WITHDRAWN: Sexual Health Knowledge and Behaviors Among War-Affected Youth in Sierra Leone Post Conflict

Purpose

Ending gender-based family and community violence has been identified as a Grand Challenge of Social Work and a cross-disciplinary priority. Adverse events experienced during adolescence have been documented to have both short- and long-term negative consequences. Between 1991 and 2002, thousands of children (50% under the age of 15) were forced to join rebel groups in Sierra Leone’s bloody civil war. During armed conflict, sexual abuse--including rape, forced oral sex, forced pregnancy, and prostitution-was often used as a control tactic; and adolescent girls were expected to provide sex, and often served as “wives” for soldiers. Due to the high rates of sexual abuse and interrupted developmental trajectories of youth during armed conflict this study explored sexual risk behaviors (condom use, age of sexual initiation, number of sexual partners) among war-affected youth and former child soldiers in post-conflict Sierra Leone.

Methods

Data are drawn from the Longitudinal Study of War-Affected youth in Sierra Leone (LSWAY). LSWAY uses a prospective longitudinal design with repeat measures administered at four intervals between 2002-2017. We hypothesized that a majority of females in this sample would have experienced a sexual debut/initiation that was against their will, and that war experiences, defined as violence exposure and sexual victimization, would negatively impact sexual health knowledge. We also hypothesized that war experiences would lead to greater levels of high-risk sexual behaviors. All analyses were conducted using IBM SPSS Statistics, version 24. Frequency distributions and central tendency scores for all study variables were examined. Binary logistic regression was used to examine primary outcomes. Chi-squared tests were used to examine gender differences.

Results

A total of 285 respondents were included in the analyses. Approximately one in four respondents identified as female (26.7%, n= 76). Just over half (51.6%) were currently in school. On average, respondents were almost 22 years old at the Wave 3 assessment (M = 21.77, SD = 3.33).  While 72.7% of male respondents reported that their first sexual intercourse was by choice, only 36.8% of female respondents reported the same, c²= 30.84, p < .001. One fifth of respondents indicated that their first sexual intercourse occurred prior to 11 years of age. Female respondents were significantly more likely to report first sexual intercourse prior to 11 years (19.7%) compared to male counterparts (7.7%), as well as reporting higher rates of first sex during early adolescence (22.4% and 12.0%, respectively). Female respondents were significantly more likely to report that they hadn’t used a condom because their partner refused (22.2% compared to 11.0%, c²= 4.54, p = .035).

Implications

Current strategies of social assistance must pay attention to the needs of young women and girls post conflict. Given the unique experiences and perspectives of girls who were attached to fighting forces, their voices and perspectives must be systematically sought in the conceptualization and implementation of social programs that are designed to directly support them.