The Association of Positive Childhood Experiences with Sexual Violence, Mental Health, and Behavioral Outcomes Among Urban Haitians Affected by Forced Displacement

In Haiti’s Cité Soleil, residents face high risks of child and adolescent sexual abuse (CASA), adult non-partner sexual violence (NPSV), extreme poverty and gang-driven displacement. Prior studies link childhood adversity to harmful adult health and behavioral outcomes. Little is known about associations of positive childhood experiences (PCEs) with CASA, NPSV, displacement, and adult outcomes in Cité Soleil. The extreme adversity and systemic violence in Cité Soleil make it a critical setting to examine whether PCEs can influence outcomes. In this study, 672 residents completed surveys assessing PCEs, adverse childhood experiences (ACEs) and their known adult outcomes, NPSV experience, displacement history, and socio-demographic characteristics. Data were analyzed using STATA 19. Nearly half reported CASA, 25.9% reported NPSV, and 17.7% experienced both, with women disproportionately affected (χ2 = 63.30, p < .001, V = 0.32). Three quarters reported forced displacement, which was not significantly associated with sexual violence exposure. Nearly half of participants (46.5%) reported high PCE scores (6–7), with a mean of 5.08 (SD = 1.69). Overall PCEs were not significantly associated with sexual violence exposure or adult mental health and behavioral outcomes. However, perceived peer support was significantly associated with a reduced likelihood of experiencing both CASA and NPSV. Over half (58.09%) endorsed community collaboration to solve problems. Adverse adult outcomes, including suicidal ideation, sleep disturbance, and avoidance behaviors, were pervasive regardless of PCE level. Findings suggest that in contexts of chronic insecurity and systemic violence, PCEs may not be protective. Interventions must address individual, interpersonal, community, and broader structural and sociocultural factors.