Background Adverse childhood experiences (ACEs) are traumatic events like abuse or neglect that are associated with dangerous behaviors like violence and substance abuse during adulthood. ACEs contribute to the development of chronic non-communicable diseases like cardiovascular diseases, diabetes, and mental health disorders, which collectively account for over 70% of global deaths yearly. Research on ACEs has been limited in low-to-middle-income countries, like Honduras, which is ranked 5th globally in violence and 131st out of 191 in healthcare. The lack of studies on the driving factors behind violence and health disparities in Honduras has hindered the understanding of the relationship between ACES, violence, and health outcomes. Thus, this cross-sectional study aims to assess the impact of ACEs on violence and poor health outcomes amongst Honduran university students.

Methods This cross-sectional study comprised randomly selected students from Universidad Nacional Autónoma de Honduras which participated in a baseline eligibility screening survey followed by three self-administered Spanish questionnaires completed from 11/01/2023 to 11/05/2023. Questionnaires included ACEs, Maudsley Violence Questionnaire (MVQ), and Tobacco, Alcohol, Prescription Medications, and Other Substances (TAPS) questionnaires. The sample size of 287 Honduran University students comprised 101 males (SD=2.6) and 186 females (SD=2.6) with ages between 17-33 (M=21; SD=2.7). The relationship between ACEs and MVQ was assessed through correlation analyses (Pearson r). The relationship between ACEs or MVQ and TAPS was assessed using Spearman correlations (rho). The statistical significance was set at p<0.05.

Results Participants completed the ACEs questionnaire, reporting experiencing 0 ACEs (14.2%), 1 ACE (12.8%), 2 ACEs (13.2%), 3 ACEs (20.2%), 4 ACEs (16.3%), 5 ACEs (9.75%), and 6+ ACEs (13.2%).

A positive correlation was observed between the number of ACEs and MVQ macho (Pearson’s r=0.16, P=0.0083). Tobacco usage showed a positive correlation with MVQ macho (rho=0.19) and total scores (rho=0.19, p-value=0.0015). Drug usage was positively correlated with ACEs total (rho=0.12, p-value=0.0491), MVQ macho (rho=0.09, p-value=0.1327), MVQ acceptance (rho=0.12, p-value=0.0486), and MVQ total (rho=0.19, p-value=0.0014).

Medication usage showed positive correlations with total ACEs (rho=0.22, p-value=0.0001), MVQ macho (rho=0.17, p-value=0.0041), MVQ acceptance (rho=0.22, p-value=0.0002), and MVQ total (rho=0.19, p-value=0.0011).

Conclusion This study identified a significant positive correlation between ACEs scores, MVQ scores, and TAPS scores. Over 80% of participants reported experiencing one ACE, aligning with research suggesting higher ACE scores in marginalized populations. The novelty of this research in Honduras offers insights that can inform national programs aimed at violence reduction and public health initiatives focused on preventing childhood trauma.