Background Existing youth violence research lacks an understanding of youth who engage in frequent physical fighting (>12 times per year).

Objective Using nationally representative samples of youth, this study examined the prevalence of ‘frequent fighting’ across 39 countries.

Methods Analyses were based on the Global School-based Student Health Survey of school-attending youth supported by the WHO and the CDC. US data from the Youth Risk Behaviour Survey were included for comparison. The surveys were conducted between 2003 and 2009 and each country dataset included more than 1000 students and was weighted to be nationally representative. Countries were categorised into the following regions: Africa, the Americas, Europe, the Eastern Mediterranean, South East Asia, and the Western Pacific. One-way ANOVA was used to determine regional differences in frequent fighting prevalence.

Results Among the 39 countries used in analyses, the prevalence of frequent fighting was highest in Tunisia (8.4%) and lowest in Myanmar (0.5%). One-way ANOVA and post hoc testing determined that the prevalence of frequent fighting varies significantly by region (F(2, 28)=4.12, p<0.05), with the Eastern Mediterranean having a significantly higher prevalence of frequent fighting than the Americas (p<0.05). The percentage of fighters that reported frequent fighting also varied significantly by region (F(2,28)=3.36, p<0.05), with the Eastern Mediterranean having a higher percentage of frequent fighters than Africa (p<0.05).

Significance The prevalence of frequent fighting varied substantially across the 39 countries examined. More cross-national research is needed to better understand the context of frequent fighting and to inform youth violence prevention efforts.