Gender-based violence is generally understood to include physical, sexual, and psychological abuse from intimate partners, sexual violence by nonpartners, sexual abuse of girls, and acts such as trafficking women for sex (2).
Since the 1993 World Bank report on health highlighted gender-based violence as a priority public health concern (3), information on the prevalence of gender-based violence has increased dramatically (4, 5).
Data were drawn from a larger study of gender-based violence and HIV carried out in Soweto, South Africa, between November 2001 and April 2002.
Participants were recruited from antenatal clinics in three community health centers and Soweto’s single public hospital.
One recent meta-analysis of revictimization literature found no independent effect for the choice of age cutoff on the magnitude of associations between child sexual assault and adult victimization (6).
Studies from the United States that examined child, adolescent, and adult sexual violence separately have suggested that adolescent victimization may be more strongly associated with adult revictimization than sexual assault in childhood (8, 11, 12), highlighting the potential importance of violent experiences associated with the onset of sexual activity.
Received for publication May 1, 2003; accepted for publication February 5, 2004.
Child sexual assault was associated with increased risk of physical and/or sexual partner violence (risk ratio = 2.43, 95% confidence interval: 1.93, 3.06) and with adult sexual assault by a nonpartner (risk ratio = 2.33, 95% confidence interval: 1.40, 3.89).Women arrived at the clinics early each weekday morning, and the patient queue was established prior to commencement of voluntary counseling for HIV.The number of women seeking care at each clinic on a given day ranged from zero to over 50.A team of six South African female fieldworkers trained in gender-based violence and HIV/acquired immunodeficiency syndrome awareness visited the clinics in a systematic rotation and screened women who had received HIV pretest counseling for possible participation in the study.When patient volume in a clinic was low (generally 12 patients or less), all patients were screened for eligibility as they completed voluntary counseling for HIV; when patient volume was higher, we used the established clinic queues to systematically sample women for eligibility screening.