Physical Abuse in Early Childhood and Transition to First Sexual Intercourse among Youth in Cape Town, South Africa

Article excerpt

Early age of sexual debut may represent a risky sexual behavior, owing to cognitive and emotional immaturity, inexperience, and vulnerability to exploitation and has implications for HIV prevention and programming. Various studies have shown that having sex early in the life course is related to negative outcomes and multiple risk behaviors (Akwara, Madise, & Hinde, 2003; Bankole, Singh, Woog, & Wulf, 2004; Pettifor et al., 2004). Understanding the timing of first sex is particularly important because it is associated with subsequent risk behaviors such as non-use of condoms and multiple sexual partner relationships (see Hulton, Cullen, & Khalokho, 2000; Odu et al., 2008; Zulu, Dodoo, & Chika-Ezeh, 2002). Early sexual initiation has also been linked to lower academic achievement, binge drinking, and substance use (Tapert, Aarons, Sedlar, Sandra, & Brown, 2001; Warren et al., 1997).

Childhood physical abuse, which is prevalent in South Africa (Pierce & Bozalek, 2004; Richter & Dawes, 2008), has been identified as a risk factor for early initiation of sexual intercourse (Black et al., 2009; Briere & Runtz, 1988; Meston, Heiman, & Trapnell, 1999). Yet very little is known about the impact of childhood physical abuse and other psychosocial experiences of youth on the timing of first sex in both sub-Saharan Africa and, specifically, South Africa. Although previous studies have focused exclusively on the impact of childhood sexual abuse on the sexual outcomes of young people, little or no reference is made to how other forms of abuse--in particular, physical abuse affect the sexual experiences of youth in later years (Bensley, Eenwyk, & Simmons, 2000; Mullen, Martin, Anderson, Romans, & Herbison, 1994; Ompad et al., 2005; Parillo, Freeman, Collier, & Young, 2001; Tyler, Hoyt, Whitbeck, & Cauce, 2001). Using longitudinal data from the Cape Area Panel Survey (CAPS), this study explored the relationship between childhood physical abuse and the timing of first sexual intercourse among young South Africans in Cape Town.

Childhood Physical Abuse and Early Sexual Onset

Different and conflicting definitions of childhood physical abuse exist, and the concept has diverse legal, medical, psychological, and sociological interpretations that may vary across time and culture. What is considered childhood physical abuse in some cultures may be the norm in others. In the South African context, childhood physical abuse was historically "racialized," with only Whites as its identified legitimate target (see Pierce & Bozalek, 2004; Richter & Dawes, 2008). Notwithstanding this, it is widely agreed that abuse is a function of proscribed parental behaviors or children's harmful environments (Besharov, 1981; Edwards, Holden, Felliti, & Anda, 2003; Meyerson, Long, Miranda, & Marx, 2002). Some have indicated that childhood physical abuse can include physical injury, neglect, emotional abuse, and sexual abuse (Meston et al., 1999; Edwards et al., 2003; Sidebotham, 2000). The multidimensional nature of childhood physical abuse makes it, understandably, a very difficult construct to measure. For the purposes of this study, we focused on the first three dimensions of childhood physical abuse: physical injury, neglect, and emotional abuse.

Physical abuse, as defined in this research context, is considered a risk factor for various antisocial outcomes including emotional distress, depression, low self-esteem, dependency, scholastic underachievement, and risky sexual behavior (Briere & Runtz, 1988; Cassels, 2010; Meston et al., 1999; Springer, 2010). For instance, research by Black et al. (2009) indicated that female youth with a history of physical abuse were more likely to initiate sexual intercourse by age 14 than those without such a history. Similarly, Wise, Palmer, Rothman, and Rosenberg (2009) discovered that childhood physical abuse had a weak, but significant, impact on age at menarche, as women who experienced such abuse reported early menarche compared to those who did not. …