Latent classes of adverse childhood experiences and adult health and behavioural outcomes in Haiti's Cité Soleil

Exposure to adverse childhood experiences (ACEs) is associated with harmful biopsychosocial and behavioral outcomes in adulthood and with reduced community capacity. We investigated the prevalence of ACEs and differential risk of adverse adult outcomes based on latent class assignment in a resource-limited, high-violence and understudied setting of urban Haiti, i.e., Cit & eacute; Soleil (N 673, 41.4% men, 58.6% women, mean age 28.5). We identified 3 distinct classes and evaluated associations between class membership and ACE correlates (e.g., experience of non-partner sexual violence as adults [NPSV], suicidal ideation [SI], substance use). 100% reported at minimum one ACE; 70% reported physical and emotional abuse as ACEs; 47% reported experience of child sexual abuse (CSA). Family dysfunction existed across all three classes. Class 2 members were at highest risk for adverse adult outcomes and were distinguished by experience of CSA. Substance use, SI, fear of going outside, NPSV experience, and hypervigilance increased odds of Class 2 assignment. Education, access to health care, and being men NPSV survivors reduced odds of Class 2 assignment. ACEs are prevalent in this sample and are associated with adverse adult outcomes, but some are more at risk. Haiti needs ACE prevention and trauma-informed care at the population level.