Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Department of Research, The AIDS Support Organization (TASO), Kampala, Uganda.
BMC Pediatr. 2023 Jun 20;23(1):311. doi: 10.1186/s12887-023-04131-w.
Female sex workers (FSWs) live and work in high-risk environments, experience high levels of adversity, and have multigenerational trauma that can negatively affect their children. Yet not much is known about the prevalence of victimization (i.e., exposure to maltreatment and trauma) among children of FSWs. This study compared the prevalence of lifetime victimization among adolescents of FSWs and adolescents of non-FSWs in Gulu City, Northern Uganda.
A comparative cross-sectional study was conducted among adolescents (10-17 years) enrolled in the Children of At-Risk Parents (CARP) study. This study included 147 adolescents of FSWs and 147 adolescents of non-FSWs selected for comparison in Gulu City, Northern Uganda. The adolescents of FSWs were identified through their mothers using respondent-driven sampling. Data on the residence of FSWs guided a proportionate stratified sampling of adolescents of non-FSWs. Using the Juvenile Victimization Questionnaire, we screened for 34 different types of victimization during participants' lifetimes. Percentage point differences within groups of adolescents and comparison between adolescents of FSWs and non-FSWs were calculated using STATA version 14.1. Statistical significance was set to p < 0.05.
99.3% of the participants experienced at least one form of lifetime victimization. The median number of lifetime victimizations was 12.4. Overall, lifetime victimization was higher among adolescents of FSWs than non-FSWs (13.4 vs. 11.5), male vs. female adolescents (13.4 vs. 11.9), and older [14-17 years] vs. younger (10-13 years) adolescents (14.0 vs. 11.7). Further, more adolescents of FSWs experienced lifetime victimization in the following domains and subdomains, all of which were statistically significant: kidnap (15.8% vs. 4.8%), emotional abuse (65.8% vs. 50.0%), emotional neglect (37.4% vs. 21.1%), physical intimidation (10.2% vs. 4.1%), relational aggression (36.4% vs. 18.4%), verbal aggression (68.7% vs. 46.9%), sexual victimization (31.3% vs. 17.7%), verbal sexual harassment (20.4% vs. 5.4%), exposure to murder scene (42.9% vs. 26.5%), witness to domestic violence (39.5% vs. 26.5%), and witness to the murder of relatives (31.3% vs. 21.1%). Conversely, more adolescents of non-FSWs experienced caregiver victimization than the adolescents of FSWs (98.0 vs. 92.5; p < 0.05).
Childhood victimization is highly prevalent in Northern Uganda and disproportionately affects the adolescents of FSWs. Therefore, government and development partners should urgently develop policies and interventions targeting prevention, early detection, and timely management of victimization in this vulnerable population.
性工作者（FSW）生活和工作在高风险环境中，经历高水平的逆境，并且存在代际创伤，这可能会对他们的孩子产生负面影响。然而，我们对性工作者子女遭受创伤（即遭受虐待和创伤）的流行程度知之甚少。本研究比较了在乌干达北部古卢市，性工作者子女和非性工作者子女青少年一生中遭受创伤的发生率。
采用青少年（10-17 岁）参与的比较性横断面研究。该研究包括在乌干达北部古卢市招募的 147 名性工作者子女和 147 名非性工作者子女青少年。通过母亲识别性工作者子女，使用应答者驱动抽样进行选择。性工作者居住地的数据指导了非性工作者子女青少年的比例分层抽样。使用青少年受害问卷，我们筛查了参与者一生中 34 种不同类型的创伤。使用 STATA 版本 14.1 计算了组内青少年的百分点差异和性工作者子女与非性工作者子女之间的比较。设定统计显著性水平为 p<0.05。
99.3%的参与者至少经历过一种形式的终生创伤。终生创伤的中位数为 12.4。总体而言，性工作者子女的终生创伤发生率高于非性工作者子女（13.4 比 11.5）、男性比女性青少年（13.4 比 11.9）以及年龄较大（14-17 岁）比年龄较小（10-13 岁）的青少年（14.0 比 11.7）。此外，更多的性工作者子女经历了以下领域和子领域的终生创伤，所有这些都具有统计学意义：绑架（15.8%比 4.8%）、情绪虐待（65.8%比 50.0%）、情感忽视（37.4%比 21.1%）、身体恐吓（10.2%比 4.1%）、关系侵犯（36.4%比 18.4%）、言语侵犯（68.7%比 46.9%）、性创伤（31.3%比 17.7%）、言语性骚扰（20.4%比 5.4%）、目睹谋杀现场（42.9%比 26.5%）、目睹家庭暴力（39.5%比 26.5%）和目睹亲属被谋杀（31.3%比 21.1%）。相反，非性工作者子女的照顾者创伤发生率高于性工作者子女（98.0 比 92.5；p<0.05）。
乌干达北部儿童期创伤发生率很高，而且不成比例地影响性工作者子女青少年。因此，政府和发展伙伴应紧急制定政策和干预措施，针对这一弱势群体的预防、早期发现和及时管理创伤。
