Quarshie Emmanuel Nii-Boye
Department of Psychology, University of Ghana, Accra, Ghana.
School of Psychology, University of Leeds, Leeds, United Kingdom.
Front Sociol. 2021 May 20;6:605865. doi: 10.3389/fsoc.2021.605865. eCollection 2021.
A growing body of evidence from high-income contexts suggests a strong association between sexual violence victimisation and self-harm and eventual suicide. However, both sexual violence and self-harm among adolescents are still less researched in sub-Saharan African countries, including Ghana. To estimate the 12-month prevalence of self-harm, and to describe the associated factors and reported reasons for self-harm among school-going adolescent survivors of sexual violence victimisation during the previous 12 months in urban Ghana. Analytic data came from a regional-based representative cross-sectional survey including in-school youth ( = 1,723) conducted in 2017 within the Greater Accra Region of Ghana. Of these, 297 (17.2%) self-reported sexual violence victimisation in the previous 12 months; this proportion of the participants ( = 297) was the focus of the current study. Items measuring sexual violence victimisation, self-harm, and correlates were adopted from the 2012 Ghana WHO-Global School-based Student Health Survey and the Child and Adolescent Self-harm in Europe Study. Data analysis involved multivariable logistic regression models. The estimate of self-harm ideation during the previous 12 months was 45.8% (95% CI: 40-52), whereas the estimate of self-harm behaviour was 38.7% (95% CI: 33-44). About two in five of the participants who reported self-harm wanted to die by their last episode of the behaviour. While bullying victimisation was associated with increased odds of self-harm ideation (aOR = 1.97, 95% CI 1.17, 3.31, = 0.010) and behaviour (aOR = 2.76, 95% CI 1.59, 4.80, < 0.001), weekly alcohol use (aOR = 2.56, 95% CI 1.32, 4.93, = 0.005), conflict with parents (aOR = 2.30, 95% CI 1.28, 4.12, = 0.005), and physical abuse victimisation (aOR = 1.80, 95% CI 1.03, 3.15, = 0.037) showed strong associations with increased odds of self-harm behaviour in the past 12 months. The evidence underscores the need for both universal and targeted multi-level intervention and prevention programmes to mitigate the offence of sexual violence and reduce the chances of self-harm among adolescent survivors of sexual violence in urban Ghana.
来自高收入地区的越来越多的证据表明，性暴力受害与自我伤害及最终自杀之间存在密切关联。然而，在撒哈拉以南非洲国家，包括加纳，青少年中的性暴力和自我伤害现象仍较少受到研究。本研究旨在估计加纳城市地区在过去12个月遭受性暴力侵害的在校青少年中自我伤害行为在12个月内的发生率，并描述其相关因素及自我伤害行为的报告原因。分析数据来自2017年在加纳大阿克拉地区进行的一项基于区域的代表性横断面调查，该调查涵盖在校青年（n = 1,723）。其中，297人（17.2%）自我报告在过去12个月遭受过性暴力侵害；本研究聚焦于这部分参与者（n = 297）。测量性暴力侵害、自我伤害及相关因素的条目取自2012年加纳世界卫生组织全球学校学生健康调查以及欧洲儿童和青少年自我伤害研究。数据分析采用多变量逻辑回归模型。过去12个月内自我伤害意念的估计发生率为45.8%（95%置信区间：40 - 52），而自我伤害行为的估计发生率为38.7%（95%置信区间：33 - 44）。约五分之二报告有自我伤害行为的参与者表示，在其最后一次自我伤害行为时曾有过想死的念头。虽然遭受欺凌与自我伤害意念（调整后比值比 = 1.97，95%置信区间1.17, 3.31，P = 0.010）及行为（调整后比值比 = 2.76，95%置信区间1.59, 4.80，P < 0.001）的发生几率增加相关，但每周饮酒（调整后比值比 = 2.56，95%置信区间1.32, 4.93，P = 0.005）、与父母发生冲突（调整后比值比 = 2.30，95%置信区间1.28, 4.12，P = 0.005）以及遭受身体虐待（调整后比值比 = 1.80，95%置信区间1.03, 3.15，P = 0.037）与过去12个月内自我伤害行为发生几率增加显示出强关联。该证据强调需要制定普遍且有针对性的多层次干预和预防方案，以减轻性暴力犯罪，并降低加纳城市地区遭受性暴力的青少年幸存者自我伤害的几率。
