Sexual violence against girls widespread in Swaziland

A third of girls in Swaziland have experienced sexual violence by the age of 18, according to a study published in the May 9^th edition of The Lancet. Such violence was strongly associated with sexually transmitted infections, pregnancy complications or miscarriages, unwanted pregnancy and mental health problems.

Sexual violence against girls (females under the age of 18) is a substantial health and human rights problem and is of particular concern in sub-Saharan Africa.

There is, however, little information on the prevalence and consequences of sexual violence. Investigators from the US Centers for Disease Control and Prevention and UNICEF therefore conducted a study involving girls and young women aged 13 to 24 in Swaziland. The study was conducted between May and June 2007, the study participants being recruited from a representative selection of households.

A total of 1244 individuals participated in the study and provided details of their experience of sexual violence. This was defined as forced intercourse; coerced intercourse; attempted unwanted intercourse; unwanted touching; and forced touching.

A little over a third of participants reported sexual violence by the age of 18, and this increased to 38% when the investigators included young women aged between 18 and 24 years. Forced intercourse was reported by 5% of girls before the age of 18, with coerced intercourse being reported by 9%. The youngest age at which sexual violence was experienced was twelve, with the mean age being a little under 16 years.

Of the girls who reported sexual violence, 43% had experienced two or more incidents by the age of 18.

The most common perpetrators of the first incident of sexual violence were men or boys from the respondent's neighbourhood (32%) or boyfriends or husbands (26%). Over a quarter of all incidents of sexual violence occurred in the respondent's own home, with a fifth occurring at the home of a friend, relative or neighbour. The use of drugs or alcohol by the perpetrator was suspected in 30% of incidents.

Sexual violence was associated with a significantly increased risk of mental health problems including depression (adjusted odds ratio [AOR] 2.30, 95% CI, 1.7-3.11, p < 0.0001) and thoughts of suicide (AOR 2.31, 95% CI, 1.57-3.4, p = 0.0001).

Such violence was also associated with unwanted pregnancy (AOR 2.92, 95% CI, 1.87-4.55, p < 0.0001), complications in pregnancy (AOR 3.54, 95% CI, 1.47-8.55, p = 0.0061) and sexually transmitted infections (AOR 3.69, 95% CI, 1.78-7.66).

“This study documents that sexual violence against girls younger than 18 years of age affected one in three…and has serious health consequences”, note the investigators. They also comment that in most cases the perpetrators of sexual violence “were men or boys from the respondent’s neighbourhood, boyfriends or husbands, or male relatives”.

The investigators conclude that “this pattern could indicate the vulnerability of girls to victimisation and the importance of cultural factors that influence relationships between men, women, and children. Future strategies should focus on prevention of perpetration by men of sexual violence against girls, and since sexual and intimate partner violence might have common roots, local and national initiatives could be reviewed, adapted, and potentially scaled up for this purpose.”