Intimate Partner Violence, Depression, and Anxiety Are Associated With Higher Perceived Stress Among Both Young Men and Women in Soweto and Durban, South Africa

Abstract

Objectives: Psychological stress is an important determinant of health, including formental well-being and sexual health. However, little is known about the prevalenceand psychosocial and sexual health correlates of perceived stress among youngpeople in South Africa, where elevated life-stressors are an important driver of healthinequities. This study examines the association between intimate partner violence (IPV),psychosocial and sexual health, and perceived stress, by gender, among South Africanadolescents and young adults.Methods: Using baseline survey data from AYAZAZI, a cohort study enrolling youth(16–24 years) from Durban and Soweto, we used the 10-item Perceived Stress Scale(PSS-10) to measure the degree to which an individual perceives their life situationsas unpredictable, uncontrollable, and overloaded. Possible scores range between 0and 40; higher scores indicating higher perceived stress. Crude and adjusted genderstratifiedlinear regression models examined associations between sexual health factors,experiences (young women) and perpetration (young men) of IPV, anxiety (APA 3-itemScale, 2 = probable anxiety), and depression (10-item CES-D Scale, 10 = probabledepression) and perceived stress. Multivariable models adjusted for age, income, sexualorientation, and financial dependents.Results: Of the 425 AYAZAZI participants, 60%were young women. At baseline, 71.5%were students//learners and 77.2% earned ZAR1600 per month ($100 USD). ThePSS-10 had moderate reliability (a = 0.70 for young women, 0.64 for young men). Youngwomen reported significantly higher mean PSS scores than young men [18.3 (6.3) vs.16.4 (6.0)]. In adjusted linear regression models, among young women experiences ofIPV (b = 4.33; 95% CI: 1.9, 6.8), probable depression (b = 6.63; 95% CI: 5.2, 8.1), andprobable anxiety (b = 5.2; 95%CI: 3.6, 6.8) were significantly associated with higher PSSscores. Among young men, ever perpetrating IPV (b = 2.95; 95% CI: 0.3, 5.6), probabledepression (b = 6; 95% CI: 4.3, 7.6), and probable anxiety (b = 3.9; 95% CI: 2.1, 5.8)were significantly associated with higher perceived stress.Conclusion: We found that probable depression, anxiety, perpetration of IPV amongyoung men, and experiences of IPV among young women, were associated with higherperceived stress. Critical efforts are needed to address the gendered stressors of youngmen and women and implement services to address mental health within violenceprevention efforts.