Associations between WASH-related violence and depressive symptoms in adolescent girls and young women in South Africa (HPTN 068): a crosssectional analysis
Date
2022-06-13
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Abstract
Objective There is a lack of research on experiences
of WASH-related violence. This study aims to quantify
the association between experience or worry of violence
when using the toilet or collecting water and depressive
symptoms among a cohort of young women in South
Africa.
Methods Data are from visit 3 of the HPTN 068 cohort of
adolescent girls in rural Mpumalanga Province, South Africa.
Participants (n=1798) included in this analysis were aged
13–21 at baseline. Lifetime experience of violence or fear
of violence when using the toilet and collecting water was
collected by self-report; depressive symptoms in the past
week were measured using the Center for Epidemiological
Studies Depression Scale (CES-D). We used G-computation
to calculate the prevalence difference (PD) and prevalence
ratio of depression (CES-D score >15) associated with each
domain of violence, controlling for baseline covariates.
Findings A total of 15.1% of respondents reported
experiencing violence when using the toilet; 17.1%
reported experiencing violence when collecting water and
26.7% reported depression. In adjusted models, those who
reported experiencing violence when using the toilet had
an 18.1% higher prevalence of depression (95% CI: 11.6%
to 24.4%) than those who did not experience violence
when using the toilet. Adjusted prevalence of depression
was also higher among those who reported violence when
collecting water (PD 11.9%, 95% CI: 6.7% to 17.2%),
and who worried about violence when using the toilet (PD
12.8%, 95% CI: 7.9% to 19.8%), as compared with those
who did not report these experiences. Worrying about
violence when collecting water was not associated with
depression after adjusting for covariates.
Conclusion Experience of WASH-related violence is
common among young women in rural South Africa, and
experience or worry of experiencing violence is associated
with higher prevalence of depressive symptoms.