The association between childhood rape and non-partner rape and emotional violence by intimate partners as an adult: a cross-sectional survey
2018
INTRODUCTION: with a largely migrant population of 550,000 Rustenburg is South Africa’s platinum mining capital. We quantify prevalence and incidence of rape during childhood and describe associations with rape and intimate partner violence as an adult. METHODS: a cross-sectional cluster-randomized household survey among women aged 18 - 49 years living in Rustenburg on experiences of rape and associated behaviours and attitudes. Proxy incidence was calculated using the number of childhood rapes reported and person years at risk. Associations were assessed using multivariable logistic regression. RESULTS: response rate was 86.5% (836/966). Mean age was 31.6 years; 45% (361/829) had completed secondary school or higher and 60% (488/828) were unemployed. Mean age of sexual initiation was 17.8 years; 7.7% indicated their first sexual experience was forced; 9.0% (95% CI: 6.6 - 12.1) were raped before age fifteen. Incidence of childhood rape was 1.1 per 100 person-years (123/10,980). Among women who experienced childhood rape, the most common perpetrators were male family members (other than father/stepfather) (30%; 20/66) and strangers (29%; 19/66). Two third of women who were raped by a male family member (13/20) were raped more than twice. None of the women who experienced childhood rape only told the police or health staff; approximately 50% (18/37) told a family member. Women who experienced childhood rape had 6.3 (95% CI: 3.1 - 12.8) times the odds of non-partner rape as an adult compared to those who didn’t. CONCLUSION: we found a high prevalence of childhood rape and clustering of risk in adulthood. Adult survivors should be screened for childhood experiences. Children who present for rape care should receive medical care, mental-health and psycho-social interventions to mitigate the risk of ongoing, lifelong exposure to rape and other forms of sexual violence. School-based and peer-led programs may provide access to children who experience rape.
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