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AbstractViolence victimization is a key threat to adolescents’ well-being in urban slums in sub-Saharan Africa. We examined the association between violence victimization and aspiration–expectations disjunction using cross-sectional data from 2360 girls aged 11–15 years in a slum settlement in Nairobi, Kenya. We conducted bivariate and multivariate analyses to assess the association between violence victimization and aspirations–expectations disjunction, a measure of the difference between aspirations and expectations for achieving them. One-third (n = 798) of girls had experienced at least one form of violence. At bivariate and multivariate level, violence victimization was significantly associated with higher aspirations–expectations disjunction but not with aspirations, suggesting that girls who had experienced violence had lower expectations for achieving aspirations. Results imply that girls who experience violence may lose hope in their future. Interventions to screen girls for violence victimization and enable positive coping may be critical.

BackgroundExpanding access to antiretroviral therapy (ART) means that HIV is no longer a death sentence. This change has implications for reproductive decisions and behaviors of HIV-infected individuals.DesignUsing multiple rounds of biomarker data from Demographic and Health Surveys (2004–2012) in nine sub-Saharan African countries, we compare patterns of associations between HIV status and fertility intention and between current use of modern contraception and HIV status in the context of expanding ART coverage.ResultsGenerally, results show that knowledge of HIV status and proportion of women ever tested for HIV increased substantially between the two surveys for almost all countries. Whereas modern contraceptive use slightly increased, fertility intentions remained relatively stable, except for Rwanda, where they decreased. Results from the two surveys for the nine countries do however indicate that there is no clear consistent pattern of fertility intention and modern contraceptive use behavior by HIV status, with variations observed across countries. However, multivariate analyses show that for Rwanda and Zimbabwe women who were HIV positive, with knowledge of their status, had lower odds of wanting more children. Similarly only in Rwanda (both surveys) were HIV-positive women who knew their status more likely to be current users of contraception compared with women who were HIV negative. The reverse was observed for Zimbabwe.ConclusionsGenerally, the results point to the fact that the assumption that reproductive intention and behavior of HIV-positive women will differ compared with that of HIV-negative women may only hold true to the extent that women know their HIV status. Continuous expansion of voluntary counseling and testing services and integration of HIV treatment and care services with reproductive health services are thus warranted.