Knowledge and attitude towards rape and child sexual abuse--a community-based cross-sectional study in rural Tanzania.
BACKGROUND
Violence against women and children is globally recognized as a social and human rights concern. In Tanzania, sexual violence towards women and children is a public health problem. The aim of this study was to determine community knowledge of and attitudes towards rape and child sexual abuse, and assess associations between knowledge and attitudes and socio-demographic characteristics.


METHODS
A cross-sectional study was undertaken between May and June 2012. The study was conducted in the Kilombero and Ulanga rural districts in the Morogoro Region of Tanzania. Men and women aged 18-49 years were eligible for the study. Through a three-stage cluster sampling strategy, a household survey was conducted using a structured questionnaire. The questionnaire included socio-demographic characteristics, attitudes about gender roles and violence, and knowledge on health consequences of rape. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 21. Main outcome measures were knowledge of and attitudes towards sexual violence. Multivariate analyses were used to assess associations between socio-demographic characteristics and knowledge of and attitudes towards sexual violence.


RESULTS
A total of 1,568 participants were interviewed. The majority (58.4%) of participants were women. Most (58.3%) of the women respondents had poor knowledge on sexual violence and 63.8% had accepting attitudes towards sexual violence. Those who were married were significantly more likely to have good knowledge on sexual violence compared to the divorced/separated group (AOR = 1.6 (95% CI: 1.1-2.2)) but less likely to have non-accepting attitudes towards sexual violence compared to the single group (AOR = 1.8 (95%CI: 1.4-2.3)). Sex of respondents, age, marital status and level of education were associated with knowledge and attitudes towards sexual violence.


CONCLUSIONS
Our study showed that these rural communities have poor knowledge on sexual violence and have accepting attitudes towards sexual violence. Increasing age and higher education were associated with better knowledge and less accepting attitudes towards sexual violence. The findings have potentially important implications for interventions aimed at preventing violence. The results highlight the challenges associated with changing attitudes towards sexual violence, particularly as the highest levels of support for such violence were found among women.
Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, SE-75185, Sweden. muzsalim@yahoo.com.|Department of Obstetrics/Gynecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, P.O.Box 65117, Tanzania. muzsalim@yahoo.com.
Muzdalifat
M
Abeid
Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, SE-75185, Sweden. promuga@yahoo.com.|Department of Obstetrics/Gynecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, P.O.Box 65117, Tanzania. promuga@yahoo.com.
Projestine
P
Muganyizi
Department of Obstetrics/Gynecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, P.O.Box 65117, Tanzania. snanzia@gmail.com.
Siriel
S
Massawe
Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, P.O.Box 65117, Tanzania. rcmpembeni@yahoo.com.
Rose
R
Mpembeni
Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, SE-75185, Sweden. elisabeth.darj@kbh.uu.se.|Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, P.O.Box 8905, Norway. elisabeth.darj@kbh.uu.se.
Elisabeth
E
Darj
Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, SE-75185, Sweden. pia.axemo@kbh.uu.se.
Pia
P
Axemo
D000293:Adolescent; D000328:Adult; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005783:Gender Identity; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011902:Rape / Q000523:psychology / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult