely underserved communities (i.e., on the streets and in the slums) who are at a high risk of experiencing adversity. The purpose of this study was to compute the prevalence of self-reported psychological distress among youth living in the slums of Kampala, Uganda, and examine how orphan status and commercial sexual exploitation (CSE) are related to youth psychological distress. Analyses are based on a 2014 cross-sectional survey of service-seeking youth ( = 1134) in Kampala, Uganda. Bivariate and multivariable multinomial regression analyses were used to determine associations between orphan status, sexual exploitation, and psychological distress (defined as experiencing the following proxy variables for more complex psychopathology: hopelessness and/or worry). Among all youth participants, 83.2% ( = 937) reported at least one type of psychological distress; 51.3% ( = 578) reported experiencing both types. The reported prevalence of any type of psychological distress was highest among youth who reported experiencing sexual exploitation (91.2%), double orphans (90.0%), and single orphans (83.8%); however, a high prevalence (76.7%) of any type of distress was also found among youth who reported both parents alive. Experiencing both types of distress was associated with being a double orphan (adjusted odds ratio [AOR] = 2.92, 95% confidence interval [CI] = [1.77, 4.81]), reporting CSE (AOR = 2.71, 95% CI = [1.67, 4.41]), and increased age (AOR = 1.31, 95% CI = [1.20, 1.44]). Psychological distress is prevalent among all youth living in the slums of Kampala and is independently associated with being a double orphan and experiencing CSE. These findings underscore the urgent need to intervene with all youth who reside in this particular underserved community, especially those who have lost both parents, and to prevent CSE among this vulnerable, underserved population.
心理困扰是低收入和中等收入国家的一个优先健康问题；然而，在生活在服务极度匮乏社区（即街头和贫民窟）的弱势青年中，这一问题未得到充分解决，这些青年面临着经历逆境的高风险。本研究的目的是计算乌干达坎帕拉贫民窟青年自我报告的心理困扰患病率，并研究孤儿身份和商业性剥削（CSE）与青年心理困扰之间的关系。分析基于2014年对乌干达坎帕拉寻求服务的青年（n = 1134）的横断面调查。采用双变量和多变量多项回归分析来确定孤儿身份、性剥削和心理困扰（定义为经历以下更复杂精神病理学的替代变量：绝望和/或担忧）之间的关联。在所有青年参与者中，83.2%（n = 937）报告至少有一种心理困扰类型；51.3%（n = 578）报告经历了两种类型。报告经历性剥削的青年（91.2%）、双亲孤儿（90.0%）和单亲孤儿（83.8%）中，任何类型心理困扰的报告患病率最高；然而，在报告父母均在世的青年中也发现了较高的任何类型困扰患病率（76.7%）。经历两种困扰类型与成为双亲孤儿（调整后的优势比[AOR] = 2.92，95%置信区间[CI] = [1.77, 4.81]）、报告遭受商业性剥削（AOR = 2.71，95% CI = [1.67, 4.41]）以及年龄增长（AOR = 1.31，95% CI = [1.20, 1.44]）相关。心理困扰在所有生活在坎帕拉贫民窟的青年中普遍存在，并且与成为双亲孤儿和经历商业性剥削独立相关。这些发现强调了迫切需要对居住在这个特定服务匮乏社区的所有青年进行干预，特别是那些失去双亲的青年，并防止在这个脆弱、服务不足的人群中发生商业性剥削。
