The Prevalence of Childhood Violence and Psychological Distress Among Adolescents and Young Adults Living with HIV in Zimbabwe

Background and Purpose: Many adolescents and young adults (AYA) living with HIV encounter severe mental health problems due to stigma. This is particularly worse for an individual exposed to emotional, physical, and sexual violence during their childhood. Despite this, many studies have not explored an understanding of the significant connection between childhood violence and its negative impact on psychological distress for AYA living with HIV. Therefore, the purpose of this study is to determine the prevalence and association between childhood violence and psychological distress among AYA living with HIV in Zimbabwe.

Methodology: Data used for this study was a cross-sectional study derived from the 2017 Zimbabwe Violence Against Children Survey (ZVACS), specifically for AYA living with HIV (13 to 24; n=249). The independent variables included (1) childhood physical violence, (2) sexual violence, (3) childhood emotional violence, and (4) any childhood violence were all dichotomously coded as either “no” or “yes” and sex (male vs. male) and age group (13-17 vs. 18-24). Psychological distress in the past 30 days (dependent variable), measured by the Kessler 6 scale, is based on 24 items ranging from 0 to 24. A score of 0-4 indicates lower psychological distress and 4-24 indicates moderate/higher psychological distress. The unweighted descriptive characteristics were obtained using frequencies and percentages. Chi-square tests were used to obtain the significant association and the prevalence estimates between independent and dependent variables. A p-value of .05 was used to determine statistical significance.

Results: Out of the 249 AYA living with HIV, 42.6% had moderate/severe psychological distress in the past 30 days, 92.8% were females, 86.7% were aged 18-24, 32.1% experienced any form of childhood violence, 19.9% experienced childhood physical violence, 13.5% experienced childhood emotional violence, and 9.6% experienced childhood sexual violence. Chis-square results indicate a statistically significant association for gender, age, childhood emotional violence, sexual violence, and childhood violence with psychological distress in the past 30 days for AYA living with HIV. Particularly, psychological distress in the past 30 days was highly prevalent for AYA living with HIV who were female (45%), χ2 =7.85, p <.005, and aged 18-24 (45.4%), χ2 =5.23, p <.005. In addition, AYA living with HIV who experienced childhood sexual violence (58.8%), χ2 =7.85, p <.001, any childhood violence (58.8%) χ2 =12.62, p <.001, and emotional violence reported a higher prevalence of psychological distress in the past 30 days compared to those who did not.

Conclusion and Implications: The results have shown that AYAs living with HIV are at risk of developing psychological distress, and this is notably worse for those who have experienced childhood sexual violence followed by emotional violence and a combination of various forms of violence primarily due to stigma, prejudice, and discrimination. Continuous efforts are needed to prevent violence that has been normalized in the Zimbabwean culture and screen for sexual violence to prevent psychological harm and distress for AYA living with HIV. More so, intervening earlier can help to reduce the risk of psychological distress and other psychopathology for AYA living with HIV in Zimbabwe.