Adverse Childhood Experiences and HIV Risk Behaviors in Young Adult Afghan Immigrants to Eastern Iran
- 4 Downloads
This study aims to examine the association between separate and accumulative ACEs and migration-associated HIV risk behaviors among Afghan immigrants to Iran.
A retrospective survey was conducted in three provinces of Iran. Respondent-driven sampling (RDS) technique recruited a sample of 772 young adult Afghan immigrants aged 18 to 37 years. Data were collected through structured interviews between January and March 2019. ACEs and HIV risk behaviors were measured, respectively, by an adapted version of the WHO Adverse Childhood Experiences InternationalQuestionnaire (ACE-IQ) and HIV Risk-taking Behavior Scale (HRBS).
A notable proportion of participants with a mean percentage of 78.3 ± 10.49 reported cumulative ACEs. Only a mean percentage of 5.5 ± 3.18 of participants reported HIV risk behaviors. After adjusting for intra-class correlation (ICC), significantly higher odds of drug-related behaviors were found among respondents who were exposed to family dysfunction during childhood (aOR= 2.53, 95% CI 1.32–3.75) and those who experienced cumulative childhood adversities (aOR= 1.96, 95% CI 1.09–2.83). Respondents with no education (aOR= 1.38, 95% CI 0.85–1.92), those who were exposed to childhood family dysfunction (aOR= 2.10, 95% CI 1.39–2.81), and those who experienced cumulative childhood adversities (aOR= 2.31, 95% CI 1.33–3.29) were more likely to report sexual risk behaviors.
Prevention of ACEs and support for Afghan immigrants exposed to ACEs to develop resilience are essential to improving the HIV health of young adults in future generations. Cumulative ACEs and, separately, family dysfunction, are overlapping risk factors for HIV risk behaviors in young adult Afghan immigrants
KeywordsAdverse childhood experiences HIV risk behaviors Iran Afghan immigrants
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Statement of Informed Consent
Informed consent was obtained from all individual participants included in the study.
- Ashton, K., Bellis, M., & Hughes, K. (2016). Adverse childhood experiences and their association with health-harming behaviors and mental wellbeing in the Welsh adult population: a national cross-sectional survey. The Lancet, 388, S21. https://doi.org/10.1016/S0140-6736(16)32257-7.CrossRefGoogle Scholar
- Bellis, M. A., Hughes, K., Leckenby, N., Jones, L., Baban, A., Kachaeva, M., Povilaitis, R., Pudule, I., Qirjako, G., Ulukol, B., Raleva, M., & Terzic, N. (2015). Adverse childhood experiences and associations with health-harming behaviors in young adults: surveys in eight eastern European countries. Bulletin of the World Health Organization, 92(9), 641–655 https://doi.org/10.2471/BLT.13.129247.CrossRefGoogle Scholar
- Carroll, T. D., Currier, J. M., McCormick, W. H., & Drescher, K. D. (2017). Adverse childhood experiences and risk for suicidal behavior in male Iraq and Afghanistan veterans seeking PTSD treatment. Psychological Trauma Theory Research Practice and Policy, 9(5), 583–586. https://doi.org/10.1037/tra0000250.CrossRefGoogle Scholar
- Catani, C., Schauer, E., Elbert, T., Missmahl, I., Bette, J. P., & Neuner, F. (2009). War, trauma, child labor, and family violence: life adversities and PTSD in a sample of school children in Kabul. Journal of Traumatic Stress, 22(3), 163–171. https://doi.org/10.1002/jts.20415.CrossRefGoogle Scholar
- Chartier, M. J., Brownell, M. D., Isaac, M. R., Chateau, D., Nickel, N. C., Katz, A., et al. (2017). Is the families first home visiting program effective in reducing child maltreatment and improving child development? Child Maltreatment, 22(2), 121–131. https://doi.org/10.1177/1077559517701230.CrossRefGoogle Scholar
- Forster, M., Grigsby, T. J., Rogers, C. J., & Benjamin, S. M. (2018). The relationship between family-based adverse childhood experiences and substance use behaviors among a diverse sample of college students. Addictive Behaviors, 76, 298–304. https://doi.org/10.1016/j.addbeh.2017.08.037.CrossRefGoogle Scholar
- Hahm, H. C., Lee, Y., Ozonoff, A., & Wert, M. J. (2010). The impact of multiple types of child maltreatment on subsequent risk behaviors among women during the transition from adolescence to young adulthood. Journal of Youth and Adolescence, 39(5), 528–540. https://doi.org/10.1007/s10964-009-9490-0.CrossRefGoogle Scholar
- Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., et al. (2017). The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366. https://doi.org/10.1016/S2468-2667(17)30118-4.CrossRefGoogle Scholar
- International Organization of Migration., World Health Organization., & Office of the United Nations High Commissioner for Human Right. (2013). International migration, health and human rights. Retrieved from http://publications.iom.int/bookstore/index.php?main_page=product_info&cPath=41_7&products_id=976. Accessed 10 February 2018.
- Jabbari, H., Sharifi, A. H., SeyedAlinagh, S., Kheirandish, P., Sedaghat, A., Sargolzaei, M., et al. (2011). Assessing the prevalence of HIV among afghan immigrants in Iran through rapid HIV testing in the field. Acta Medica Iranica, 49(7), 478–479.Google Scholar
- Johnson, K., Woodward, A., Swenson, S., Weis, C., Gunderson, M., Deling, M., Cristiani, V., & Lynch, B. (2017). Parents' adverse childhood experiences and mental health screening using home visiting programs: A pilot study. Public Health Nursing, 34(6), 522–530. https://doi.org/10.1111/phn.12345.CrossRefGoogle Scholar
- Joint United Nations Programme on HIV/AIDS, International Labour Organization, International Organization for Migration. (2008). HIV and international labour migration, Retrieved from http://www.unaids.org/en/Resources/PressCentre/Featurestories/2008/July/20080716NewUNAIDSpolicyHIVandintlabourmig. Accessed 28 May 2015.
- Joint United Nations Programme on HIV/AIDS. (2018). Country factsheets, Iran (Islamic Republic of) 2018, HIV and AIDS Estimates. Retrieved from https://www.unaids.org/en/regionscountries/countries/islamicrepublicofiran. Accessed 5 September 2019.
- Kramer, M. A., van Veen, M. G., Op de Coul, E. L. M., Geskus, R. B., Coutinho, R. A., Van de Laar, M. J., & Prins, M. (2008). Migrants travelling to their country of origin: a bridge population for HIV transmission? Sexually Transmitted Infections, 84(7), 554–555. https://doi.org/10.1136/sti.2008.032094.CrossRefGoogle Scholar
- Latack, J. A., Rodriguez-Seijas, C., Stoh, M., Blanco, C., Hasin, D. S., & Eatona, N. R. (2015). Transdiagnostic psychopathology mediates the relationship between childhood sexual abuse and HIV/AIDS and other sexually transmitted infections in adulthood. Comprehensive Psychiatry, 62, 71–79. https://doi.org/10.1016/j.comppsych.2015.06.002.CrossRefGoogle Scholar
- Nicholas, P. K., Mfono, N., Corless, I. B., Davis, S. M., O’Brien, E., Padua, J., et al. (2016). HIV vulnerability in migrant populations in southern Africa: Sociological, cultural, health-related, and human-rights perspectives. International Journal of Africa Nursing Sciences, 5, 1–8. https://doi.org/10.1016/j.ijans.2016.09.003.CrossRefGoogle Scholar
- Olawore, O., Tobian, A., Kagaayi, J., Bazaale, J. M., Nantume, B., Kigozi, G., Nankinga, J., Nalugoda, F., Nakigozi, G., Kigozi, G., Gray, R. H., Wawer, M. J., Ssekubugu, R., Santelli, J. S., Reynolds, S. J., Chang, L. W., Serwadda, D., & Grabowski, M. K. (2018). Migration and risk of HIV acquisition in Rakai, Uganda: a population-based cohort study. Lancet HIV, 5(4), e181–e189. https://doi.org/10.1016/S2352-3018(18)30009-2.CrossRefGoogle Scholar
- United Nations Department of Economic and Social Affairs, Population Division. (2017). International migration report: highlights (ST/ESA/SER.A/404), Retrieved from http://www.un.org/en/development/desa/population/migration/publications/migrationreport/migreport.shtml. Accessed 18 December 2017.
- Ward, J., Darke, S., & Hall, W. (1990). The HIV Risk-taking Behavior Scale (HRBS) manual. National Drug and Alcohol Research Centre (NDARC): Australia.Google Scholar
- World Health Organization. (2007). Preventing injuries and violence: a guide for ministries of health, Retrieved from https://www.who.int/violence_injury_prevention/publications/injury_policy_planning/prevention_moh/en. Accessed 20 April 2019.
- World Health Organization. (2018). Adverse childhood experiences international questionnaire, Retrieved from http://www.who.int/violence_injury_prevention/violence/activities/adverse_childhood_experiences/en. Accessed 5 March 2019.