南非青少年女孩和年轻妇女中与 WASH 相关的暴力与抑郁症状之间的关联（HPTN 068）：一项横断面分析。
Associations between WASH-related violence and depressive symptoms in adolescent girls and young women in South Africa (HPTN 068): a cross-sectional analysis.
机构信息
Ibis Reproductive Health, Oakland, California, USA
Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California, USA.
出版信息
BMJ Open. 2022 Jul 5;12(7):e061032. doi: 10.1136/bmjopen-2022-061032.
OBJECTIVE
There is a lack of research on experiences of WASH-related violence. This study aims to quantify the association between experience or worry of violence when using the toilet or collecting water and depressive symptoms among a cohort of young women in South Africa.
METHODS
Data are from visit 3 of the HPTN 068 cohort of adolescent girls in rural Mpumalanga Province, South Africa. Participants (n=1798) included in this analysis were aged 13-21 at baseline. Lifetime experience of violence or fear of violence when using the toilet and collecting water was collected by self-report; depressive symptoms in the past week were measured using the Center for Epidemiological Studies Depression Scale (CES-D). We used G-computation to calculate the prevalence difference (PD) and prevalence ratio of depression (CES-D score >15) associated with each domain of violence, controlling for baseline covariates.
FINDINGS
A total of 15.1% of respondents reported experiencing violence when using the toilet; 17.1% reported experiencing violence when collecting water and 26.7% reported depression. In adjusted models, those who reported experiencing violence when using the toilet had an 18.1% higher prevalence of depression (95% CI: 11.6% to 24.4%) than those who did not experience violence when using the toilet. Adjusted prevalence of depression was also higher among those who reported violence when collecting water (PD 11.9%, 95% CI: 6.7% to 17.2%), and who worried about violence when using the toilet (PD 12.8%, 95% CI: 7.9% to 19.8%), as compared with those who did not report these experiences. Worrying about violence when collecting water was not associated with depression after adjusting for covariates.
CONCLUSION
Experience of WASH-related violence is common among young women in rural South Africa, and experience or worry of experiencing violence is associated with higher prevalence of depressive symptoms.
TRIAL REGISTRATION NUMBER
NCT01233531; Post-results.
目的
有关 WASH 相关暴力的研究较少。本研究旨在定量评估在使用厕所或收集水时经历或担心暴力与南非年轻女性队列中抑郁症状之间的关联。
方法
数据来自南非姆普马兰加省农村 HPTN 068 青少年女性队列的第 3 次访问。本分析纳入的参与者（n=1798）在基线时年龄为 13-21 岁。通过自我报告收集使用厕所和收集水时的暴力经历或对暴力的恐惧；使用流行病学研究中心抑郁量表（CES-D）在过去一周内测量抑郁症状。我们使用 G 计算来计算与每种暴力领域相关的抑郁（CES-D 评分>15）的患病率差异（PD）和患病率比，同时控制基线协变量。
结果
共有 15.1%的受访者报告在使用厕所时经历过暴力；17.1%报告在收集水时经历过暴力，26.7%报告患有抑郁。在调整后的模型中，报告在使用厕所时经历过暴力的人患抑郁的流行率高出 18.1%（95%CI：11.6%至 24.4%），而没有在使用厕所时经历过暴力的人。报告在收集水时发生暴力的人（PD11.9%，95%CI：6.7%至 17.2%）和在使用厕所时担心暴力的人（PD12.8%，95%CI：7.9%至 19.8%），其调整后的抑郁患病率也较高与那些没有报告这些经历的人相比。调整协变量后，担心在收集水时发生暴力与抑郁无关。
结论
在南非农村地区，年轻女性中普遍存在与 WASH 相关的暴力经历，而经历或担心经历暴力与更高的抑郁症状患病率相关。
试验注册号
NCT01233531；post-results。
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