ASSOCIATIONS BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND ATTITUDES TOWARDS ABUSE AGAINST WOMEN AND CHILDREN AMONG ADOLESCENTS AND YOUNG ADULTS IN MALAWI

The purpose of this study was to examine attitudes towards abuse against women and children between adolescents, aged 13 to 17, who had adverse childhood experiences (ACEs) and those who did not, and young adults, aged 18 to 24, who had ACEs and those who did not. The study also evaluated whether the region of residence moderates the relationship between participants’ adverse childhood experiences and attitudes towards abuse against women and children. Secondary data collected from adolescents and young adults aged 13 to 24 between September and October of 2013 in the Violence Against Children and Young People Malawi Survey (VACS Malawi) was utilized in this cross-sectional retrospective study. The VACS Malawi is a nationally representative cross-sectional household survey that conducted face-to-face interviews with 2162 participants using a four-stage cluster survey design. Multivariate logistic regression was conducted to examine the associations between ACEs, including sexual, physical and emotional abuse and witnessing spousal abuse, and attitudes towards Intimate Partner Violence (IPV) and towards child physical abuse. The results revealed a significant relationship between witnessing spousal abuse and tolerant attitudes towards IPV among adolescents. No significant relationship was found between having ACEs when considering a direct relationship with tolerant attitudes towards child physical abuse among adolescents. However, when considering the region as a moderator, adolescents who were physically abused in the South were less likely to have tolerant attitudes towards child physical abuse than adolescents who were physically abused in the North. Among young adults, no significant relationship was observed between adverse childhood experiences and attitudes towards IPV. However, using the region as a moderator, young adults who witnessed spousal abuse in South and Central were more likely to have tolerant attitudes towards IPV than young adults who witnessed spousal abuse in the North. These findings indicate that associations between ACEs and attitudes towards abuse against women and children vary depending on the type of abuse experienced during childhood. Because ACEs and IPV negatively impact the health of women and children, nurses are well-positioned to develop targeted, educational interventions focused on changing attitudes towards IPV and child physical abuse to help reduce violence and break intergenerational transmission of violence