Clea Sarnquist1, Benjamin Omondi2, Jake Sinclair3, Carolinah Gitau2, Lee Paiva4, Munyae Mulinge5, David N Cornfield1, Yvonne Maldonado1. 1. Department of Pediatrics, Stanford University School of Medicine, Stanford, California; 2. UJAMAA Africa, Nairobi, Kenya; 3. John Muir Medical Center, Walnut Creek, California; UJAMAA United States of America, San Francisco, California; jakesinclairmd@gmail.com. 4. No Means No Worldwide, San Francisco, California; and. 5. United States International University, Nairobi, Kenya.
Abstract
BACKGROUND AND OBJECTIVE: Sexual assault is a major cause of injury, unplanned pregnancy, HIV infection, and mental health problems worldwide. In parts of sub-Saharan Africa, sexual assault has reached epidemic proportions. This study evaluated the efficacy of an empowerment and self-defense intervention for adolescent girls to decrease the incidence of sexual assault and harassment in Nairobi's large informal settlements. METHODS: A prospective cohort of 1978 adolescents from 4 neighborhoods near Nairobi were taught empowerment, deescalation, and self-defense skills in six 2-hour sessions. The standard-of-care (SOC) group (n = 428) received a life skills class. Self-reported, anonymous survey data were collected at baseline and 10.5 months after intervention. RESULTS:Annual sexual assault rates decreased from 17.9/100 person-years at baseline to 11.1 at follow-up (rate ratio = 1.61; 95% confidence interval [CI], 1.26-1.86; P < .001); there was no significant change in the SOC group (14.3 to 14.0, rate ratio = 1.02; 95% CI, 0.67-1.57, P = .92). Sexual assault disclosure in the intervention group increased from 56% to 75% (P = .006), compared with a constant incidence of disclosure (53%) in the SOC group. The majority (52.3%) of adolescents in the intervention group reported using skills learned to stop an assault. CONCLUSIONS: This intervention decreased sexual assault rates among adolescent girls in Kenya. The intervention was also associated with an increase in the disclosure of assaults, thereby enabling survivors to seek care and support and possibly leading to the identification and prosecution of perpetrators. This model should be adaptable to other settings both in Africa and globally.
RCT Entities:
BACKGROUND AND OBJECTIVE: Sexual assault is a major cause of injury, unplanned pregnancy, HIV infection, and mental health problems worldwide. In parts of sub-Saharan Africa, sexual assault has reached epidemic proportions. This study evaluated the efficacy of an empowerment and self-defense intervention for adolescent girls to decrease the incidence of sexual assault and harassment in Nairobi's large informal settlements. METHODS: A prospective cohort of 1978 adolescents from 4 neighborhoods near Nairobi were taught empowerment, deescalation, and self-defense skills in six 2-hour sessions. The standard-of-care (SOC) group (n = 428) received a life skills class. Self-reported, anonymous survey data were collected at baseline and 10.5 months after intervention. RESULTS: Annual sexual assault rates decreased from 17.9/100 person-years at baseline to 11.1 at follow-up (rate ratio = 1.61; 95% confidence interval [CI], 1.26-1.86; P < .001); there was no significant change in the SOC group (14.3 to 14.0, rate ratio = 1.02; 95% CI, 0.67-1.57, P = .92). Sexual assault disclosure in the intervention group increased from 56% to 75% (P = .006), compared with a constant incidence of disclosure (53%) in the SOC group. The majority (52.3%) of adolescents in the intervention group reported using skills learned to stop an assault. CONCLUSIONS: This intervention decreased sexual assault rates among adolescent girls in Kenya. The intervention was also associated with an increase in the disclosure of assaults, thereby enabling survivors to seek care and support and possibly leading to the identification and prosecution of perpetrators. This model should be adaptable to other settings both in Africa and globally.
Authors: Kimberly H Nguyen; Howard Kress; Victor Atuchukwu; Dennis Onotu; Mahesh Swaminathan; Obinna Ogbanufe; Wezi Msungama; Steven A Sumner Journal: J Interpers Violence Date: 2018-02-15
Authors: Michael Baiocchi; Benjamin Omondi; Nickson Langat; Derek B Boothroyd; Jake Sinclair; Lee Pavia; Munyae Mulinge; Oscar Githua; Neville H Golden; Clea Sarnquist Journal: Prev Sci Date: 2017-10
Authors: H Luz McNaughton Reyes; Laurie M Graham; May S Chen; Deborah Baron; Andrew Gibbs; Alison K Groves; Lusajo Kajula; Sarah Bowler; Suzanne Maman Journal: Lancet Child Adolesc Health Date: 2020-11-19
Authors: Michele R Decker; Shannon N Wood; Esther Ndinda; Gayane Yenokyan; Jacob Sinclair; Nankali Maksud; Brendan Ross; Benjamin Omondi; Martin Ndirangu Journal: BMC Public Health Date: 2018-12-04 Impact factor: 3.295