title: Prevalence and correlates of forced sex perpetration and victimization in Botswana and Swaziland.
abstract: OBJECTIVE
  We sought to identify correlates of forced sex perpetration among men and victimization among women in Botswana and Swaziland.
  
  
  METHODS
  We surveyed a 2-stage probability sample of 2074 adults from the 5 districts of Botswana with the highest HIV prevalence rates and all 4 regions of Swaziland. We used multivariable logistic regression to identify correlates of forced sex victimization and perpetration.
  
  
  RESULTS
  Lifetime prevalence rates of forced sex victimization of women were 10.3% in Botswana and 11.4% in Swaziland; among men, rates of perpetration were 3.9% in Botswana and 5.0% in Swaziland. Lifetime history of forced sex victimization was the strongest predictor of forced sex perpetration by men in Botswana (adjusted odds ratio [OR] = 13.70; 95% confidence interval [CI] = 4.55, 41.50) and Swaziland (adjusted OR = 5.98; 95% CI = 1.08, 33.10). Problem or heavy drinking was the strongest predictor of forced sex victimization among women in Botswana (adjusted OR = 2.55; 95% CI = 1.19, 5.49) and Swaziland (OR = 14.70; 95% CI = 4.53, 47.60).
  
  
  CONCLUSIONS
  Sexual violence in Botswana and Swaziland is a major public health and human rights problem. Ending codified gender discrimination can contribute to fundamentally changing gender norms and may be an important lever for gender-based violence prevention in these countries.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, USA. atsai@hsph.harvard.edu
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Tsai
authors.forename: Karen
authors.initials: K
authors.lastname: Leiter
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
authors.forename: Vincent
authors.initials: V
authors.lastname: Iacopino
authors.forename: William
authors.initials: W
authors.lastname: Wolfe
authors.forename: Kate
authors.initials: K
authors.lastname: Shannon
authors.forename: Nthabiseng
authors.initials: N
authors.lastname: Phaladze
authors.forename: Zakhe
authors.initials: Z
authors.lastname: Hlanze
authors.forename: Sheri D
authors.initials: SD
authors.lastname: Weiser
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D001902:Botswana / Q000453:epidemiology; D019548:Crime Victims / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D013541:Eswatini / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D011902:Rape / Q000706:statistics & numerical data*; D012307:Risk Factors