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BMC Public Health

, Volume 17, Supplement 3, pp 41–50

First Online: 04 July 2017


BackgroundPolyvictimisation PV – exposure to violence across multiple contexts – causes considerable morbidity and mortality among adolescents. Despite high levels of violence in urban disadvantaged settings, gender differences in associations between PV and mental health have not been well established.

MethodsWe analysed data from a survey with 2393 adolescents aged 15-19 years, recruited using respondent-driven sampling from urban disadvantaged settings in Baltimore USA, Delhi India, Ibadan Nigeria, Johannesburg South Africa and Shanghai China. PV was defined as exposure to two or more types of violence in the past 12 months with family, peers, in the community, or from intimate partners and non-partner sexual violence. Weighted logistic regression models are presented by gender to evaluate whether PV is associated with posttraumatic stress, depression, suicidal thoughts and perceived health status.

ResultsPV was extremely common overall, but ranged widely, from 74.5% of boys and 82.0% of girls in Johannesburg, to 25.8 and 23.9% respectively in Shanghai. Community violence was the predominant violence type, affecting 72.8–93.7% across the sites. More than half of girls 53.7% and 45.9% of boys had at least one adverse mental health outcome. Compared to those that did not report violence, boys exposed to PV had 11.4 higher odds of having a negative perception of health 95%CI adjusted OR = 2.45-53.2, whilst this figure was 2.58 times in girls 95%CI = 1.62-4.12. Among girls, PV was associated with suicidal thoughts adjusted OR = 4.68; 95%CI = 2.29-9.54, posttraumatic stress aOR = 4.53; 95%CI = 2.44-8.41 and depression aOR = 2.65; 95%CI = 1.25-5.63. Among boys, an association was only detected between PV and depression aOR = 1.82; 95%CI = 1.00-3.33.

ConclusionThe findings demonstrate that PV is common among both sexes in urban disadvantaged settings across the world, and that it is associated with poor mental health outcomes in girls, and with poor health status in both girls and boys. Clearly, prevention interventions are failing to address violence exposure across multiple contexts, but especially within community settings and in Johannesburg. Interventions are needed to identify adolescents exposed to PV and link them to care, with services targeting a range of mental health conditions among girls and perhaps focusing on depression among boys.

KeywordsPolyvictimisation Mental health Adolescents Gender differences Urban disadvantaged environments AbbreviationsIPVIntimate partner violence

LMICLow- and Middle-Income Countries

NPSVNon-partner sexual violence


RDSRespondent-driven Sampling

UNDPUnited Nations Development Programme

WAVEWellbeing of Adolescents in Vulnerable Environments Study

Electronic supplementary materialThe online version of this article doi:10.1186-s12889-017-4348-y contains supplementary material, which is available to authorized users.

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Autor: Mphatso Kamndaya - Pedro T. Pisa - Matthew F. Chersich - Michele R. Decker - Adesola Olumide - Rajib Acharya - Yan Cheng


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