Exposure to violence in childhood is associated with risky sexual behaviors among youth: Findings from the Humanitarian Violence against Children and Youth Survey in Uganda

Background : Exposure to violence in childhood has long-term negative consequences; however, there is a notable gap in studies examining the relationship between violence against children (VAC) and risky sexual behaviors within refugee populations. We investigate the association between exposure to violence in childhood and engaging in risky sexual behaviors among youths in refugee settings in Uganda. Methods :We analyzed data from 18–24-year-olds enrolled in the 2022 Uganda Humanitarian Violence against Children and Youth Survey (HVACS), the first-ever HVACS conducted across all 13 refugee settlements in Uganda. Statistical associations between exposure to physical, sexual, or emotional violence, witnessing physical violence in the home or in the community and engaging in risky sexual behaviors, defined as one or more of early sexual debut, transactional sex, sex with multiple partners and unprotected sex with a non-spousal partner, were examined using chi-square tests, and logistic regression. Analyses were conducted separately for males and females. Results : A total of 622 females and 395 males were interviewed. The prevalence of risky sexual behaviors was 30.6% (95% CI: 23.4% - 38.9%) among females and 33.2% (95% CI: 22.2% -46.5%) among males. Risky sexual behaviors were higher among female participants who experienced sexual violence in childhood, with twice the odds of engaging in such behaviors (AOR=2.2; 95% CI=1.2–4.1, p=0.018) compared to those not exposed to sexual violence in childhood. Male participants who witnessed physical violence in the community had higher odds of engaging in risky sexual behaviors (AOR=1.9; 95% CI=1.1–3.3, p=0.03. Conclusion : Engaging in risky sexual behaviors among adolescents and young people in humanitarian settings in Uganda is associated with gender-specific prior exposures to violence in childhood. Addressing risky sexual behaviors among adolescents and young people in humanitarian settings requires an age and gender life-course approach starting from childhood violence prevention efforts to reduce exposure to both individual and community-level violence, specifical sexual, physical, and witnessing physical violence in the community.