"At a Young Age, I could not Understand My Problems, But Now I Can… I Have Learned Through My Bad Experiences"-A Community-based Mixed-method Study on Adverse Childhood Experiences among the Youth in Southern India.

Background: Adverse Childhood Experiences (ACEs) are stressful or traumatic experiences that arise from household dysfunction, separation of parents, imprisonment of family members, or violence in the community. This study was done to determine the prevalence of adverse childhood experiences among the youth residing in Puducherry and to explore their lived experience in the cultural context. Materials and Methods: A community-based sequential explanatory mixed method study (QUAN→qual) was conducted among the youth residing in Puducherry in the period between June 2021 to December 2022. Participants were chosen using simple random sampling for the quantitative part and purposive sampling for qualitative part. Results: The prevalence of adverse childhood experiences was 57.3% (95% CI 50.9-63.3). The common ACEs were witnessing community violence with a prevalence of 73.7 % (95% CI 67.7-78.9), followed by household members treated violently at 64.7% (95% CI 58.4-7.05), physical abuse at 46.4% (95% CI 40.2-52.8) and emotional abuse 45.0% (95%CI 38.9-51.3). The history of sexual abuse and emotional neglect had a long-term impact on the children. During the qualitative exploration of adversities in the cultural context, categories like non-acceptance of gender dysphoria and economic hardship emerged as other traumatic experiences. Conclusion: One out of two persons had ACE in the community, even when they were staying at home with their parents. Different types of adversities have varying effects on children, so the adversities experienced by children need to be studied in the background of the cultural context.