Early life factors associated with childhood trajectories of violence among the Birth to Twenty-Plus Cohort in Soweto, South Africa

Violence against children (VAC) has devastating and long-term negative consequences on individuals’ and society’s health, social and economic well-being. There is limited research on the life course experience of VAC, especially in Africa. This study aimed to identify sub-groups of physical & sexual violence victimization patterns separately in childhood, and evaluate early life factors predicting violence trajectories. This study used data from ages 5 to 18 years from the ongoing prospective Birth to Twenty Plus cohort (Bt20+). Children with data on physical and sexual violence in at least 2-time points between 5 and 18 years were included in the analyses. Group-based trajectory modelling was employed to identify groups of children with similar patterns of violence over time, while multivariable logistic regression was used to identify early life factors associated with violence trajectory group membership. Separately, two trajectory groups of physical violence (adolescent limited (65.1%) and chronic increasing (34.9%)) and sexual violence (adolescent limited (74.1%) and late increasing (25.9%)) victimization were identified. Early life factors associated with a higher risk of chronic increasing trajectory group membership, after adjusting for covariates, were being male (aOR 1.67, 95% CI 1.31; 2.10) and having a mother with at least secondary education compared to higher education (aOR 1.73, 95% CI 1.08; 2.76). In addition, residing in middle, compared to low, socioeconomic households (aOR 0.68, 95% CI 0.50; 0.92) was protective against membership in this group. Residing in high compared to low socioeconomic households, was the only early life factor with marginally significant (aOR 0.63, 95% CI 0.42; 0.95) association with membership in the late-increasing sexual violence victimization trajectory group. In conclusion, children follow different violence victimization trajectories over childhood. Identifying early life factors predicting violence trajectories provides key prevention intervention areas that can mitigate children’s violence experience. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Yes ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval for the primary Bt20+ study was obtained from the Human Ethics and Research Committee (HREC-Medical) of the University of Witwatersrand prior to the start of the study (certificate number M111182). Written informed consent was initially obtained from the primary caregivers of the participants and at the appropriate age both children and the caregivers then provided written informed consent. For this secondary data analyses, permission to use the data was granted by Development Pathways for Health Research Unit (DPHRU) responsible for the primary study and a memorandum of agreement signed. Ethical clearance for the current study was granted by HREC-Medical at the University of Witwatersrand (certificate number M230218). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable The Birth to Twenty-Plus Cohort data underlying the results presented in the study can be requested from the Birth to Thirty Executive Committee (). Alternatively, the authors can be contacted for a copy of the analytic dataset.