Complex trauma and its relation to hope and hopelessness among young people in KwaZulu-Natal, South Africa

Informed by an existing hope scale, we explored the roles of hope, happiness, and life satisfaction in adolescent risk behaviours in rural KwaZulu-Natal, South Africa, a setting with high HIV prevalence. In 2016 data were collected from two resource-limited communities using in-depth interviews, group discussions and lifeline-drawings with 53 young people (aged 15 to 17 years). Applying both deductive and inductive approaches, thematic analysis was used to analyse the data. Young people felt that there was nothing to do in their communities and no way out of their adverse situations. They experienced trauma of loss due to HIV-related deaths, and lack of support and guidance which they wanted if they were to be more hopeful. Continual and extended exposure to adverse experiences such as community violence and economic hardship had a negative impact on young people’s lives and increased participation in risk behaviours. To develop HIV prevention and resilience interventions in such communities, there is a need to take account of the context of young people’s lives. Rather than ignoring the structural causes of the infection, risk factors should be contextualised as a key component of any attempts to change behaviours. Resource and power inequalities should be addressed rather than developing individualised interventions which may inadvertently increase social inequalities.