Adverse childhood experiences and HIV sexual risk-taking behaviors among young adults in Malawi

Adverse childhood experiences exhibit a dose–response association with poor health outcomes in adulthood, including HIV. This study analyzed responses from sexually active 19- to 24-year-old males and females participating in the Malawi Violence Against Children and Youth Survey.

The study tested the association between respondents’ exposure to six adverse childhood experiences (having experienced emotional, physical, or sexual violence; witnessing intimate partner violence or an attack in the community; one or both parents died) and infrequent condom use in the past year and multiple sexual partners in the past year.

Sage journals

CDC Research brief: Adverse Childhood Experiences increase risk for HIV sexual risk taking behaviors in Malawi young adults

Key findings:

  • 82% of youth in Malawi experienced one or more adverse childhood experiences, and 29% reported two or more adverse childhood experiences.

  • Exposure to adverse childhood experiences in Malawi was higher than in non-African settings.

  • adverse childhood experiences were associated with using condoms never or infrequently as young adults.

  • The more adverse childhood experiences people had, the more likely they were to never or rarely use condoms as young adults.

What is added by this report?

This study establishes a critical link between HIV risk behaviors and adverse childhood experiences. It was one of the first studies to examine the prevalence and outcomes related to adverse childhood experiences in an African country. As the HIV epidemic in Malawi is mainly from heterosexual transmission, reducing sexual risk behaviors among young people is key to interrupting HIV transmission. For that reason, the results from this study highlight the importance of preventing violence against all children as a key HIV prevention strategy in Malawi.