Prevalence and Correlates of Forced Sex Perpetration and Victimization in Botswana and Swaziland

Objectives. We sought to identify correlates of forced sex perpetration among men and victimization among women in Botswana and Swaziland. Methods. We surveyed a 2-stage probability sample of 2074 adults from the 5 districts of Botswana with the highest HIV prevalence rates and all 4 regions of Swaziland. We used multivariable logistic regression to identify correlates of forced sex victimization and perpetration. Results. Lifetime prevalence rates of forced sex victimization of women were 10.3% in Botswana and 11.4% in Swaziland; among men, rates of perpetration were 3.9% in Botswana and 5.0% in Swaziland. Lifetime history of forced sex victimization was the strongest predictor of forced sex perpetration by men in Botswana (adjusted odds ratio [OR]=13.70; 95% confidence interval [CI]=4.55, 41.50) and Swaziland (adjusted OR=5.98; 95% CI=1.08, 33.10). Problem or heavy drinking was the strongest predictor of forced sex victimization among women in Botswana (adjusted OR=2.55; 95% CI=1.19, 5.49) and Swaziland (OR=14.70; 95% CI=4.53, 47.60). Conclusions. Sexual violence in Botswana and Swaziland is a major public health and human rights problem. Ending codified gender discrimination can contribute to fundamentally changing gender norms and may be an important lever for gender-based violence prevention in these countries. (Am J Public Health. 2011;101:1068-1074. doi:10.2105/AJPH.2010.300060)