纳米比亚减少青少年和青年暴力、艾滋病毒风险及早孕的促进因素:针对儿童及青少年暴力调查的横断面分析
Accelerators to reduce violence, HIV risk, and early pregnancy among adolescents and young people in Namibia: A cross-sectional analysis of the Violence Against Children & Youth Survey.
作者信息
Little Madison T, Hertzog Lucas, Rudgard William E, Toska Elona, Banougnin Boladé, Yates Rachel, Chipanta David, Annor Francis B, Chiang Laura, Cluver Lucie
机构信息
Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, Oxford, United Kingdom.
Green Templeton College, University of Oxford, Oxford, United Kingdom.
出版信息
PLOS Glob Public Health. 2025 May 20;5(5):e0004633. doi: 10.1371/journal.pgph.0004633. eCollection 2025.
Our study applied the INSPIRE Framework - the WHO's 2016 technical package of evidence-based interventions for addressing violence against children - to identify accelerators for youth in Namibia. Accelerators are protective factors that contribute toward achieving multiple SDG targets. Using nationally representative data from the 2019 Namibia Violence Against Children & Youth Survey (n = 5167), three hypothesised accelerators (food security, parental support, and gender-equitable attitudes) were investigated for their impact on 12 adolescent outcomes. Associations between the hypothesised accelerators and outcomes were assessed using multivariable logistic regressions, and adjusted probabilities, differences, and ratios. Among girls, food security, gender-equitable attitudes, and parental support were accelerators, being associated with lower odds for 8, 6, and 2 outcomes, respectively. When all three were present, the combination was significantly associated with 10 out of 12 outcomes, including >75% lower prevalences of child marriage; > 50% lower prevalences of child abuse, sexual violence victimisation, early sexual debut/early pregnancy, and peer violence victimisation; and >25% lower prevalences of intimate partner violence (IPV) victimisation, not being in school or paid work, mental health distress, inconsistent condom use, and age-disparate or transactional sex. Among boys, gender-equitable attitudes was an accelerator and was significantly associated with 7 out of 10 outcomes, including approximately 50% lower prevalences of sexual violence victimisation, child abuse, age-disparate or transactional sex, IPV victimisation, multiple sexual partners, peer violence victimisation, and inconsistent condom use. Adolescents (especially girls) with access to INSPIRE provisions experience lower rates of violence and HIV-related risks. Implementing interventions on these priority protective factors could accelerate progress in achieving the SDGs for adolescents and young people in Namibia.
我们的研究应用了“激励框架”(WHO于2016年发布的基于证据的干预措施技术包,用于应对暴力侵害儿童问题)来确定纳米比亚青少年的促进因素。促进因素是有助于实现多个可持续发展目标的保护因素。利用2019年纳米比亚暴力侵害儿童和青少年调查的全国代表性数据(n = 5167),研究了三个假设的促进因素(粮食安全、父母支持和性别平等态度)对12项青少年结果的影响。使用多变量逻辑回归以及调整后的概率、差异和比率来评估假设的促进因素与结果之间的关联。在女孩中,粮食安全、性别平等态度和父母支持是促进因素,分别与8项、6项和2项结果的较低发生率相关。当这三个因素都存在时,该组合与12项结果中的10项显著相关,包括童婚发生率降低75%以上;虐待儿童、性暴力受害、过早性行为/早孕和同伴暴力受害发生率降低50%以上;亲密伴侣暴力(IPV)受害、未上学或未从事有偿工作、心理健康困扰、避孕套使用不一致以及年龄差距过大或交易性性行为发生率降低25%以上。在男孩中,性别平等态度是一个促进因素,与10项结果中的7项显著相关,包括性暴力受害、虐待儿童、年龄差距过大或交易性性行为、IPV受害、多个性伴侣、同伴暴力受害和避孕套使用不一致的发生率降低约50%。能够获得“激励框架”相关措施的青少年(尤其是女孩)遭受暴力和与艾滋病毒相关风险的发生率较低。针对这些优先保护因素实施干预措施可以加速纳米比亚青少年和年轻人实现可持续发展目标的进程。