Background: Sexually transmitted Infections (STIs) are a significant public health concern, affecting two-thirds of the youth under 25 years in developing countries. Violence exposure increases engagement in risky sexual behaviors among the youth. However, studies examining STIs, and violence exposure, mental distress, and suicide risk are lacking for youth in Zimbabwe. To address this knowledge gap, this study (1) Assess associations between STIs and exposure to violence and (2) Assess associations between STIs and mental health outcomes among youth in Zimbabwe.
Methods: This study used data from the 2018 Zimbabwe Violence Against Children and Youth Survey, a cross-sectional survey of youth between 13 to 24 years (n= 8,715). The independent variable was sexually transmitted infections (STIs; yes/no). Dependent variables included youth who experienced any violence, physical violence (PV), sexual violence (SV), or witnessed physical violence (PV) before 18 years old (yes/no). Mental distress was measured with the Kessler-6 Psychological Distress Scale, and suicide risk was measured by asking respondents whether they had ever hurt themselves, thought, or attempted suicide (yes/no). Control variables were sex, age, marital status, education, and closeness to biological parents. Cross-tabulations were used to obtain prevalence estimates. Bivariate and logistic regression models were performed between independent and dependent variables.
Results: About 45.5% of youth with STIs experienced violence, 30.8% experienced PV, 16.1% experienced SV, and 42.2% witnessed PV. About 49.8% of the youth with STIs were at risk of suicide, and 44.9% had mental distress. Youth with STIs were more likely to have experienced any form of violence, PV, SV, and witnessed PV than those with no STIs. Equally, youth with STIs had higher odds of being at risk of suicide and mental distress than those without STIs.
Conclusions: Overall, youth with STIs were exposed to violence at some point, which might have increased their risk of engaging in risky sexual behaviors. STIs can carry the additional burden of societal stigma and can lead to severe mental distress and suicide risk. Therefore, education should focus on reducing the stigma of youth with STIs who risk being exposed to violence and minimizing the risk of suicide or mental distress in Zimbabwe.
