EXPERIENCES OF SEXUAL VIOLENCE AMONG ADOLESCENTS IN BOTH URBAN AND RURAL KENYA The 8th Pan-African PCAF Psychotrauma Conference Victoria Mutiso, PhD, Senior Researcher, Africa Mental Health Foundation 13 th -16 th July, 2015

Background Types of sexual violence among adolescents:  Sexual violence is common among the adolescents.  Nearly one in 10 of the 14- to 21-year-olds report perpetrating sexual violence in their lifetime (Ybarra ML).  Of the 9% who committed some type of sexual violence;  8% engaged in forced sexual contact (kissing, touching).  3% persuaded someone to yield to their sexual demand (referred to as coercive sex).  3% attempted rape and were unsuccessful.  2% completed rape.

Perpetrators  Perpetrators meet their victims at school engaging in more than one type of sexual perpetration, forced contact, coercive sex, unsuccessful rape, and completed rape.  There were differences in the type of sexual violence by age of first perpetration.  Upto age 15, oral sex was the most common (65%), followed by vaginal sex (46%), and anal sex (40%). At ages 18 or 19, vaginal sex was the most common perpetration (96%), followed by anal sex (13%).

Risk factors of perpetrators  Risk factors are associated with a greater likelihood of sexual violence (SV) perpetration.  They are contributing factors and might not be direct causes. Not everyone who is identified as "at risk" becomes a perpetrator of violence.  A combination of individual, relational, community and societal factors contribute to the risk of becoming a perpetrator of SV.  Understanding these multilevel factors can help identify various opportunities for prevention.

Method  Questionnaire: Survey of Alcohol and Substance use and Living Conditions of Youth  Cross-sectional data from a school survey (in urban and rural sites in Kenya)  22 (8 from Nairobi - urban, 8 from Machakos - peri-urban and 6 from Makueni - rural)  Among other data - alcohol, substance use and the living conditions of Kenyan school youth conducted in July-October  Aim: Estimate the prevalence and socio-demographic correlates of sexual violence and related behaviors within the last 12 months  assessed the association between self-reported history of having engaging in a sexual violence and a selected list of independent variables using logistic regression analysis

Variable Boy n(%) Girl n(%) Total n(%) Gender1707(51.6)1604(48.8)3311 Age (30.0)677(43.9)1174(36.7) (45.9)674(43.7)1434(44.9) (20.2)152(9.9)487(15.2) (3.9)38(2.5)102(3.2) Family structure both parents1140(72.6)1059(71.9)2199(72.3) Single parent431(27.4)413(28.1)844(27.7) Witnessed physical violence in home where adult was involved NO963(64.7)1016(70.4)1979(67.5) YES526(35.3)427(29.6)953(32.5) Involved in physical violence at home where adult was involved NO1024(70.0)1080(75.7)2104(75.7) YES439(30.0)346(24.3)785(27.2) Results

Results contd.  Of the 3311 respondents, 7.4% (9% males and 5.7% females) reported having engaged in any form of sexual physical violence in the past 12 months.  Males were more likely to have been involved in physical violence behaviors than females.  Involving forcing someone to have sexual relations: boys 7.6% and girls 6.2% (p=0.001) and forcing someone to have sexual intercourse 7.9% among the boys and 4.9% among the girls (p=0.001).

Results Cont:  Boys contributed a significant difference among the victims of sexual violence (9%) and girls (5.2%)  Both male and female substance users (cigarette smoking O.R. 2.87( ), Alcohol use O.R ( ) and Cannabis use O.R ( ) were more likely to engage in sexual violence than non substance users.

Prevalence of adolescents engaging in or exposed to sexual violence related behaviors Violence-related behaviors Male n(%) female n(%) Total n(%) Forced somebody to have sexual relations**115(7.6)68(4.7)183(6.2) Forced somebody to have sexual intercourse**118(7.9)71(4.9)189(6.4) Engage in any form of sexual violence**153(9)92(5.7)245(7.4) Being a victim of sexual violence*138(9)76(5.2)214(7.2)

Summary  Students who engaged in cigarette smoking were 2.9 times more likely to engage in sexual violence than those who are non smokers.  Students who consume alcohol were 2.2 times more likely to engage in any form of sexual violence than those who don’t  Cannabis use was strongly associated with sexual violence with those who consume being 4.4 times more likely to engage in sexual violence than those who don’t.  Boys were significantly associated to perpetrate sexual violence compared to girls.  Among the victims boys reported a higher prevalence compared to girls.

Limitations  Cross section study  Mainly quantitative  Needed to include qualitative especially focus group discussions in schools

Conclusion  Gender and drug use are associated with sexual violence and need to be the focus of intervention.  For an intervention to be effective, the targeted risk factors must be amenable to change.  Since many of the strongest predictors can be changed, they offer possible targets for successful intervention