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APHA Scientific Session and Event Listing

Ilene S. Speizer, PhD, MHS, SPH - Maternal and Child Health, University of North Carolina at Chapel Hill, MEASURE Evaluation Project, 206 W. Franklin St., Chapel Hill, NC 27516, 919-966-7411, ilene_speizer@unc.edu, Audrey Pettifor, PhD, MPH, Epidemiology, School of Public Health, University of North Carolina/Reproductive Health Resarch Unit (S. Africa), Campus Box 7435, Chapel Hill, NC 27599, Stirling Cummings, MPH, MEASURE Evaluation Project, University of North Carolina, 206 W. Franklin St., Chapel Hill, NC 27516, and Catherine MacPhail, PhD, MSc, Reproductive Health Research Unit, University of Witwatersrand, Dept. of OBstetrics and Gynaecology, Johannesburg, South Africa.

Recent studies of youth from South Africa indicate wide variation in HIV prevalence across the nine provinces and additional heterogeneity within provinces. Young women are at the greatest risk of HIV infection and suffer additional consequences of unprotected sex, including unwanted pregnancy. Young women who are exposed to violence are at higher risk of these negative reproductive health outcomes. Using data from a national household survey of youth ages 15-24 conducted in South Africa in 2003, this study examines the association between sexual violence and reproductive health outcomes among female youth. Two sexual violence measures are examined: experiences with violence and perceived norms about violence. The first analysis uses GIS mapping to examine the association between violence and HIV prevalence, teen pregnancy, condom use, and family planning use by province and enumeration area. Second, we perform multi-level multivariable regression analyses of whether, controlling for an individual's characteristics, the prevalence of violence in the enumeration area is associated with the reproductive health outcomes. Among female sexually experienced youth, 6% reported that their first sexual partner ever forced them to have sex. This varied across the regions with Kwazulu-Natal having the highest proportion reporting violence experience (10.6%). Among all females surveyed, 15.5% were HIV positive, and 15.5% of 15-19 year olds were ever pregnant. Outcomes varied by region with Eastern Cape ranking highest followed closely by Kwazulu-Natal and Mpumalanga. This study indicates the importance of addressing violence at the community level to help reduce young women's risk of negative reproductive health outcomes.

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