Violence and Racial Discrimination in South African Youth: Profiles of a Continuum of Exposure

Objectives: In high-violence countries with limited resources, it can be difficult to identify youth who are at greatest risk for poor health outcomes due to violence exposure. Profile analysis can help achieve this goal by identifying at-risk groups based on multi-variable patterns, especially if the indicators of violence exposure are sensitive enough to identify most of the youth who are at-risk for poor health, but specific enough to identify subpopulations of youth who might benefit most from intervention programs. Methods: We conducted profile analyses to identify subgroups of secondary school students in South Africa (N = 1,317; 54% female; 40% Black; 50% Coloured; 8% White; 2% other races) who were at highest risk for substance use and risky sexual behaviors based on their exposure to different forms of violence, including witnessing violence in the community, at home, and at school, and directly experiencing community violence and racial discrimination. Results: Our analyses yielded five profiles: youth with (1) low-violence exposure; (2) average violence exposure ; (3) high exposure to violence at home; (4) high community victimization; and (5) very high violence exposure characterized by high to very high direct and indirect violence exposure at home, school, and in the community, and moderate levels of personal racial discrimination. Profiles were differentially associated with risk behavior. Conclusions: These data underscore the need to examine racial discrimination on the continuum of exposure to violence, as it may exacerbate the effects of exposure to other types of violence and the likelihood of risky behaviors