Intimate Partner Violence and Food Insecurity Predict Early Behavior Problems Among South African Children over 5-years Post-Birth


Households experiencing intimate partner violence (IPV) and food insecurity are at high risk of lifelong physical and behavioral difficulties. Longitudinal data from a perinatal home-visiting cluster-randomized controlled intervention trial in South Africa townships were used to examine the relationships between household settings and mothers’ histories of risk and children’s behavior problems at 3 and 5 years of age. IPV, food insecurity, maternal depressed mood, and geriatric pregnancy (at age of 35 or older) were consistently associated with children’s internalizing and externalizing behavior problems. Aggressive behavior was more prevalent among 3- and 5-year olds boys, and was associated with maternal alcohol use. The effects of these factors on child behavior were more prominent than maternal HIV status. There is a continuing need to reduce IPV and household food insecurity, as well as supporting older, depressed, alcohol using mothers in order to address children’s behavioral needs.

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Fig. 1





Child behavior checklist


Community health workers


Confidence interval


Edinburgh postnatal depression scale


Household food insecurity access scale


High-income countries


Intimate partner violence


Low- and middle-income countries


Mean difference


Odds ratio


Prevention of mother to child transmission


Road-to-health card


Standard deviation


Standard error


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This work was funded by the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) R01AA017104 and supported by the U.S. National Institutes of Health (NIH) MH58107, 5P30AI028697, and UL1TR000124. PHR is supported by the U.S. National Institute of Mental Health (NIMH) T32MH109205 and Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) P30MH58107. MT is supported by the National Research Foundation (South Africa) and is a lead investigator of the Centre of Excellence in Human Development, University of the Witwatersrand, in South Africa. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have declared that they have no competing or potential conflicts of interest.

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Correspondence to Panteha Hayati Rezvan.

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The Institutional Review Boards of University of California Los Angeles (UCLA) and Stellenbosch University approved the study (IRB#10–000386). All procedures were in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Table S1.

Estimated regression coefficient with 95% CI obtained from linear mixed-effects model for analysis of child behavioral outcomes on potential structural factors and maternal risks. Supplementary file1 (DOCX 18 kb)

Table S2.

Estimated regression coefficient with 95% CI obtained from logistic mixed-effects model for analysis of child behavioral outcomes on potential structural factors and maternal risks. Supplementary file2 (DOCX 18 kb)

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Hayati Rezvan, P., Tomlinson, M., Christodoulou, J. et al. Intimate Partner Violence and Food Insecurity Predict Early Behavior Problems Among South African Children over 5-years Post-Birth. Child Psychiatry Hum Dev (2020).

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  • Child behavior problems
  • Maternal risks
  • Intimate partner violence
  • Food insecurity
  • HIV
  • Longitudinal studies