Keeping our core values ALIV[H]E. Holistic, community-led, participatory and rights-based approaches to addressing the links between violence against women and girls, and HIV

Trauma-Informed Research With Emerging Adult Survivors of Sexual Violence

Health researchers have had increasing calls to include vulnerable populations in research to tailor inclusive evidence-based practice interventions. The inclusion of vulnerable populations in research is sensitive and complex. Sensitive topics such as dating and sexual violence are especially complex, with emerging adults the highest risk group for all forms of sexual violence and an especially hard-to-reach population for inclusion in research. Impacts of trauma, including physiological and psychological, complex needs of survivors, and potential for revictimization during interactions when participating in research must be considered. Researchers must be equipped with specialized, trauma-informed skills to safely and ethically conduct all aspects of research. Using the trauma-informed framework, the purpose of this paper is to discuss the complexities of conducting research with emerging adult survivors of sexual violence and to explore evidence-based approaches that can safely include this vulnerable population through the application of trauma-informed approaches. The use of evidence-based, trauma-informed research approaches tailored to engage this population in research can further help to develop effective interventions that are context-sensitive to emerging adults.

Power and poverty: A participatory study on the complexities of HIV and intimate partner violence in an informal urban settlement in Nairobi, Kenya

People in informal urban settlements in Kenya face multiple inequalities, yet researchers investigate issues such as HIV or intimate partner violence (IPV) in isolation, targeting single populations and focusing on individual behaviour, without involving informal settlement dwellers. We formed a study team of researchers (n = 4) and lay investigators (n = 11) from an informal settlement in Nairobi, Kenya to understand the power dynamics in the informal urban settlement that influence vulnerability to IPV and HIV among women and men from key populations in this context. We facilitated participatory workshops with 56 women and 32 men from different marginalised groups and interviewed 10 key informants. We used a participatory data analysis approach. Our findings suggest the IPV and HIV nexus is rooted in the daily struggle for cash and survival in the informal urban settlement where lucrative livelihoods are scarce and a few gatekeepers regulate access to opportunities. Power is gendered and used to exercise control over people and resources. Common coping strategies applied to mitigate against the effects of poverty and powerlessness amplify vulnerabilities to HIV and IPV. These complex power relations create and sustain an environment conducive to IPV and HIV. Prevention interventions thus need to address underlying structural drivers, uphold human rights, create safe environments, and promote participation to maximise and sustain the positive effects of biomedical, behavioural, and empowerment strategies.

Analysis of the trend of mortality from HIV/AIDS according to sociodemographic characteristics in Brazil, 2000 to 2018

This investigation analyzed the trend of HIV/AIDS mortality by sociodemographic characteristics in the Brazilian states from 2000 to 2018. This is an ecological study of time-series of standardized rates of mortality from AIDS overall, by gender, age group, marital status, and ethnicity/skin color, employing the Prais-Winsten generalized linear model. The results showed that the states with the highest rates were Rio Grande do Sul, Rio de Janeiro, São Paulo, and Santa Catarina. The trend was increasing in the North and Northeast. Men had higher rates than women and the general population. The most advanced age groups showed a growing trend. The analysis by marital status showed higher and growing rates among the unmarried. Blacks had higher rates, except for Paraná, with a mainly increasing trend. Mortality due to HIV/AIDS had different trends by sociodemographic characteristics, with a need for preventive and care actions for men, adults, older adults, unmarried, and black people due to the change in the mortality profile.

On the CUSP: the politics and prospects of scaling social norms change programming

In the past decades, donors and development actors have been increasingly mindful of the evidence to support long-term, dynamic social norms change. This paper draws lessons and implications on scaling social norms change initiatives for gender equality to prevent violence against women and girls (VAWG) and improve sexual and reproductive health and rights (SRHR), from the Community for Understanding Scale Up (CUSP). CUSP is a group of nine organisations working across four regions with robust experience in developing evidence-based social norms change methodologies and supporting their scale-up across various regions and contexts. More specifically, the paper elicits learning from methodologies and experiences from five CUSP members - GREAT, IMAGE, SASA!, Stepping Stones, and Tostan. The discussion raises political questions around the current donor landscape including those positioned to assume leadership to take such methodologies to scale, and the current evaluation paradigm to measure social norms change at scale. CUSP makes the following recommendations for donors and implementers to scale social norms initiatives effectively and ethically: invest in longer-term programming, ensure fidelity to values of the original programmes, fund women's rights organisations, prioritise accountability to their communities and demands, critically examine the government and marketplace's role in scale, and rethink evaluation approaches to produce evidence that guides scale-up processes and fully represents the voices of activists and communities from the Global South.