Substance abuse and behavioral correlates of sexual assault among South African adolescents.
OBJECTIVE
The aim of this article is twofold: first, to examine the prevalence of being the victim of actual and attempted rape among a large representative sample of Cape Town high school students; and second, to identify the correlates of sexual assault for both boys and girls, including alcohol, tobacco and other drug use, behavioral problems, and suicidality.


METHODS
Data for this study were derived from the 1997 South African Community Epidemiology Network on Drug Use (SACENDU) school survey. A stratified sampling procedure was used to select students in Grades 8 and 11 at non-private high schools in Cape Town. A total of 2,946 students completed a survey consisting of socio-demographic questions and items about substance abuse, sexual activity, and other adolescent health risk behaviors. A subsample of 939 was randomly selected to complete items about sexual violence.


RESULTS
The results revealed that 8.4% of respondents were victims of attempted rape, while 5.8% were victims of actual rape. Ordinal logistic regression showed that girls were 3.9 times more likely than boys to have been victims of sexual abuse. Family structure was also significantly related to rape as persons who lived with a single parent (OR = 1.74, CI = 1.00-3.04) and those who resided with one biological parent and one step parent (OR = 2.59, CI = 1.34-5.01) were more likely to have been have been victims of sexual abuse than those living with both biological parents. Alcohol use (OR = 2.0, CI = 1.10-3.62), anti-social behavior (stolen property, caused physical damage to property, bullied others, or been in physical fights) (OR = 1.44, CI = 1.12-1.86), suicidal dialogue (OR = 2.48, CI = 1.19-5.19), and suicidal attempts (OR = 3.2, CI = 1.65-6.30) were also significant predictors of sexual abuse victimization. Racially classified social groups (RCSG), age, drug use, and cigarette smoking were not significant predictors of sexual abuse victimization, while socioeconomic status was found to be marginally significant.


CONCLUSIONS
This study reinforces the importance of multiple factors including alcohol use, anti-social behavior, suicidal thoughts and actions, and family structure with respect to sexual assault of adolescents in South Africa. Establishing and strengthening intervention programs, school based child protective protocols, professional education of teachers and school personnel, community prevention programs, and initiatives could help prevent adolescent sexual violence and reduce the sequelae associated with this problem.
King
Gary
G
Department of Biobehavioral Health, 315 HHDE, Penn State University, University Park, PA 16802, USA.
Flisher
Alan J
AJ
Noubary
Farzad
F
Reece
Robert
R
Marais
Adele
A
Lombard
Carl
C
D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking; D019548:Crime Victims; D003625:Data Collection; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011902:Rape; D012307:Risk Factors; D012919:Social Behavior; D013019:South Africa; D019966:Substance-Related Disorders / Q000523:psychology*; D013406:Suicide, Attempted