Victimization among adolescent children of female sex workers: findings from the Children of At-Risk Parents (CARP) study in Uganda

Abstract Background: Female sex workers (FSWs) live in high-risk environments, experience high levels of adversity and have multigenerational trauma that can negatively affect their children, yet there is only minimal information on victimization among children of FSWs. This study aimed to evaluate the association between maternal sex work and victimization among adolescents in Uganda.Methods: The sample consisted of 294 respondents to the Children of At-Risk Parents (CARP) study, a comparative cross-sectional quantitative study among adolescents in Northern Uganda. We collected data among 147 adolescent children (10-17 years) of FSWs and 147 adolescent children of non-FSWs. We screened for victimization using the Juvenile Victimization Questionnaire. The data were analyzed using STATA version 14. Results: The prevalence of lifetime victimization stood at 99.3% but on average, each adolescent experienced 12.4 out of 34 different victimizations. Significantly, the adolescent children of FSWs were exposed to more victimizations than their comparators (13.4 vs 11.5; p<0.01). Specifically, compared with the adolescent children of non-FSWs, more adolescent children of FSWs experienced kidnap (15.8% vs 4.8%; p<0.01), emotional abuse (65.8% vs 50.0%; p<0.05), neglect (37.4% vs 21.1%; p<0.01), physical intimidation (10.2% vs 4.1%; p<0.05), relational aggression (36.4% vs 18.4%; p<0.01), verbal aggression (68.7% vs 46.9%; p<0.001), sexual victimization (31.3% vs 17.7%; p<0.01), verbal sexual harassment (20.4% vs 5.4%: p<0.001), exposure to murder scene (42.9% vs 26.5%; p<0.01), witness to domestic violence (39.5% vs 26.5%; p<0.05), and witness to murder of relatives (31.3% vs 21.1%; p<0.05). Conversely, the adolescent children of non-FSWs reported more caregiver victimization (98.0 vs 92.5; p<0.05) than the adolescent children of FSWs. Conclusions: Disproportionately, children of FSWs are more likely to experience victimization than children of non-FSWs. Therefore, government and development partners must deliberately develop policies and programs targeting victimizations among children of FSWs.