Childhood Exposure to Violence and Forced Sexual Initiation — Malawi, 2013

  • Forced first sex is common, and has lifelong consequences
    • Among Malawian girls and women who ever had sex, 38.9% were forced or coerced into their first sex. Previous studies show that forced sexual initiation is associated with being a future victim of sexual violence, mental illness, teenage pregnancy, HIV, and dangerous sexual risk-taking behaviors.
  • Emotional violence is associated with forced first sex
    • Girls and women who experienced any emotional violence in childhood had odds of forced sexual initiation 250% higher than girls who didn’t experience emotional violence in childhood.
  • Emotional Violence is underappreciated as a risk factor for adverse health outcomes
    • Despite several studies that have shown that emotional violence is an independent risk factor for adverse outcomes, emotional violence is underappreciated as a harmful exposure.
Quote from the Disease Detective

“In our study, nearly 40% of Malawian girls’ and young women’s first sexual encounter was forced or coerced. Understanding the risk factors for forced sexual initiation may help to prevent this and other forms of sexual violence. Emotional violence appears to be one such risk factor that is often underappreciated as a harmful exposure.”

-Elizabeth Swedo, MD, MPH, EIS Class of 2017

Contact Information

CDC Media Relations
(404) 639-3286

Conference Information
Elizabeth Swedo, MD, MPH, EIS Class of 2017


Elizabeth Swedo, MD, MPH, EIS Class of 2017
CDC’s National Center for Injury Prevention and Control
Division of Violence Prevention
Research & Evaluation Branch

Education: MD: Emory University, 2012; MPH: Emory University, 2012; BA: Dartmouth College, 2006

Work Experience: Urgent Care Physician, Seattle Children’s Hospital, Seattle, WA, 2015-Present; Clinical Instructor, University of Washington School of Medicine Department of Pediatrics, Seattle, WA, 2016- present; Resident Physician, Seattle Children’s Hospital at University of Washington, 98105, WA, 2012-2015; Work-Study Student, Emory University Department of Pediatrics, Atlanta, GA, 2011-2011; Assistante de Langue (English Teacher), Ecole Pierre et Marie Curie, 2006-2007

Volunteer Experience: Medical Reserve Corps Volunteer, Public Health Reserve Corps + Medical