The Impact of Childhood Violence Exposure on Suicidality Among Adolescents and Young Adults Living with HIV/Aids in Zimbabwe

Background and Purpose

International research has demonstrated the association between lifetime suicidality and childhood neglect, though this same association is left unexplored in African countries and for those living with HIV/AIDS. To address these gaps, this study sought to examine the relationship between childhood violence and suicidality among adolescents and young adults (AYA) living with HIV/AIDS in Zimbabwe. We hypothesize that AYA who experienced any form of childhood violence (i.e., childhood emotional, physical, and sexual violence) will have an increased risk of suicide compared to AYA who have not experienced childhood violence, after controlling for covariates.

Methodology

Data from the 2017 Zimbabwe Violence Against Children Survey (ZVACS). The sample size was n=249 adolescents and young adults living with HIV. The independent variables included childhood physical violence (PV), childhood sexual violence (SV), childhood emotional violence (EV), and any childhood violence that was dichotomously coded as “no” or “yes.” Suicide risk was assessed by asking AYA whether they ever experienced (1) thoughts of killing themselves, (2) attempts to end their lives, (3) intentional harming of themselves (coded yes or no). Covariates included sex, age, highest level of education, marital status, and number of close friends. Two logistic regression models (unadjusted and adjusted) were performed to determine significant associations between independent and dependent variables. Multicollinearity was checked to ensure parsimonious models. A significance level of .05 was used to determine statistical significance for multivariate analyses.

Results

Before and after adjustment of the models, AYA living with HIV/AIDS who experienced childhood emotional violence (EV) had higher odds of reporting suicide risk compared to those who did not experience childhood emotional violence (OR=3.62 [CI=1.60--8.15], aOR=4.29 [CI=1.57--11.77]). Similarly, AYA living with HIV/AIDS who experienced childhood sexual violence had higher odds of suicide risk relative to those who did not experience childhood sexual violence (OR=3.75 [CI=1.44--9.80], aOR=3.44 [CI=1.14--10.39]). AYA living with HIV/AIDS who experienced any form of childhood violence had higher odds of suicide risk than the unadjusted model (OR=3.62 [CI=1.60--8.15]). However, after adjustment of the model, AYA living with HIV/AIDS who experienced any childhood violence had lower odds of suicide risk compared to those who did not experience any form of childhood violence (OR=0.33 [CI=0.18--0.63). Finally, childhood physical violence was not significantly associated with suicide risk before and after covariate adjustment.

Conclusion and Implications

The significant finding is that in both models, AYA living with HIV/AIDS who experienced childhood emotional violence (EV) had higher odds of reporting suicide risk compared to those who did not experience childhood emotional violence. This correlates with past findings across countries that non-HIV/AIDS adults who have experienced emotional abuse and/or emotional neglect in childhood have higher rates of all suicidality. While it is known that these findings cross age and culture, more exploration into the specific variables that associate the abuse/neglect with suicidality is needed to consider preventative measures. Further, given that all childhood violence actually is associated with lower later suicide in HIV/AIDS AYA, this need be further understood to further enhance preventative measures.