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Perkins JM, Nyakato V, Kakuhikire B, Sriken J, Schember CO, Baguma C, Namara EB, Ahereza P, Ninsiima I, Comfort AB, Audet CM, Tsai AC. Misperception of Norms About Intimate Partner Violence as a Driver of Personal IPV Attitudes and Perpetration: A Population-Based Study of Men in Rural Uganda. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241254143. [PMID: 38842209 DOI: 10.1177/08862605241254143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Intimate partner violence (IPV) against women is a global public health problem. Conceptual frameworks suggest misperceived norms around IPV might drive perpetration of violence against women in southern and eastern Africa. We conducted a cross-sectional, population-based survey of all men residing in a rural parish in southwest Uganda, eliciting their endorsement of IPV in five hypothetical scenarios and their reported frequency of perpetration of violence against their wife/main partner. They also reported their perceptions about the extent to which most other men in their villages endorsed and/or perpetrated IPV, which we compared against the population data to measure the primary explanatory variable of interest: whether individuals misperceived norms around IPV. We fitted multivariable Poisson regression models specifying personal IPV endorsement and IPV perpetration as the outcomes. Overall, 765 men participated in the study (90% response rate): 182 (24%) personally endorsed IPV, and 78 of 456 partnered men (17%) reported perpetrating one or more acts of IPV at least once per month. Although most men neither endorsed nor reported perpetrating IPV, 342 (45%) men mistakenly thought that most other men in their villages endorsed IPV and 365 (48%) men mistakenly thought that most other men perpetrate IPV at least monthly. In multivariable regression models, men who misperceived most men to endorse IPV were more likely to endorse IPV themselves (adjusted relative risk [aRR] = 2.44; 95% CI [1.66, 3.59]; p < .001). Among partnered men, those who misperceived IPV perpetration to be normative were more likely to perpetrate IPV themselves (aRR = 4.38; [2.53, 7.59]; p < .001). Interventions to correct misperceived norms about IPV may be a promising method for reducing violence against women in rural Uganda.
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Affiliation(s)
- Jessica M Perkins
- Vanderbilt University, Nashville, TN, USA
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Viola Nyakato
- Mbarara University of Science & Technology, Mbarara, Uganda
| | | | | | | | - Charles Baguma
- Mbarara University of Science & Technology, Mbarara, Uganda
| | | | | | | | | | | | - Alexander C Tsai
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Brounéus K, Forsberg E, Bhattarai P, de Mel N, Lonergan K, Peiris P, Roy P, Samarasinghe G, Wanasinghe-Pasqual M. Women, peace and insecurity: The risks of peacebuilding in everyday life for women in Sri Lanka and Nepal. PLoS One 2024; 19:e0303023. [PMID: 38809820 PMCID: PMC11135728 DOI: 10.1371/journal.pone.0303023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/15/2024] [Indexed: 05/31/2024] Open
Abstract
Truth telling processes, initiatives to prosecute war-time perpetrators, and ex-combatant reintegration are examples of common peacebuilding practices after war. Yet, little is known of how women are affected by peacebuilding initiatives such as these, or how they perceive these initiatives for peace. For many women, peace after war does not bring peace to everyday life; research shows that domestic violence increases during and after war. In addition, some peacebuilding measures have been found to increase risk and insecurity, not least for women. To better understand the interconnections between gender and post-conflict attitudes to peacebuilding, we asked 2,041 women and men in Sri Lanka and Nepal of their views on post-war peace initiatives. In line with our expectations, we find that women are more skeptical than men towards peacebuilding measures that involve increased risk in everyday life, such as truth-telling and coexisting with former adversaries and warring groups reintegrating in local communities. There are no gender differences pertaining to peacebuilding initiatives that take place far away at the national level, for example, concerning accountability or, in the case of Nepal, the peace agreement. Our findings suggest that international peacebuilding practice is blind to the everyday insecurities of women after war. That a basic gendered lens is missing from most peacebuilding designs is both alarming and deeply troubling, but identifying this critical aspect provides the opportunity for imperative change. By shedding light on the challenges women face after war, we hope this article contributes to finding ways to mitigate unknown and unintended side-effects of peacebuilding efforts, and thereby to the development of better, evidence-based peacebuilding practice-of benefit to both men and women.
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Affiliation(s)
- Karen Brounéus
- Department of Peace and Conflict Research, Uppsala University, Uppsala, Sweden
| | - Erika Forsberg
- Department of Peace and Conflict Research, Uppsala University, Uppsala, Sweden
| | | | | | - Kate Lonergan
- Department of Peace and Conflict Research, Uppsala University, Uppsala, Sweden
| | | | - Pawan Roy
- Centre for Social Change (CSC), Kathmandu, Nepal
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Karakasi MV, Nikolaidis I, Fotou E, Sapounas A, Patounas A, Sakka S, Ntentopoulos C, Pavlidis P, Voultsos P. Emerging Trends in Intimate Partner Rape and Marital/Spousal Rape During the Biennium 2020 and 2021, Including the COVID-19 Pandemic in Greece. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241247552. [PMID: 38769870 DOI: 10.1177/08862605241247552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Intimate partner or marital/spousal rape is a phenomenon with unique characteristics and dynamics. Furthermore, it is an under-explored, under-defined, under-reported, and widely tolerated phenomenon. Gender-based violence and intimate partner violence are the main topics of the present study. The study aimed at exploring the trends in reported intimate partner and marital/spousal rape, within the wider context of reported domestic violence during the years 2020 and 2021 in Greece. Statistical analysis has not indicated positive correlation between the rate of reported domestic violence per year and the rate of reported domestic rape per year, with the former following an upward trend and the latter maintaining an almost steady course. Similarly, the rate of reported victims of intimate partner rape per year remained almost stable within in the 2 years. Importantly however, in 2021, the rate of reported victims of marital rape per year increased remarkably compared to 2020. In 2021, the rates of reported domestic violence per month and reported domestic rape per month indicated remarkable increase over the period May to December 2021. Notwithstanding, the rates mentioned above remained almost stable over the year 2020, showing an upward trend during the summer months. In August 2020 and 2021 the abovementioned rates reached their peak. In both years, the vast majority of victims of domestic rape were females, mostly between 30 and 45 years of age. The present study indicated an increase in rates of reported domestic violence and reported domestic rape per month after the lockdowns, especially after the second long-lasting lockdown that ended in May 2021. This increase, however, might be only apparent. Further research is needed to study the epidemiology of intimate partner and marital rape over a much longer timespan to provide further insight into the dynamics surrounding a public health concern.
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Affiliation(s)
- Maria-Valeria Karakasi
- University General Hospital of Alexandroupolis, Greece
- Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Eleni Fotou
- Democritus University of Thrace, Alexandroupolis, Greece
| | - Anestis Sapounas
- Public Order Branch, General Policing Division, Domestic Violence Department, Hellenic Police Headquarters, Athens, Greece
| | - Apostolos Patounas
- Public Order Branch, General Policing Division, Domestic Violence Department, Hellenic Police Headquarters, Athens, Greece
| | - Sofia Sakka
- Public Order Branch, General Policing Division, Domestic Violence Department, Hellenic Police Headquarters, Athens, Greece
| | - Charalampos Ntentopoulos
- Public Order Branch, General Policing Division, Domestic Violence Department, Hellenic Police Headquarters, Athens, Greece
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Stöckl H, Sorenson SB. Violence Against Women as a Global Public Health Issue. Annu Rev Public Health 2024; 45:277-294. [PMID: 38842174 DOI: 10.1146/annurev-publhealth-060722-025138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Violence against women, especially intimate partner violence, is recognized as a global public health issue due to its prevalence and global reach. This article outlines the scope of the issue, with respect to its prevalence, health outcomes, and risk factors, and identifies key milestones that led to its global recognition: methodological and data advances, acknowledgment as a criminal justice and health issue, support by the global women's movement, and the robust evidence demonstrating that intimate partner violence is preventable. Key issues for the future include recognition and consideration of intersectionality in research, improvements in the measurement of other forms of violence against women, and the need to scale up prevention efforts that have documented success. Violence against women is an urgent priority as it affects individuals, their families and surroundings, and the entire global health community.
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Affiliation(s)
- Heidi Stöckl
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians-Universität in Munich, Munich, Germany;
- Pettenkofer School of Public Health, Munich, Germany
| | - Susan B Sorenson
- School of Social Policy & Practice; Program in Health & Sciences, School of Arts & Sciences; and Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Carlisle S, Bunce A, Prina M, Cook E, Barbosa EC, McManus S, Feder G, Lewis NV. Trends in outcomes used to measure the effectiveness of UK-based support interventions and services targeted at adults with experience of domestic and sexual violence and abuse: a scoping review. BMJ Open 2024; 14:e074452. [PMID: 38688671 PMCID: PMC11086554 DOI: 10.1136/bmjopen-2023-074452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 03/19/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVES In the UK, a range of support services and interventions are available to people who have experienced or perpetrated domestic and sexual violence and abuse (DSVA). However, it is currently not clear which outcomes and outcome measures are used to assess their effectiveness. The objective of this review is to summarise, map and identify trends in outcome measures in evaluations of DSVA services and interventions in the UK. DESIGN Scoping review. DATA SOURCES MEDLINE, EMBASE, PsycINFO, Social Policy and Practice, ASSIA, IBSS, Sociological abstracts and SSCI electronic databases were searched from inception until 21 June 2022. Grey literature sources were identified and searched. ELIGIBILITY We included randomised controlled trials, non-randomised comparative studies, pre-post studies and service evaluations, with at least one outcome relating to the effectiveness of the support intervention or service for people who have experienced and/or perpetrated DSVA. Outcomes had to be assessed at baseline and at least one more time point, or compared with a comparison group. CHARTING METHODS Outcome measures were extracted, iteratively thematically grouped into categories, domains and subdomains, and trends were explored. RESULTS 80 studies reporting 87 DSVA interventions or services were included. A total of 426 outcome measures were extracted, of which 200 were used more than once. The most commonly reported outcome subdomain was DSVA perpetration. Cessation of abuse according to the Severity of Abuse Grid was the most common individual outcome. Analysis of temporal trends showed that the number of studies and outcomes used has increased since the 1990s. CONCLUSIONS Our findings highlight inconsistencies between studies in outcome measurement. The increase in the number of studies and variety of measures suggests that as evaluation of DSVA services and interventions matures, there is an increased need for a core of common, reliable metrics to aid comparability. PROTOCOL REGISTRATION https://osf.io/frh2e.
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Affiliation(s)
- Sophie Carlisle
- Health Service and Population Research, King's College London, London, UK
| | - Annie Bunce
- Violence and Society Centre, City University of London, London, UK
| | - Matthew Prina
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Elizabeth Cook
- Violence and Society Centre, City University of London, London, UK
| | | | - Sally McManus
- Violence and Society Centre, City University of London, London, UK
- National Centre for Social Research, London, UK
| | - Gene Feder
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Natalia V Lewis
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Lemon CA, Svob C, Bonomo Y, Dhungana S, Supanya S, Sittanomai N, Diatri H, Haider II, Javed A, Chandra P, Herrman H, Hoven CW, Sartorius N. Priorities for research promoting mental health in the south and east of Asia. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 23:100287. [PMID: 38404519 PMCID: PMC10884971 DOI: 10.1016/j.lansea.2023.100287] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 02/27/2024]
Abstract
Progress in promoting mental health, preventing mental illness, and improving care for people affected by mental illness is unlikely to occur if efforts remain separated from existing public health programs and the principles of public health action. Experts met recently to discuss integrating public health and mental health strategies in the south and east of Asia, especially in low- and middle-income countries. Areas of research identified as high priority were: 1) integrating mental health into perinatal care; 2) providing culturally-adjusted support for carers of people with mental and physical disorders; 3) using digital health technologies for mental health care in areas with limited resources and 4) building local research capacity. Selection of these areas was informed by their relative novelty in the region, ease of implementation, likely widespread benefit, and potential low costs. In this article, we summarise available evidence, highlight gaps and call for collaborations with research centres, leaders and persons with lived experience within and beyond the region.
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Affiliation(s)
- Christopher A. Lemon
- NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Connie Svob
- Department of Psychiatry, College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, United States of America
| | - Yvonne Bonomo
- Department of Medicine, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Victoria, Australia
- Department of Addiction Medicine, St Vincent's Hospital, Melbourne, Australia
| | - Saraswati Dhungana
- Department of Psychiatry, Institute of Medicine, Tribhuvan University, Nepal
| | - Suttha Supanya
- Somdet Chaopraya Institute of Psychiatry, Department of Mental Health, Bangkok, Thailand
| | - Napat Sittanomai
- Division of Child and Adolescent Psychiatry, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Hervita Diatri
- Department of Psychiatry, Faculty Medicine Universitas Indonesia and Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | - Afzal Javed
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christina W. Hoven
- Department of Psychiatry, College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, United States of America
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland
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Ayubi M, Satyen L. Factors Associated with Intimate Partner Violence Perpetration Among Migrant Men: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1365-1381. [PMID: 37300321 PMCID: PMC10913363 DOI: 10.1177/15248380231178758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Intimate partner violence (IPV) is the most widespread form of violence against women and the most common perpetrators are male partners. Immigration can involve stressors and barriers that are linked to male IPV perpetration. The objective of this systematic review was to identify the factors associated with IPV perpetration among migrant men. Four electronic databases, MEDLINE Complete, Embase, PsycInfo, and SocINDEX with full text, were searched up to August 2021. Studies were selected that examined factors associated with IPV perpetration among first-generation migrants who identified as men/males and were aged 18 years or older. In all, 18 articles met the eligibility criteria for the review, representing a total of 12,321 male participants, including 4,389 migrant men. A wide range of factors associated with IPV perpetration were found at the individual, relationship, community, and societal levels. Unique risk factors for migrant men's IPV perpetration were exposure to political violence, deportation experiences, and minimal legal sanctions for perpetration in some countries of origin. Societal factors explored among Latino immigrants were traditional gender roles such as machismo and norms of violence. All identified factors should be considered in the cultural contexts of the relevant samples and should not be generalized to all migrant men. The findings of modifiable and culture-specific factors have important implications for strategies aimed at reducing IPV perpetration. Future research should explore factors associated with IPV perpetration within specific cultures rather than across broad cultural groupings.
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Wei X, Wang W, Law YW, Zhang H. The Impacts of Intimate Partner Violence on Postpartum Depression: An Updated Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1531-1550. [PMID: 37480328 DOI: 10.1177/15248380231188068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
The associations between intimate partner violence (IPV) and postpartum depression (PPD) have been well established in previous reviews. However, none has explored potential differences between IPV subtypes or exposure times, which could help healthcare providers recognize the adverse impacts of various IPV subtypes and conduct comprehensive IPV screening. This study aimed to estimate the impacts of overall IPV and its subtypes (physical, psychological, and sexual) on PPD using an updated meta-analysis and to examine the potential role of IPV exposure time and regional income levels. Four English databases (Medline, PsycINFO, PubMed, and Web of Science) and two Chinese databases (China National Knowledge Infrastructure [CNKI] and Wanfang Database) were systematically searched. We included 76 studies with 388,966 samples. Random-effects models were used to pool the odds ratios (ORs) across studies. Overall, IPV and its subtypes had statistically significant impacts on PPD (overall: OR = 2.50, physical: OR = 2.31, psychological: OR = 2.22, sexual: OR = 1.75). A higher impact of IPV on PPD was observed in middle- and low-income regions (OR = 3.01) than in high-income regions (OR = 1.92). IPV during pregnancy (OR = 2.73) had a greater impact on PPD than lifetime IPV (OR = 2.24). This study provides updated evidence for the significant impact of IPV and its subtypes and exposure time on PPD. Women at risk of exposure to physical IPV, especially during pregnancy, are in urgent need of support to reduce the risk of PPD.
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Affiliation(s)
- Xinyi Wei
- The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Yik Wa Law
- The University of Hong Kong, Pokfulam, Hong Kong
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Bandara P, Page A, Rajapakse T, Knipe D. Intimate partner violence, suicide and self-harm in Sri Lanka: Analysis of national data. PLoS One 2024; 19:e0298413. [PMID: 38512911 PMCID: PMC10956877 DOI: 10.1371/journal.pone.0298413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/25/2024] [Indexed: 03/23/2024] Open
Abstract
There is increasing evidence from South Asia and internationally that intimate partner violence (IPV) is strongly associated with self-harm, however its association with suicide and self-harm has not been extensively examined, nor has this relationship been explored at a national level. Using national datasets, area-level variation in IPV, suicide and self-harm in Sri Lanka were examined. In addition, the association between individual level exposure to past-year IPV and non-fatal self-harm by any household member were explored in a series of multi-level logistic regression models, adjusting for age. Similar patterns in the distribution of suicide and IPV were found, with higher rates evident in post-conflict districts, specifically Batticaloa, Kilinochchi, and Mullaitivu. Experience of past year IPV and its various forms were strongly associated with household-level self-harm in the past year (adjusted odds ratio [AOR] = 3.83 95% CI 2.27-6.46). A similar magnitude was found for physical/sexual abuse (AOR 5.17 95% CI 2.95-9.05) and psychological abuse (AOR 4.64 95% CI 2.50-7.00). A dose-response association was also evident for frequency of abuse, with an increasing risk of household-level self-harm for women reporting abuse 'less often' (AOR 2.95 95% CI 1.46-5.92), and abuse experienced 'daily, weekly, or monthly' (AOR 4.83 95% CI 2.59-9.00), compared to no abuse. This study contributes to a growing body of evidence on the relationship between IPV and suicidal behaviour in South Asia. Addressing IPV and its various forms should be a priority for suicide prevention in Sri Lanka, alongside trauma-informed approaches in post-conflict settings.
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Affiliation(s)
- Piumee Bandara
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Translational Health Research Institute, Western Sydney University, New South Wales, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, New South Wales, Australia
| | - Thilini Rajapakse
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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van der Boor CF, Taban D, Tol WA, Akellot J, Neuman M, Weiss HA, Greco G, Vassall A, May C, Nadkarni A, Kinyanda E, Roberts B, Fuhr DC. Effectiveness and cost-effectiveness of a transdiagnostic intervention for alcohol misuse and psychological distress in humanitarian settings: study protocol for a randomised controlled trial in Uganda. Trials 2024; 25:148. [PMID: 38414078 PMCID: PMC10900822 DOI: 10.1186/s13063-024-07980-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The war in South Sudan has displaced more than four million people, with Uganda hosting the largest number of South Sudanese refugees. Research in Uganda has shown elevated levels of alcohol misuse and psychological distress among these refugees. The World Health Organization (WHO) has developed a trans-diagnostic scalable psychological intervention called Problem Management Plus (PM +) to reduce psychological distress among populations exposed to adversities. Our study aims to evaluate the effectiveness and cost-effectiveness of the CHANGE intervention, which builds on PM + , to also address alcohol misuse through problem-solving therapy and selected behavioural strategies for dealing with alcohol use disorders. We hypothesise that the CHANGE intervention together with enhanced usual care (EUC) will be superior to EUC alone in increasing the percentage of days abstinent. METHODS A parallel-arm individually randomised controlled trial will be conducted in the Rhino Camp and Imvepi settlements in Uganda. Five hundred adult male South Sudanese refugees with (i) elevated levels of alcohol use (between 8 and 20 on the Alcohol Use Disorder Identification Test [AUDIT]); and (ii) psychological distress (> 16 on the Kessler Psychological Distress Scale) will be randomly assigned 1:1 to EUC or CHANGE and EUC. CHANGE will be delivered by lay healthcare providers over 6 weeks. Outcomes will be assessed at 3 and 12 months post-randomisation. The primary outcome is the percentage of days abstinent, measured by the timeline follow-back measure at 3 months. Secondary outcomes include percentage of days abstinent at 12 months and alcohol misuse (measured by the AUDIT), psychological distress (i.e. depression, anxiety, posttraumatic stress disorder), functional disability, perpetration of intimate partner violence, and health economic indicators at 3 and 12 months. A mixed-methods process evaluation will investigate competency, dose, fidelity, feasibility, and acceptability. Primary analyses will be intention-to-treat. DISCUSSION CHANGE aims to address alcohol misuse and psychological distress with male refugees in a humanitarian setting. If it is proven to be effective, it can help fill an important under-researched gap in humanitarian service delivery. TRIAL REGISTRATION ISRCTN ISRCTN10360385. Registered on 30 January 2023.
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Affiliation(s)
- Catharina F van der Boor
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - Dalili Taban
- HealthRight International, Plot 855, Mawanda Road -Kamwokya, Kampala, Uganda
| | - Wietse A Tol
- Department of Public Health, University of Copenhagen, Bartholinsgade 4, Bg. 9, 1356 København K, CSS, Bg. 9, Building: 9.2.16, Copenhagen, Denmark
| | - Josephine Akellot
- HealthRight International, Plot 855, Mawanda Road -Kamwokya, Kampala, Uganda
| | - Melissa Neuman
- MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Helen A Weiss
- MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Giulia Greco
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Anna Vassall
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Carl May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Abhijit Nadkarni
- Centre for Global Mental Health (CGMH), Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Addictions Research Group, Sangath, Goa, India
| | - Eugene Kinyanda
- MRC/UVRI Uganda Research Unit, London School of Hygiene and Tropical Medicine, Plot 51-59 Nakiwogo Road, PO Box 49, Entebbe, Uganda
| | - Bayard Roberts
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Daniela C Fuhr
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Achterstraße 30, 28359, Bremen, Germany
- Health Sciences, University of Bremen, Bremen, Germany
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Clark CJ, Bergenfeld I, Shervinskie A, Johnson ER, Cheong YF, Kaslow NJ, Yount KM. Validity of a Common Measure of Intimate Partner Violence Perpetration: Impact on Study Inference in Trials in Low- and Middle-Income Countries. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.28.24301897. [PMID: 38352606 PMCID: PMC10862994 DOI: 10.1101/2024.01.28.24301897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Background In lower-and middle-income countries (LMICs), studies of interventions to reduce intimate partner violence (IPV) perpetration are expanding, yet measurement equivalence of the IPV perpetration construct that is the primary outcome in these investigations has not been established. We assessed the measurement equivalence of physical and sexual IPV perpetration item sets used in recent trials in LMICs and tested the impact of non-invariance on trial inference. Methods With data from three intervention trials among men (sample size 505-1537 across studies) completed in 2019, we calculated tetrachoric correlations among items and used multiple-group confirmatory factor analysis to assess invariance across arms and over time. We also assessed treatment effects adjusting for covariate imbalance and using inverse probability to treatment weights to assess concordance of invariant measures with published results, where warranted. Findings The average correlation among items measuring IPV perpetration was high and increased by 0.03 to 0.15 for physical IPV and 0.07 to 0.17 for sexual IPV over time with several items in two studies showing correlations ≥ 0.85 at endline. Increases in the degree of correlation for physical IPV were concentrated in the treatment arm in two of the studies. The increase in correlation in sexual IPV differed by arm across studies. Across all studies, a correlated two-factor solution was the best fitting model according to the EFAs and CFAs. One study demonstrated measurement invariance across arms and over time. In two of the studies, longitudinal measurement non-invariance was detected in the intervention arms. In post hoc testing, one study attained invariance with a one-factor model and study inference was concordant with published findings. The other study did not attain even partial invariance. Conclusion Common measures of physical and sexual IPV perpetration cannot be used validly for comparisons across treatment versus control groups over time without further refinement. The study highlights the need for an expanded item set, content validity assessments, further measurement invariance testing, and then consistent use of the item sets in future intervention trials to ensure valid inferences regarding the effectiveness of IPV perpetration prevention interventions within and across trials.
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Affiliation(s)
- Cari Jo Clark
- Hubert Department of Global Health, Rollins School of Public Health, Emory University
| | - Irina Bergenfeld
- Hubert Department of Global Health, Rollins School of Public Health, Emory University
| | - Abbie Shervinskie
- Hubert Department of Global Health, Rollins School of Public Health, Emory University
| | - Erin R. Johnson
- Hubert Department of Global Health, Rollins School of Public Health, Emory University
| | | | - Nadine J. Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Kathryn M Yount
- Hubert Department of Global Health, Rollins School of Public Health, Emory University
- Department of Sociology, Emory University
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Bourey C, Musci RJ, Bass JK, Glass N, Matabaro A, Kelly JTD. Drivers of men's use of intimate partner violence in conflict-affected settings: learnings from the Democratic Republic of Congo. Confl Health 2024; 18:9. [PMID: 38254170 PMCID: PMC10804634 DOI: 10.1186/s13031-023-00562-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Intimate partner violence against women (IPVAW) is prevalent in conflict-affected settings. Yet, there is limited knowledge about the risk factors that influence men's use of IPVAW in conflict-affected settings. This paper adopts a transdisciplinary perspective to understand how experiences hypothesized to increase men's use of IPVAW relate to each other and to men's use of IPVAW. The findings may help researchers and interventionists to better select and target interventions for IPVAW in conflict-affected settings. METHODS We used baseline data from the Tushinde Ujeuri project in the Democratic Republic of Congo. Men with at least partial data for the variables of interest were included in the analysis (n = 2080). We estimated a structural equation model that explored how five constructs - interpersonal violence, mental health, socioeconomic adversity, gender inequitable attitudes, and conflict violence - influenced men's self-reported past-year use of physical and/or sexual IPVAW. RESULTS The model had acceptable fit (χ2 = 1576.574, p = 0.000; RMSEA = 0.041; CLI = 0.882; SRMR = 0.055). There was a statistically significant path from interpersonal violence to IPVAW (β = 0.875; OR = 2.40). Interpersonal violence also was linked to gender inequitable attitudes (β = 0.364), which were linked to increased use of IPVAW (β = 0.180; OR = 1.20). Moreover, interpersonal violence was linked to trauma symptoms (β = 0.331), which were linked to increased use of IPVAW (β = 0.238; OR = 1.27). Use of IPVAW decreased as conflict exposures increased (β=-0.036; OR = 0.96), and there was no path from socioeconomic adversity to IPVAW. CONCLUSIONS Our findings suggest interpersonal violence exposures, trauma symptoms, and gender inequitable attitudes are all risk factors for the use of IPVAW in a conflict-affected setting. While continuing to focus on gender inequitable attitudes and norms, interventionists should also consider addressing men's experiences of victimization and mental wellbeing. Doing so can help to improve trauma symptoms and may hold promise to reduce IPVAW in conflict-affected settings.
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Affiliation(s)
- Christine Bourey
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Rashelle J Musci
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Judith K Bass
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Nancy Glass
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | - Jocelyn T D Kelly
- Harvard Humanitarian Initiative, Harvard University, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
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13
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Zharima C, Singh R, Closson K, Beksinska M, Zulu B, Jesson J, Pakhomova T, Dong E, Dietrich J, Kaida A, Basham CA. Economic hardship and perpetration of intimate partner violence by young men in South Africa during the COVID-19 pandemic (2021-2022): a cross-sectional study. Inj Epidemiol 2024; 11:2. [PMID: 38229136 PMCID: PMC10790426 DOI: 10.1186/s40621-024-00483-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Economic hardship is a potential trigger for intimate partner violence (IPV) perpetration. While higher IPV rates have been reported in low-income regions, few African studies have focused on IPV being triggered by economic hardship among young men during the COVID-19 pandemic. We therefore estimated economic hardship's effect on IPV perpetration by young men in eThekwini District, South Africa, during the COVID-19 pandemic. METHODS A cross-sectional survey of COVID-19 pandemic experiences was conducted among youth aged 16-24 years through an anonymous self-administered questionnaire, including questions about economic hardship (increased difficulty accessing food or decreased income) and IPV perpetration. A prespecified statistical analysis plan with a directed acyclic graph of assumed exposure, outcome, and confounder relationships guided our analyses. We measured association of economic hardship and IPV perpetration through odds ratios (ORs) computed from a multivariable logistic regressions adjusted for measured confounders. Secondary outcomes of physical and sexual IPV perpetration were analyzed separately using the same specifications. Propensity score matching weights (PS-MW) were used in sensitivity analyses. Analysis code repository: https://github.com/CAndrewBasham/Economic_Hardship_IPV_perpetration/ RESULTS: Among 592 participants, 12.5% reported perpetrating IPV, 67.6% of whom reported economic hardship, compared with 45.6% of those not reporting IPV perpetration (crude OR = 2.49). Median age was 22 years (interquartile range 20-24). Most (80%) were in a relationship and living together. Three quarters identified as Black, 92.1% were heterosexual, and half had monthly household income < R1600. We estimated an effect of economic hardship on the odds of perpetrating IPV as OR = 1.83 (CI 0.98-3.47) for IPV perpetration overall, OR = 6.99 (CI 1.85-36.59) for sexual IPV perpetration, and OR = 1.34 (CI 0.69-2.63) for physical IPV perpetration. PS-MW-weighted ORs for IPV perpetration by economic hardship were 1.57 (overall), 4.45 (sexual), and 1.26 (physical). CONCLUSION We estimated 83% higher odds of self-reported IPV perpetration by self-reported economic hardship among young South African men during the COVID-19 pandemic. The odds of sexual IPV perpetration were The seven-times higher by economic hardship, although with limited precision. Among young men in South Africa, economic hardship during COVID-19 was associated with IPV perpetration by men. Our findings warrant culturally relevant and youth-oriented interventions among young men to reduce the likelihood of IPV perpetration should they experience economic hardship. Further research into possible causal mechanisms between economic hardship and IPV perpetration could inform public health measures in future pandemic emergencies.
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Affiliation(s)
- Campion Zharima
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Rishav Singh
- Vaccine Evaluation Centre, BC Children's Hospital and Research Institute, Vancouver, BC, Canada
| | - Kalysha Closson
- Center On Gender Equity and Health, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada
| | - Mags Beksinska
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Bongiwe Zulu
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Julie Jesson
- Center for Epidemiology and Research in POPulation Health (CERPOP), Inserm, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Tatiana Pakhomova
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada
| | - Erica Dong
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada
| | - Janan Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa
- African Social Sciences Unit of Research and Evaluation (ASSURE), A Division of the Wits Health Consortium, Johannesburg, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada.
- Women's Health Research Institute, Vancouver, BC, Canada.
| | - C Andrew Basham
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
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Morrison AM, Campbell JK, Sharpless L, Martin SL. Intimate Partner Violence and Immigration in the United States: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:846-861. [PMID: 37078533 PMCID: PMC10666473 DOI: 10.1177/15248380231165690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This systematic review sought to describe the prevalence of intimate partner violence (IPV) victimization among immigrants in the United States (U.S.) and the prevalence of IPV perpetration among immigrants in the U.S. PsycInfo, PubMed, Global Health and Scopus databases were searched for peer-reviewed literature that quantitatively examined IPV in relation to immigration. Twenty-four articles were included in the final review. Past-year IPV victimization rates among immigrants ranged from 3.8% to 46.9% and lifetime IPV victimization rates ranged from 13.9% to 93%; past-year IPV perpetration rates ranged from 3.0% to 24.8% and the one lifetime IPV perpetration rate was 12.8%. Estimates varied widely by country of origin, type of violence measured, and measure used to quantify IPV. Reliance on small convenience samples is problematic when trying to determine the true prevalence of IPV among immigrants. Epidemiological research is needed to improve the accuracy and representativeness of findings.
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15
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Oyekunle V, Gibbs A, Tomita A. Assessing the role of depression in reducing intimate partner violence perpetration among young men living in urban informal settlements using a mediation analysis of the Stepping Stones and Creating Futures intervention. Glob Health Action 2023; 16:2188686. [PMID: 36927500 PMCID: PMC10026746 DOI: 10.1080/16549716.2023.2188686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/03/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Stepping Stones and Creating Futures (SS/CF) is a gender transformative and economic empowerment intervention that has effectively reduced the perpetration of intimate partner violence (IPV) by young men living in informal settlements in South Africa. OBJECTIVE This study examines whether depression mediated the association between SS/CF intervention and decreased IPV. METHOD Data from a two-arm cluster randomised community-based controlled trial that evaluated the effectiveness of SS/CF in lowering IPV were obtained from 674 young men aged 18-30 within urban informal settlements in South Africa. After being randomly assigned to either the experimental arm (SS/CF) or the control arm, the participants were followed up for 24 months. Logistic regression using mediation analysis was conducted to see whether changes in depressive symptoms mediated the association between the intervention and reduced IPV perpetration. RESULTS Findings from the mediation analysis indicated that those assigned to the SS/CF experimental group reported lower depression (β = -0.42, p < 0.05) at 12 months, and this was subsequently associated with reduced IPV (β = 0.43, p < 0.05) at 24 months. The direct path from SS/CF to IPV was originally (β = -0.46, p < 0.01), but reduced in the mediation model to (β = -0.13, p = 0.50). Depressive symptoms mediated the association between the SS/CF intervention and decreased IPV perpetration. CONCLUSION These findings suggest that one pathway through which SS/CF decreased IPV was through improvement in mental health (i.e. depression). Future IPV prevention interventions may consider incorporating components that focus on improving mental health as a way of also reducing IPV perpetration in disadvantaged settings.
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Affiliation(s)
- Victoria Oyekunle
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Gibbs
- Department of Psychology, University of Exeter, Exeter, UK
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Maurya P, Muhammad T, Maurya C. Relational dynamics associated with adolescent and young adult (13 to 23 years of age) partner violence: The role of inter-parental violence and child abuse. PLoS One 2023; 18:e0283175. [PMID: 38153957 PMCID: PMC10754437 DOI: 10.1371/journal.pone.0283175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/21/2023] [Indexed: 12/30/2023] Open
Abstract
PURPOSE The study aimed to examine the effect of witnessing inter-parental violence and experiencing childhood abuse on victimization of intimate partner violence (IPV) after marriage among adolescent and young girls. METHOD Data were drawn from the second wave of the Understanding the lives of adolescents and young adults (UDAYA) survey (2018-2019). The sample size was 5480 married adolescent and young girls aged 13-23 years. The outcome variable of the study was the victimization of IPV. Descriptive statistics, bivariate analysis and structural equation modelling (SEM) were performed. RESULT A total of 39% of married adolescent and young girls experienced physical violence, followed by sexual violence (35%) and emotional violence (28%) by their partner. Around 30% of respondents witnessed inter-parental violence, and 32% of the participants were beaten by their parents during childhood. Participants who had witnessed inter-parental violence were significantly correlated with experiencing childhood abuse, and this association was positively correlated with exposure to IPV in adolescence and young adulthood. Further, the parameter estimates of the indicators of IPV were highest for emotional violence (1.10) followed by physical violence (1.00) and sexual violence (0.62). Witnessing inter-parental violence significantly increases parents' physical violence to adolescents and young adult girls (β = 0.49, P<0.001, CI: 0.47-0.51). No tie between witnessing inter-parental violence and childhood abuse mediates their effect on later victimization of IPV. CONCLUSION The findings indicate that witnessing inter-parental violence is a strong risk factor for IPV victimization among adolescent and young adult girls. Our findings advocate prerequisite collaborative effort with multiple service providers for greater empowerment at national, state, community, and family levels to achieve SDG goals pertaining to eliminating violence against women.
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Affiliation(s)
- Priya Maurya
- Department of Population and Development, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - T. Muhammad
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Chanda Maurya
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Carlisle S, Bunce A, Prina M, McManus S, Barbosa E, Feder G, Lewis NV. How effective are UK-based support interventions and services targeted at adults who have experienced domestic and sexual violence and abuse at improving their safety and wellbeing? A systematic review protocol. PLoS One 2023; 18:e0289192. [PMID: 38060529 PMCID: PMC10703258 DOI: 10.1371/journal.pone.0289192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Domestic and sexual violence and abuse (DSVA) is prevalent in the UK, with wide-ranging impacts both on individuals and society. However, to date, there has been no systematic synthesis of the evidence for the effectiveness of UK-based support interventions and services for victim-survivors of DSVA. This review will aim to systematically collate, synthesise and quality assess the evidence regarding the effectiveness of UK support interventions and services targeted at those who have experienced DSVA. The review will use findings of a preliminary scoping review, as well as input from stakeholders representing domestic and sexual violence third sector organisations to identify and prioritise the most relevant outcomes to focus on. METHODS We will undertake a systematic search for peer-reviewed literature in MEDLINE, EMBASE, PsycINFO, Social Policy and Practice, Applied Social Sciences Index and Abstracts (ASSIA), International Bibliography of the Social Sciences (IBSS), Sociological abstracts and SSCI. Grey literature will be identified by searching grey literature databases, circulating a call for evidence to local and national DSVA charities and organisations, and targeted website searching. Two reviewers will independently perform study selection and quality appraisal, with data extraction undertaken by one reviewer and checked for accuracy by a second reviewer. Narrative synthesis will be conducted, with meta-analysis if possible. DISCUSSION Existing individual studies and evaluations have reported positive impacts of support interventions and services for those who have experienced DSVA. Thus, it is expected that this review and synthesis will provide robust and conclusive evidence of these effects. It will also allow comparisons to be made between different types of support interventions and services, to inform policy makers and funders regarding the most effective ways of reducing domestic and sexual violence and abuse and its impacts.
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Affiliation(s)
- Sophie Carlisle
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Annie Bunce
- Violence and Society Centre, City, University of London, London, United Kingdom
| | - Matthew Prina
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Sally McManus
- Violence and Society Centre, City, University of London, London, United Kingdom
- National Centre for Social Research, London, United Kingdom
| | - Estela Barbosa
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Gene Feder
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Natalia V. Lewis
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Saunders KRK, Landau S, Howard LM, Fisher HL, Arseneault L, McLeod GFH, Oram S. Past-year intimate partner violence perpetration among people with and without depression: an individual participant data (IPD) meta-mediation analysis. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1735-1747. [PMID: 34842963 PMCID: PMC10627935 DOI: 10.1007/s00127-021-02183-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 10/31/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate whether (1) depression is associated with increased risk of past-year intimate partner violence (IPV) perpetration, disaggregated by sex, after controlling for potential confounders; (2) observed associations are mediated by alcohol misuse or past-year IPV victimisation. METHODS Systematic review and individual participant data (IPD) meta-mediation analysis of general population surveys of participants aged 16 years or older, that were conducted in a high-income country setting, and measured mental disorder and IPV perpetration in the last 12 months. RESULTS Four datasets contributed to meta-mediation analyses, with a combined sample of 12,679 participants. Depression was associated with a 7.4% and 4.8% proportion increase of past-year physical IPV perpetration among women and men, respectively. We found no evidence of mediation by alcohol misuse. Among women, past-year IPV victimisation mediated 45% of the total effect of depression on past-year IPV perpetration. Past-year severe IPV victimisation mediated 60% of the total effect of depression on past-year severe IPV perpetration. We could not investigate IPV victimisation as a mediator among men due to perfect prediction. CONCLUSIONS Mental health services, criminal justice services, and domestic violence perpetrator programmes should be aware that depression is associated with increased risk of IPV perpetration. Interventions to reduce IPV victimisation might help prevent IPV perpetration by women. Data collection on mental disorder and IPV perpetration should be strengthened in future population-based surveys, with greater consistency of data collection across surveys, as only four studies were able to contribute to the meta-mediation analysis.
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Affiliation(s)
- Katherine R K Saunders
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Sabine Landau
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Louise M Howard
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Louise Arseneault
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Geraldine F H McLeod
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Sian Oram
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Wu Y, Wang Y, Long H, Liu L, Dai L, Cao W, Liu J, Liu M. Prevalence of Intimate Partner Violence and Associated Factors Among People With HIV: A Large-Sample Cross-Sectional Study in China. J Infect Dis 2023; 228:1592-1599. [PMID: 37565503 PMCID: PMC10681864 DOI: 10.1093/infdis/jiad328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/14/2023] [Accepted: 08/10/2023] [Indexed: 08/12/2023] Open
Abstract
To assess the prevalence and exacerbating factors of intimate partner violence in people with human immunodeficiency virus (PWH) in China, we conducted a cross-sectional study, involving 2792 PWH in 4 provinces in China from 1 September 2020 to 1 June 2021. The categories of intimate partner violence (IPV) included physical violence, sexual violence, emotional abuse, and controlling behavior. The severity of a violent act was divided into mild, moderate, and severe. Among PWH, the prevalence of IPV was 15.4% (95% confidence interval, 14.1%-16.8%). The severity of physical violence was mainly moderate, and the severity of sexual violence, emotional abuse, and controlling behavior was mainly mild. The prevalence of IPV in men was higher than that in women. Results from the multivariable logistic regression showed that age, ethnic, registered residence, education, and duration of HIV antiretroviral therapy were factors related to IPV in PWH (P < .05).
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Affiliation(s)
- Yu Wu
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Beijing, China
| | - Yaping Wang
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Beijing, China
| | - Hai Long
- Guiyang Public Health Clinical Center, Guizhou, China
| | - Lirong Liu
- Shangqiu Center for Disease Prevention and Control, Henan, China
| | - Lili Dai
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wanxian Cao
- Hefei Infectious Disease Hospital, Anhui, China
| | - Jue Liu
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Beijing, China
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Abramsky T, Guadarrama DS, Kapiga S, Mtolela G, Madaha F, Lees S, Harvey S. Pathways to reduced physical intimate partner violence among women in north-western Tanzania: Evidence from two cluster randomised trials of the MAISHA intervention. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002497. [PMID: 37956111 PMCID: PMC10642778 DOI: 10.1371/journal.pgph.0002497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 09/22/2023] [Indexed: 11/15/2023]
Abstract
Intimate partner violence (IPV) affects over one-in-four women globally. Combined economic and social empowerment interventions are a promising IPV prevention model. However, questions remain on the mechanisms through which such interventions prevent IPV, and whether standalone social empowerment interventions can work in the absence of an economic component. This secondary analysis of MAISHA Study data (north-western Tanzania) explores pathways through which a group-based gender-training intervention, delivered to women standalone or alongside microfinance, may impact on physical IPV risk. Two cluster-randomised trials (CRT) assessed the impact of the MAISHA intervention on women's IPV risk; CRT01 among women in 66 pre-existing microfinance groups (n = 919), and CRT02 among 66 newly-formed groups not receiving microfinance (n = 1125). Women were surveyed at baseline and 29 months follow-up. Sub-group analyses explored whether intervention effects on past-year experience of physical IPV varied by participant characteristics. Mediators of intervention effect on physical IPV were explored using mixed-effects logistic regression (disaggregated by trial). In CRT01, MAISHA was associated with reduced past-year physical IPV (adjusted-OR 0.63, 95%CI 0.41-0.98), with stronger effects among those younger, more financially independent, and without prior physical IPV. CRT02 showed no impact on physical IPV, overall or among sub-groups. In CRT01, individual-level reduced acceptability of IPV and group-level confidence to intervene against IPV emerged as potential mediators of intervention effect, while relationship-level indicators of communication were not impacted. In CRT02, positive impacts on individual-level attitudes did not translate into reduced IPV risk. In CRT02, arguments with partners over perceived transgressions of gender roles increased in the intervention-arm. Neither trial resulted in increased separations. Findings illustrate the importance of addressing poverty and women's economic dependence on men, structural factors that may impede the success of socially oriented violence prevention programming. Programming with men is also crucial to ameliorate risks of backlash against attitudinal/behavioural change among women. Trial registration: ClinicalTrials.gov #NCT02592252.
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Affiliation(s)
- Tanya Abramsky
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Diana Sanchez Guadarrama
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Flora Madaha
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
| | - Shelley Lees
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sheila Harvey
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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21
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Vyas S, Jansen HAFM, Viet NNT, Gardner J, Loan TTB, Phan H. Changes in the Correlates for Intimate Partner Violence Against Women in Vietnam: Evidence From the 2010 and 2019 National Prevalence Surveys. Violence Against Women 2023; 29:2699-2729. [PMID: 37654183 DOI: 10.1177/10778012231197566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
This study sought to understand whether the risk and protective factors associated with current partner violence changed in Vietnam using findings from two comparable surveys conducted in 2010 and 2019. Fifteen (2010) and 17 (2019) factors were significantly associated with violence, and the level of consistency was high-nonpartner sexual violence, respondent and partner prior abuse, men's expressions of masculinity, and indicators of low economic status continue to put women at risk. Gender-transformative approaches that address power inequalities, foster positive parenting, and promote the political and social influence of women are required and should be adapted to the Vietnam context.
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Affiliation(s)
| | | | | | | | | | - Hien Phan
- United Nations Population Fund, Myanmar
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22
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Maposa I, Twabi HS, Matsena-Zingoni Z, Batidzirai JM, Singini G, Mohammed M, Bere A, Kgarosi K, Mchunu N, Nevhungoni P, Moyo-Chilufya M, Ojifinni O, Musekiwa A. Bayesian spatial modelling of intimate partner violence and associated factors among adult women and men: evidence from 2019/2020 Rwanda Demographic and Health Survey. BMC Public Health 2023; 23:2061. [PMID: 37864202 PMCID: PMC10589974 DOI: 10.1186/s12889-023-16988-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 10/13/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) remains a global public health concern for both men and women. Spatial mapping and clustering analysis can reveal subtle patterns in IPV occurrences but are yet to be explored in Rwanda, especially at a lower small-area scale. This study seeks to examine the spatial distribution, patterns, and associated factors of IPV among men and women in Rwanda. METHODS This was a secondary data analysis of the 2019/2020 Rwanda Demographic and Health Survey (RDHS) individual-level data set for 1947 women aged 15-49 years and 1371 men aged 15-59 years. A spatially structured additive logistic regression model was used to assess risk factors for IPV while adjusting for spatial effects. The district-level spatial model was adjusted for fixed covariate effects and was implemented using a fully Bayesian inference within the generalized additive mixed effects framework. RESULTS IPV prevalence amongst women was 45.9% (95% Confidence interval (CI): 43.4-48.5%) while that for men was 18.4% (95% CI: 16.2-20.9%). Using a bivariate choropleth, IPV perpetrated against women was higher in the North-Western districts of Rwanda whereas for men it was shown to be more prevalent in the Southern districts. A few districts presented high IPV for both men and women. The spatial structured additive logistic model revealed higher odds for IPV against women mainly in the North-western districts and the spatial effects were dominated by spatially structured effects contributing 64%. Higher odds of IPV were observed for men in the Southern districts of Rwanda and spatial effects were dominated by district heterogeneity accounting for 62%. There were no statistically significant district clusters for IPV in both men or women. Women with partners who consume alcohol, and with controlling partners were at significantly higher odds of IPV while those in rich households and making financial decisions together with partners were at lower odds of experiencing IPV. CONCLUSION Campaigns against IPV should be strengthened, especially in the North-Western and Southern parts of Rwanda. In addition, the promotion of girl-child education and empowerment of women can potentially reduce IPV against women and girls. Furthermore, couples should be trained on making financial decisions together. In conclusion, the implementation of policies and interventions that discourage alcohol consumption and control behaviour, especially among men, should be rolled out.
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Affiliation(s)
- Innocent Maposa
- Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Epidemiology & Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Halima S Twabi
- Department of Mathematical Sciences, School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi.
| | - Zvifadzo Matsena-Zingoni
- Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Center for Biomedical Modelling, Department of Psychiatry and Biobehavioural Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Jesca M Batidzirai
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Geoffrey Singini
- Department of Mathematical Sciences, School of Natural and Applied Sciences, University of Malawi, Zomba, Malawi
| | - Mohanad Mohammed
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Alphonce Bere
- Department of Mathematical and Computational Sciences, University of Venda, Thohoyandou, South Africa
| | - Kabelo Kgarosi
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Nobuhle Mchunu
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Statistics, Durban, South Africa
- Biostatistics Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Portia Nevhungoni
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
- Biostatistics Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Maureen Moyo-Chilufya
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Oludoyinmola Ojifinni
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alfred Musekiwa
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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23
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Kuchukhidze S, Panagiotoglou D, Boily MC, Diabaté S, Imai-Eaton JW, Stöckl H, Mbofana F, Wanyenze RK, Maheu-Giroux M. Characteristics of male perpetrators of intimate partner violence and implications for women's HIV status: A pooled analysis of cohabiting couples from 27 countries in Africa (2000-2020). PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002146. [PMID: 37672520 PMCID: PMC10482294 DOI: 10.1371/journal.pgph.0002146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023]
Abstract
Intimate partner violence (IPV) may increase women's HIV acquisition risk. Still, knowledge on pathways through which IPV exacerbates HIV burden is emerging. We examined the individual and partnership-level characteristics of male perpetrators of physical and/or sexual IPV and considered their implications for women's HIV status. We pooled individual-level data from nationally representative, cross-sectional surveys in 27 countries in Africa (2000-2020) with information on past-year physical and/or sexual IPV and HIV serology among cohabiting couples (≥15 years). Current partners of women experiencing past-year IPV were assumed to be IPV perpetrators. We used Poisson regression, based on Generalized Estimating Equations, to estimate prevalence ratios (PR) for male partner and partnership-level factors associated with perpetration of IPV, and men's HIV status. We used marginal standardization to estimate the adjusted risk differences (aRD) quantifying the incremental effect of IPV on women's risk of living with HIV, beyond the risk from their partners' HIV status. Models were adjusted for survey fixed effects and potential confounders. In the 48 surveys available from 27 countries (N = 111,659 couples), one-fifth of women reported that their partner had perpetrated IPV in the past year. Men who perpetrated IPV were more likely to be living with HIV (aPR = 1.09; 95%CI: 1.01-1.16). The aRD for living with HIV among women aged 15-24 whose partners were HIV seropositive and perpetrated past-year IPV was 30% (95%CI: 26%-35%), compared to women whose partners were HIV seronegative and did not perpetrate IPV. Compared to the same group, aRD among women whose partner was HIV seropositive without perpetrating IPV was 27% (95%CI: 23%-30%). Men who perpetrated IPV are more likely to be living with HIV. IPV is associated with a slight increase in young women's risk of living with HIV beyond the risk of having an HIV seropositive partner, which suggests the mutually reinforcing effects of HIV/IPV.
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Affiliation(s)
- Salome Kuchukhidze
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Dimitra Panagiotoglou
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Marie-Claude Boily
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Souleymane Diabaté
- Département de Médecine Sociale et Préventive, Université Laval, Québec, QC, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Département de Médecine et Spécialités Médicales, Université Alassane Ouattara, Bouaké, Côte d’Ivoire
| | - Jeffrey W. Imai-Eaton
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
- Center for Infectious Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Heidi Stöckl
- Institute for Medical Information Processing, Biometry, and Epidemiology, Medical Faculty, LMU Munich, Munich, Germany
| | | | - Rhoda K. Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
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24
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Bhatt B, Bhatt N, Karki A, Giri G, Baaniya B, Neupane B, Bogati S, Mahaju S, Poudel A, Pokharel S, Kafle N, Nepal S, Sapkota R, Shrestha S, Tuitui RL, Sagtani RA. Intimate partner violence against married women of reproductive age in Nepal during the COVID-19 pandemic. Heliyon 2023; 9:e20117. [PMID: 37809852 PMCID: PMC10559861 DOI: 10.1016/j.heliyon.2023.e20117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Intimate partner violence (IPV) is a significant public health concern in Nepal and its prevalence has increased during the COVID-19 pandemic. This study aimed to assess the prevalence of IPV among married women of reproductive age in Nepal during the pandemic. Methods A web-based survey was conducted with 420 participants using a validated questionnaire adopted from the World Health Organization. Descriptive and inferential statistical analyses were performed. Results Our study found that 52.62% of participants experienced IPV during the COVID-19 pandemic with economic violence being the most prevalent type (38.81%) and followed by behavioral control (37.14%), emotional violence (26.20%), physical violence (21.43%), and sexual violence (14.05%). Despite the high level of IPV, only 14% of participants sought help and only 6% reported the violence to the police. Univariate analyses showed that factors such as the husband's level of education and occupation, number of children, property ownership, husband's alcohol use, relationship and quarrels with the husband, fear of the husband, and participation in decision-making were associated with an increased risk of IPV. Multivariate analysis revealed that women involved in decision-making faced a 2.52 times higher risk of violence, that women who reported daily quarrels had a risk 5.47 times that of women who did not endorse fights, and that women who were afraid of their husbands had a risk 16 times that of women who did not report fear. Conclusion This study reveals a concerning prevalence of IPV among married women in Nepal during the COVID-19 pandemic. Our findings emphasize the low reporting rates and help-seeking behavior among IPV victims. They also highlight the significant influence of factors such as participation in decision-making, frequent quarrels, and fear. These findings underscore the urgent need to establish support systems for IPV victims and develop targeted interventions tailored to the local context. Furthermore, conducting comprehensive research and understanding the interplay of contributing factors can guide the formulation of effective strategies to combat this pervasive societal problem.
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Affiliation(s)
- Bandana Bhatt
- Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | - Navin Bhatt
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | - Ashmita Karki
- Central Department of Public Health, Institute of Medicine, Kathmandu, Nepal
| | | | | | - Bandana Neupane
- Nepal Health Sector Support Programme (NHSSP)/DFID/Ministry of Health and Population, Kathmandu, Nepal
| | | | - Satyam Mahaju
- Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
| | - Anubhav Poudel
- Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal
| | | | | | - Shristi Nepal
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | | | - Sangita Shrestha
- Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | - Roshani Laxmi Tuitui
- Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
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25
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Saunders DG, Jiwatram-Negrón T, Nanasi N, Cardenas I. Patriarchy's Link to Intimate Partner Violence: Applications to Survivors' Asylum Claims. Violence Against Women 2023; 29:1998-2021. [PMID: 36349372 PMCID: PMC10387730 DOI: 10.1177/10778012221132299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Eligibility for asylum for survivors of intimate partner violence (IPV) has recently been contested. We summarize social science evidence to show how such survivors generally meet asylum criteria. Studies consistently show a relationship between patriarchal factors and IPV, thereby establishing a key asylum criterion that women are being persecuted because of their status as women. Empirical support is also provided for other asylum criteria, specifically: patriarchal norms contribute to state actors' unwillingness to protect survivors, and survivors' political opinions are linked to an escalation of perpetrators' violence. The findings have implications for policy reform and supporting individual asylum-seekers.
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Affiliation(s)
| | | | - Natalie Nanasi
- Dedman School of Law, Southern Methodist University, Dallas, TX, USA
| | - Iris Cardenas
- School of Social Work, Rutgers University, New Brunswick-Piscataway, NJ, USA
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26
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Giacomini SGMO, Machado MMT, de Santana OMML, Rocha SGMO, de Aquino CM, Gomes LGA, de Albuquerque LS, de Soares MDA, Leite ÁJM, Correia LL, Rocha HAL. Intimate Partner Violence among women living in families with children under the poverty line and its association with common mental disorders during COVID-19 pandemics in Ceará, Brazil. BMC Public Health 2023; 23:1299. [PMID: 37415137 PMCID: PMC10327360 DOI: 10.1186/s12889-023-16233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/03/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a pervasive public health issue that affects millions of women worldwide. Women living below the poverty line experience higher rates of violence and fewer resources to escape or cope with the abuse, and the COVID-19 pandemic has significantly impacted women's economic well-being worldwide. We conducted a cross-sectional study in Ceará, Brazil, on women in families with children living below the poverty line at the peak of the second wave of COVID to assess the prevalence of IPV and its association with common mental disorders(CMD). METHODS The study population comprised families with children up to six years of age who participated in the cash transfer program "Mais Infância". The families selected to participate in this program must meet a poverty criterion: families must live in rural areas, in addition to a monthly per capita income of less than US$16.50 per month. We applied specific instruments to evaluate IPV and CMD. To access IPV, we used the Partner Violence Screen (PVS). The Self-Reporting Questionnaire (SRQ-20) was used to assess CMD. To verify the association between IPV and the other evaluated factors with CMD, simple and hierarchical multiple logistic models were used. RESULTS Of the 479 participant women, 22% were positively screened for IPV (95% CI 18.2-26.2). After multivariate adjustment, the chances of CMD are 2.32 higher in women exposed to IPV than in those not exposed to IPV ((95%CI 1.30-4.13), p value = 0.004). CMD was also associated with job loss during the COVID-19 pandemic (ORa 2.13 (95% CI 1.09-4.35), p-value 0.029). In addition to these, separate or single marital status, as well as non-presence of the father at home and food insecurity were associated with CMD. CONCLUSION We conclude that the prevalence of intimate partner violence in families with children up to six years of age living below the poverty line in Ceará is high and is associated with greater chances of common mental disorders in mothers. Also, job loss and reduced access to food caused by the Covid 19 pandemic exacerbated both phenomena, constituting a double burden generator factor on mothers.
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Affiliation(s)
- Sâmia GMO Giacomini
- Department of Community Health, Federal University of Ceará, Fortaleza, CE Brazil
| | - Márcia MT Machado
- Department of Community Health, Federal University of Ceará, Fortaleza, CE Brazil
| | - Onélia MML de Santana
- Laboratory of Epidemiology and Data Analysis, University Health Center ABC. FMABC, Santo André, São Paulo, Brazil
| | - Sabrina GMO Rocha
- Department of Community Health, Federal University of Ceará, Fortaleza, CE Brazil
| | - Camila M. de Aquino
- Department of Maternal and Child Health, Federal University of Ceará, Fortaleza, CE Brazil
| | - Laécia GA Gomes
- Social Protection Secretariat. Ceará State Government, Fortaleza, CE Brazil
| | | | | | - Álvaro JM Leite
- Department of Maternal and Child Health, Federal University of Ceará, Fortaleza, CE Brazil
| | - Luciano L. Correia
- Department of Community Health, Federal University of Ceará, Fortaleza, CE Brazil
| | - Hermano AL Rocha
- Department of Community Health, Federal University of Ceará, Fortaleza, CE Brazil
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27
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Yount KM, Comeau D, Blake SC, Sales J, Sacks M, Nicol H, Bergenfeld I, Kalokhe AS, Stein AD, Whitaker DJ, Parrott D, Van HTH. Consortium for violence prevention research, leadership training, and implementation for excellence (CONVERGE): a protocol to train science leaders in gender-based-violence and violence-against-children research for impact. Front Public Health 2023; 11:1181543. [PMID: 37469691 PMCID: PMC10352114 DOI: 10.3389/fpubh.2023.1181543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/12/2023] [Indexed: 07/21/2023] Open
Abstract
Background Gender-based violence (GBV) and violence against children (VAC) are two prevalent and highly interconnected global health challenges, yet data and research capacities to study these forms of violence and to generate evidence-based policies and programs remain limited. To address critical shortages in research capacity in Vietnam and to establish a model for other Low- and Middle-Income Countries (LMICs), we are establishing CONVERGE-the Consortium for Violence Prevention Research, Implementation, and Leadership Training for Excellence. Methods Based on a needs assessment with partners in Vietnam, CONVERGE will provide a comprehensive research training program supporting 15 long-term, postdoctoral trainees with multi-disciplinary research training in GBV and VAC. We also will offer in-country trainings and short-courses to 40 short-term mid-career academic trainees and 60 short-term practitioner/stakeholder trainees over 5 years to build productive GBV and VAC academic, scientific, and practitioner networks. The CONVERGE training program has four components: (1) 14 h of virtual/in-person annual mentorship training to prepare research mentors and to create a pipeline of future mentors in Vietnam; (2) a one-month intensive research training for long-term postdoctoral fellows at Emory University; (3) a structured 17-month, in-country mentored research project for long-term trainees that results in a peer-reviewed manuscript and a subsequent grant submission; and, (4) week-long in-country intensive translational trainings on implementation science, advanced topics in leadership, and advanced topics in science dissemination. Opportunities for on-going virtual training and professional networking will be provided for CONVERGE trainees and mentors in Vietnam with other trainees and mentors of D43s focused on injury/violence prevention, D43s housed at Emory, and D43s with other institutions in Southeast Asia. To assess the reach, implementation, fidelity, and effectiveness of these four components, we will implement a rigorous, mixed-methods, multi-level evaluation strategy using process and outcome measures. Findings from the evaluation will be used to refine program components for future trainee and mentor cohorts and to assess long-term program impact. Discussion Led by Emory University in the US and Hanoi Medical University in Vietnam, CONVERGE represents leading institutions and experts from around the world, with a goal of providing mentorship opportunities for early-career scientists with an interest in violence prevention.
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Affiliation(s)
- Kathryn M. Yount
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Dawn Comeau
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Sarah C. Blake
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jessica Sales
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Michael Sacks
- Goizueta Business School, Emory University, Atlanta, GA, United States
| | - Hannah Nicol
- School of Medicine, Emory University, Atlanta, GA, United States
| | - Irina Bergenfeld
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Aryeh D. Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Dominic Parrott
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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28
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Bengesai AV, Khan HTA. Exploring the association between attitudes towards wife beating and intimate partner violence using a dyadic approach in three sub-Saharan African countries. BMJ Open 2023; 13:e062977. [PMID: 37316321 DOI: 10.1136/bmjopen-2022-062977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE The present study examines the association between attitudes towards wife beating and intimate partner violence (IPV) using a dyadic approach in three sub-Saharan countries. SETTING We use data from the most recent Demographic and Health Survey cross-sectional studies which were conducted between 2015 and 2018 in Malawi, Zambia and Zimbabwe PARTICIPANTS: Our sample comprised 9183 couples who also had completed the information on the domestic violence questions and our variables of interest. RESULTS Our results indicate that women in these three countries are generally comparatively more inclined to justify marital violence than their husbands or partners. In terms of IPV experience, we found that when both partners endorsed wife beating, the risk of experiencing IPV was twice as likely after controlling for other couple-level and individual factors (OR=1.91, 95% CI 1.54-2.50, emotional violence; OR=2.42, 95% CI 1.96-3.00, physical violence; OR=1.97, 95% CI 1.47-2.61, sexual violence). The risk of IPV was also higher when the women alone endorsed IPV (OR=1.59, 95% CI 1.35-1.86, emotional violence; OR=1.85, 95% CI 1.59-2.15, physical violence; OR=1.83, 95% CI 1.51-2.22, sexual violence) than when the men alone were tolerant (OR=1.41, 95% CI 1.13-1.75, physical violence; OR=1.43, 95% CI 1.08-1.90, sexual violence). CONCLUSIONS Our findings confirm that attitudes towards violence are perhaps one of the key indicators of IPV prevalence. Therefore, to break the cycle of violence in the three countries, more attention must be paid to attitudes towards the acceptability of marital violence. Programmes tailored to gender role transformation and promote non-violent gender attitudes are also needed.
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Affiliation(s)
- Annah V Bengesai
- College of Law and Management Studies, University of KwaZulu-Natal, Durban, South Africa
| | - Hafiz T A Khan
- Public Health Group, College of Nursing, Midwifery and Healthcare, University of West London, London, UK
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29
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Cerdán-Torregrosa A, Nardini K, Vives-Cases C. "I Reject it, But That's What Normally Happens": Grey Zones of Gender-Based Violence and Gender Roles in Young People. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:7656-7677. [PMID: 36710522 DOI: 10.1177/08862605221147070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
There has been growing concern about the increase in gender-based violence (GBV) among young people. The aim of this study was to explore the grey zones in GBV alongside gender (masculinities and femininities) discourses in young adults. We used the concept of a "grey zone" as an analytical tool to identify possible contradictory discursive positions where the notions of victims and perpetrators of GBV converge and become ambiguous. We performed a qualitative study based on 20 semi-structured interviews and 4 focus groups (October 2019 to February 2020) in Spain with a sample of 49 cisgender women and men, aged between 18 and 24, some involved in feminist activism and some not. We conducted a sociological analysis of the discourse system. Study findings show how culturally constructed gender norms intervene in the ways in which young people understand and deal with GBV. When asked general questions about GBV, this concept was problematized along with gender assumptions and two discursive positions were identified: the discourse of "men as authors of GBV" and the discourse of "GBV as an individual genderless issue." When vignettes of everyday GBV situations were shown, grey zones became visible when discussing subtle forms of GBV influenced by the myths of romantic love, victim-blaming around sexual violence, digital GBV and bystander men intervention on GBV. In those grey zones, discourses on GBV were articulated around unequal notions of gender that, in turn, served as its justification, reproduction, and normalization. The grey zones identified represent contexts of oppression that illustrate how GBV is systematically reproduced, as well as the ways in which young people can be involved in it, perpetuating power and health inequalities. Our findings provide information as a guide to design GBV interventions and prevention actions that incorporate a focus on gender configurations.
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Affiliation(s)
- Ariadna Cerdán-Torregrosa
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
| | - Krizia Nardini
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
| | - Carmen Vives-Cases
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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30
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Başkan B, Alkan Ö. Determinants of intimate partner controlling behavior targeting women in Türkiye. Front Psychol 2023; 14:1174143. [PMID: 37284474 PMCID: PMC10239945 DOI: 10.3389/fpsyg.2023.1174143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/02/2023] [Indexed: 06/08/2023] Open
Abstract
Background/aim Intimate partner controlling behavior toward women is an important form of intimate partner violence (IPV), both in terms of limiting women's daily lives and in terms of reproducing patriarchal culture and male dominance in societies at the micro level. A limited number of studies in the literature have identified the male intimate partner's controlling behavior as a dependent variable, which is important for understanding the determinants of this type of IPV. There is also a significant gap in the literature in terms of studies focusing on the case of Türkiye. Thus, the main aim of this study was to determine the socio-demographic, economic and violence-related factors that have an effect on women's status in terms of exposure to control behavior in Türkiye. Methods These factors were examined by using binary logistic regression analysis, based on the micro data set collected by the Hacettepe University's Institute of Population Studies in the 2014-dated National Research on Domestic Violence against Women in Türkiye. A total of 7,462 women between the ages of 15 and 59 were interviewed face-to-face. Results The findings of the study revealed that women are more likely to be exposed to controlling behavior if they live in rural areas, are unmarried, speak Turkish as their mother tongue, have bad or very bad health conditions, justify men's violence and are afraid of their intimate partners. As women's age, level of education and income contribution increase, their likelihood of exposure to controlling behavior decreases. However, women's exposure to economic, physical and emotional violence also increases their likelihood of exposure to controlling behavior. Conclusion The findings highlighted the importance of creating public policies that make women less vulnerable to men's controlling behavior, providing women with methods and mechanisms of resistance and raising public awareness of the exacerbating effects of controlling behavior on social inequalities.
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Affiliation(s)
- Burak Başkan
- Faculty of Economics and Administrative Sciences, Erzurum Technical University, Erzurum, Türkiye
| | - Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Atatürk University, Erzurum, Türkiye
- Master Araştırma Eğitim ve Danışmanlık Hizmetleri Ltd. Şti., Ata Teknokent, Erzurum, Türkiye
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Brambilla R, Mshana GH, Mosha N, Malibwa D, Ayieko P, Sichalwe S, Kapiga S, Stöckl H. A Cross-Sectional Analysis of Young Men's Gambling and Intimate Partner Violence Perpetration in Mwanza, Tanzania. Int J Public Health 2023; 68:1605402. [PMID: 37273770 PMCID: PMC10235485 DOI: 10.3389/ijph.2023.1605402] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
Objectives: The prevalence of intimate partner violence (IPV) in Tanzania is one of the highest in sub-Saharan Africa. There are very few studies on the co-occurrence of gambling and IPV and none from LMICs, despite gambling being a behaviour associated with gender norms exalting masculinity underlying IPV perpetration. Methods: Cross-sectional survey data of 755 currently partnered men aged 18-24 from Mwanza, Tanzania were analysed to investigate whether gambling was associated with past-year physical, sexual, emotional and economic IPV. We conducted bivariate and multivariate logistic regressions to control for potential confounders, based on their significant association bivariately with the main outcome variables. Results: Of the men who gambled, 18 percent perpetrated physical IPV, 39 percent sexual IPV, 60 percent emotional IPV and 39 percent economic IPV. Gambling was significantly associated with sexual (aOR: 2.59; 95% CI: 1.70-3.97), emotional (aOR: 1.55; 95% CI: 1.12-2.14) and economic IPV (aOR: 1.38; 95% CI: 1.02-1.88) after controlling for confounders. Conclusion: The analysis shows that gambling is associated with IPV perpetration. More research is needed to understand how current IPV prevention efforts can be expanded to include problem gambling treatment.
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Affiliation(s)
- Rebecca Brambilla
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Gerry Hillary Mshana
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
- National Institute for Medical Research (Mwanza Centre), Mwanza, Tanzania
| | - Neema Mosha
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
| | | | - Philip Ayieko
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | | | - Saidi Kapiga
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Heidi Stöckl
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
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Daoud N, Carmi A, Bolton R, Cerdán-Torregrosa A, Nielsen A, Alfayumi-Zeadna S, Edwards C, Ó Súilleabháin F, Sanz-Barbero B, Vives-Cases C, Salazar M. Promoting Positive Masculinities to Address Violence Against Women: A Multicountry Concept Mapping Study. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:6523-6552. [PMID: 36475434 PMCID: PMC10052420 DOI: 10.1177/08862605221134641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Interventions engaging men that challenge unequal gender norms have been shown to be effective in reducing violence against women (VAW). However, few studies have explored how to promote anti-VAW positive masculinity in young adults. This study aims to identify key multicountry strategies, as conceived by young adults and other stakeholders, for promoting positive masculinities to improve gender equity and prevent and target VAW. This study (2019-2021) involved young adults (aged 18-24 years) and stakeholders from Ireland, Israel, Spain, and Sweden. We applied concept mapping, a participatory mixed-method approach, in phases: (1) brainstorming, using semi-structured interviews with young adults (n = 105) and stakeholders (n = 60), plus focus group discussions (n = 88), to collect ideas for promoting anti-VAW positive masculinity; (2) development of an online questionnaire for sorting (n = 201) and rating ideas emerging from brainstorming by importance (n = 406) and applicability (n = 360); (3) based on sorting and rating data, creating rating maps for importance and applicability and clusters/strategies using multidimensional scaling and hierarchical cluster analysis with groupwisdom™ software; and (4) interpretation of results with multicountry stakeholders to reach agreement. The cluster map identified seven key strategies (41 actions) for promoting anti-VAW positive masculinities ranked from highest to lowest: Formal and informal education and training; Preventive education and activities in different settings/areas; Skills and knowledge; Empathy, reflection, and understanding; Media and public efforts; Policy, legislation, and the criminal justice system; and Organizational actions and interventions. Pattern matches indicated high agreement between young people and stakeholders in ranking importance (r = 0.96), but low agreement for applicability (r = 0.60). Agreement in the total sample on prioritizing statements by importance and applicability was also low (r = 0.20); only 14 actions were prioritized as both important and applicable. Young people and stakeholders suggested seven comprehensive, multidimensional, multi-setting strategies to facilitate promoting positive masculinity to reduce VAW. Discrepancy between importance and applicability might indicate policy and implementation obstacles.
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Affiliation(s)
- Nihaya Daoud
- School of Public Health, Ben-Gurion University of the Negev, Israel
| | - Ayelet Carmi
- School of Public Health, Ben-Gurion University of the Negev, Israel
| | - Robert Bolton
- School of Applied Social Studies/Institute for Social Science in the 21st Century, University College Cork, Ireland
| | | | - Anna Nielsen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Claire Edwards
- School of Applied Social Studies/Institute for Social Science in the 21st Century, University College Cork, Ireland
| | - Fiachra Ó Súilleabháin
- School of Applied Social Studies/Institute for Social Science in the 21st Century, University College Cork, Ireland
| | | | - Carmen Vives-Cases
- University of Alicante, Spain
- CIBER for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mariano Salazar
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Nwafor JA, Chamdimba E, Ajayi AI, Ushie BA, Munthali AC, Thakwalakwa C, Kabiru CW. Correlates of intimate partner violence among pregnant and parenting adolescents: a cross-sectional household survey in Blantyre District, Malawi. Reprod Health 2023; 20:60. [PMID: 37055778 PMCID: PMC10099731 DOI: 10.1186/s12978-023-01606-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/31/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Despite efforts from the government and developmental partners to eliminate gender-based violence, intimate partner violence (IPV) remains a pervasive global health and human rights problem, affecting up to 753 million women and girls globally. Few studies on IPV have focused on pregnant and parenting adolescent (PPA) girls in Africa, although the region has the highest rates of adolescent childbearing. This limited attention results in the neglect of pregnant and parenting adolescents in policies and interventions addressing IPV in the region. Our study examined IPV prevalence and its individual, household, and community-level correlates among pregnant and parenting adolescent girls (10-19 years) in Blantyre District, Malawi. METHODS We collected data from a cross-section of pregnant and parenting adolescent girls (n = 669) between March and May 2021. The girls responded to questions on socio-demographic and household characteristics, lifetime experience of IPV (i.e., sexual, physical, and emotional violence), and community-level safety nets. We used multilevel mixed-effect logistic regression models to examine the individual, household, and community-level factors associated with IPV. RESULTS The lifetime prevalence of IPV was 39.7% (n = 266), with more girls reporting emotional (28.8%) than physical (22.2%) and sexual (17.4%) violence. At the individual level, girls with secondary education (AOR: 1.72; 95% CI: 1.16-2.54), who engaged in transactional sex (AOR: 2.29; 95% CI: 1.35-3.89), and accepted wife-beating (AOR: 1.97; 95% CI: 1.27-3.08) were significantly more likely to experience IPV compared to those with no education/primary education, who never engaged in transactional sex and rejected wife beating. Girls aged 19 (AOR: 0.49; 95% CI: 0.27-0.87) were less likely to report IPV than those aged 13-16. At the household level, girls with fair and poor partner support had higher odds of experiencing IPV, but the effect size did not reach a significant level in the parsimonious model. A high perception of neighborhood safety was associated with a lower likelihood of experiencing IPV (AOR: 0.81; 95% CI: 0.69-0.95). CONCLUSION Intimate partner violence is rife among pregnant and parenting adolescent girls in Malawi, underscoring the need for appropriate interventions to curb the scourge. Interventions addressing IPV need to target younger adolescents, those engaging in transactional sex, and those having weaker community-level safety nets. Interventions to change social norms that drive the acceptance of gender-based violence are also warranted.
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Affiliation(s)
- Juliet Amarachukwu Nwafor
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Manga Close, Nairobi, 00100, Kenya
| | - Elita Chamdimba
- Centre for Social Research, University of Malawi, P. O. Box 280, Zomba, Malawi
| | - Anthony Idowu Ajayi
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Manga Close, Nairobi, 00100, Kenya.
| | - Boniface Ayanbekongshie Ushie
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Manga Close, Nairobi, 00100, Kenya
| | - Alister C Munthali
- Centre for Social Research, University of Malawi, P. O. Box 280, Zomba, Malawi
| | | | - Caroline W Kabiru
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Manga Close, Nairobi, 00100, Kenya
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Aboagye RG, Asare BYA, Adu C, Cadri A, Seidu AA, Ahinkorah BO, Yaya S. Exposure to interparental violence and justification of intimate partner violence among women in Papua New Guinea. BMC Womens Health 2023; 23:122. [PMID: 36959590 PMCID: PMC10035277 DOI: 10.1186/s12905-023-02248-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 02/28/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Previous studies have demonstrated that exposure to interparental violence is associated with intimate partner violence justification in a variety of contexts. In this study, we examined the association between exposure to interparental violence and justification of intimate partner violence among women in Papua New Guinea. METHODS We used data from the 2016-18 Papua New Guinea Demographic and Health Survey. We included 2839 women of reproductive age (15-49 years) in a sexual union (married and cohabiting) in the study. We used a multivariable binary multilevel regression analysis to examine the association between interparental violence and justification of intimate partner violence. We presented the results of the regression analysis using crude odds ratio (cOR) and adjusted odds ratios (aORs), with their 95% confidence intervals (CIs). RESULTS Women exposed to interparental violence were 1.26 (95%CI = 1.05, 1.53) times more likely to justify intimate partner violence than those who were not exposed. Women who resided in the Highlands (aOR = 2.50, 95%CI = 1.78, 3.51), Momase (aOR = 1.96, 95%CI = 1.40, 2.75), and Islands (aOR = 1.42, 95%CI = 1.01, 1.99) were more likely to justify intimate partner violence compared to those in the Southern region. Women who were exposed to one (aOR = 1.38, 95%CI = 1.06, 1.82) mass media were more likely to justify intimate partner violence compared to those who had no exposure to mass media. On the other hand, women aged 25-34 years (aOR = 0.66, 95%CI = 0.48, 0.91) and 35-49 years (aOR = 0.66, 95%CI = 0.44, 0.97) were less likely to justify intimate partner violence compared to those aged 15-24 years. CONCLUSIONS Our study has shown that exposure to interparental violence is a predictor of intimate partner violence justification. This study suggests the need for conscious and continuous efforts to identify and assist women who have been exposed to interparental violence to help prevent its transition to later life. Policies and interventions should be developed and implemented to curtail children's exposure to domestic violence in their households. Also, laws and policies need to condemn any violence and demystify community justification and acceptance of intimate partner violence, taking into consideration the significant sociodemographic characteristics of the women highlighted in the study.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
| | - Bernard Yeboah-Asiamah Asare
- Curtin School of Population Health, Curtin University, Perth, Australia
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK
| | - Collins Adu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
- Center for Social Research in Health, University of New South Wales Sydney, Sydney, NSW, 2052, Australia
| | - Abdul Cadri
- Department of Social and Behavioural Science, School of Public Health, University of Ghana, Legon- Accra, Ghana
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
- Centre For Gender and Advocacy, Takoradi Technical University, P.O.Box 256, Takoradi, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Ramsoomar L, Gibbs A, Chirwa ED, Machisa MT, Alangea DO, Addo-Lartey AA, Dunkle K, Jewkes R. Pooled analysis of the association between mental health and violence against women: evidence from five settings in the Global South. BMJ Open 2023; 13:e063730. [PMID: 36921941 PMCID: PMC10030569 DOI: 10.1136/bmjopen-2022-063730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVES To describe associations between men's poor mental health (depressive and post-traumatic stress symptomatology) and their perpetration of intimate partner violence (IPV) and non-partner sexual violence (NPSV), and women's mental health and their experiences of IPV and NPSV in five settings in the Global South. DESIGN A pooled analysis of data from baseline interviews with men and women participating in five violence against women and girls prevention intervention evaluations. SETTING Three sub-Saharan African countries (South Africa, Ghana and Rwanda), and one Middle Eastern country, the occupied Palestinian territories. PARTICIPANTS 7021 men and 4525 women 18+ years old from a mix of self-selecting and randomly selected household surveys. MAIN OUTCOME MEASURES All studies measured depression symptomatology using the Centre for Epidemiological Studies-Depression, and the Harvard Trauma Scale for post-traumatic stress disorder (PTSD) symptoms among men and women. IPV and NPSV were measured using items from modified WHO women's health and domestic violence and a UN multicountry study to assess perpetration among men, and experience among women. FINDINGS Overall men's poor mental health was associated with increased odds of perpetrating physical IPV and NPSV. Specifically, men who had more depressive symptoms had increased odds of reporting IPV (adjusted OR (aOR)=2.13; 95%CI 1.58 to 2.87) and NPSV (aOR=1.62; 95% CI 0.97 to 2.71) perpetration compared with those with fewer symptoms. Men reporting PTSD had higher odds of reporting IPV (aOR=1.87; 95% CI 1.44 to 2.43) and NPSV (aOR=2.13; 95% CI 1.49 to 3.05) perpetration compared with those without PTSD. Women who had experienced IPV (aOR=2.53; 95% CI 2.18 to 2.94) and NPSV (aOR=2.65; 95% CI 2.02 to 3.46) had increased odds of experiencing depressive symptoms compared with those who had not. CONCLUSIONS Interventions aimed at preventing IPV and NPSV perpetration and experience must account for the mental health of men as a risk factor, and women's experience.
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Affiliation(s)
- Leane Ramsoomar
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Health Systems and Public Health, University of the Pretoria, Gauteng, South Africa
| | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- Department of Psychology, University of Exeter, Exeter, Devon, UK
| | - Esnat D Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Mercilene T Machisa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Deda Ogum Alangea
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Legon, Accra, Ghana
| | - Adolphina Addoley Addo-Lartey
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Legon, Accra, Ghana
| | - Kristin Dunkle
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Health Systems and Public Health, University of the Pretoria, Gauteng, South Africa
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Jewkes R, Chirwa E, Alangea DO, Addo-Lartey A, Christofides N, Dunkle K, Ramsoomar L, Gibbs A. Pooled analysis of the association between food insecurity and violence against women: Evidence from low- and middle-income settings. J Glob Health 2023; 13:04021. [PMID: 36896806 PMCID: PMC9999307 DOI: 10.7189/jogh.13.04021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Background Intimate partner violence impacts relationships across the socioeconomic spectrum, nonetheless its prevalence is reported to be highest in areas that are most socio-economically deprived. Poverty has direct and indirect impacts on intimate partner violence (IPV) risk, however, one of the postulated pathways is through food insecurity. The aim of this paper is to describe the association between food insecurity (household hunger) and women's experiences, and men's perpetration, of intimate partner violence and non-partner sexual violence in data from Africa and Asia. Methods We conducted a pooled analysis of data from baseline interviews with men and women participating in six Violence Against Women prevention intervention evaluations and present a meta-analysis using mixed-effects Poisson regression models. Data were from South Africa (two studies), Ghana, Rwanda (two data sets), and Afghanistan and comprised interviews with 6545 adult women and 8104 adult men. We assessed food insecurity with the Household Hunger Scale. Results Overall, 27.9% of women experienced moderate food insecurity (range from 11.1% to 44.4%), while 28.8% of women reported severe food insecurity (range from 7.1 to 54.7%). Overall food insecurity was associated with an increased likelihood of women experiencing physical intimate partner violence, adjusted incidence rate ratio (aIRR) = 1.40 (95% CI = 1.23 to 1.60) for moderate food insecurity and aIRR = 1.73 (95% CI = 1.41 to 2.12) for severe food insecurity. It was also associated with an increased likelihood of men reporting perpetration of physical IPV, with aIRR = 1.24 (95% CI = 1.11 to 1.39) for moderate food insecurity and aIRR = 1.18 (95% CI = 1.02 to 1.37) for severe food insecurity. Food insecurity was not significantly associated with women's experience of non-partner sexual violence, aIRR = 1.27 (95% CI = 0.93 to 1.74) for moderate or severe food insecurity vs none, nor men's perpetration of non-partner sexual violence aIRR = 1.02 (95% CI = 0.90 to 1.15). Conclusions Food insecurity is associated with increased physical intimate partner violence perpetration and experience reported by men and women. It was not associated with non-partner sexual violence perpetration, although there was some evidence to suggest an elevated risk of non-partner sexual violence among food-insecure women. Prevention programming needs to embrace food insecurity as a driver of intimate partner violence perpetration, however, non-partner sexual violence prevention needs to be shaped around a separate understanding of its drivers.
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Affiliation(s)
- Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Pretoria, Gauteng, South Africa
| | - Esnat Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | | | | | - Nicola Christofides
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Kristin Dunkle
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Pretoria, Gauteng, South Africa
| | - Leane Ramsoomar
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- School of Public Health and Health Systems, University of the Pretoria, Pretoria, Gauteng, South Africa
| | - Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
- Department of Psychology, University of Exeter, Exeter, Devon, UK
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Franchino-Olsen H, Christofides N, Woollett N, Fouche A, Silima M, Thurston C, Monaisa K, Meinck F. Conducting Violence Research Across Multiple Family Generations and with Young Children: Findings from a Mixed-Methods Pilot Study in South Africa. INTERNATIONAL JOURNAL ON CHILD MALTREATMENT : RESEARCH, POLICY AND PRACTICE 2023:1-27. [PMID: 37360288 PMCID: PMC9988603 DOI: 10.1007/s42448-023-00157-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 03/08/2023]
Abstract
This paper presents findings from a pilot study focused on examining intergenerational violence in a three-generation sample, which included young children, in a rural area of South Africa. The aims of the pilot study were to investigate the feasibility of participant recruitment, consent, and interviewing; length and burden of the study questionnaires; appropriateness and acceptability of the measures used; and young children's (age 4-7) ability to comprehend the measures and participate meaningfully in interviews asking about violence. Data were collected for 4 months with three groups of participants, often within families (young adults, their children, and the young adults' former caregivers), using cognitive interviews, quantitative questionnaires, and qualitative in-depth interviews. All groups participated in arts-based methods and child interviews included visual and tactile aids. Pilot study findings demonstrated feasible recruitment within families for a three-generation study using comprehensive consent protocols and mandatory reporting information. Adults and young children were able to participate in the extensive interviews (2-3 h and 1 h, respectively) without significant burden. The employed measures were appropriate and acceptable to the setting, though minor revisions were made to improve comprehension of certain items. Young children were able to engage and participate meaningfully in the research, though they were not able to answer abstract reasoning items in cognitive interviews and children who were less developmentally advanced required more play- and arts-based accommodations to support their participation. Future research around sensitive topics, such as violence, appears feasible within families and including young children as participants even in resource-poor settings. Supplementary Information The online version contains supplementary material available at 10.1007/s42448-023-00157-w.
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Affiliation(s)
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Nataly Woollett
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Visual Arts, University of Johannesburg, Johannesburg, South Africa
| | - Ansie Fouche
- School of Health Sciences, North-West University, Vanderbijlpark, South Africa
- Department of Social Wellbeing, United Arab Emirates University, A1 Ain, United Arab Emirates
| | - Mpho Silima
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Christina Thurston
- School of Social and Political Sciences, University of Edinburgh, Edinburgh, UK
| | - Kopano Monaisa
- School of Health Sciences, North-West University, Vanderbijlpark, South Africa
| | - Franziska Meinck
- School of Social and Political Sciences, University of Edinburgh, Edinburgh, UK
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- School of Health Sciences, North-West University, Vanderbijlpark, South Africa
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Sikweyiya Y, Machisa M, Mahlangu P, Nunze N, Dartnall E, Pillay M, Jewkes R. "I Don't Want to Be Known as a Weak Man": Insights and Rationalizations by Male Students on Men's Sexual Violence Perpetration against Female Students on Campus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4550. [PMID: 36901558 PMCID: PMC10002200 DOI: 10.3390/ijerph20054550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/08/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Understanding how men view rape is foundational for rape prevention, but it is not always possible to interview men who rape, especially in a college campus context. We explore male students' insights into and rationalizations for why men on campus perpetrate sexual violence (SV) against female students by analysing qualitative focus group discussion data with male students. Men contended that SV is a demonstration of men's power over women, yet they did not perceive sexual harassment of female students as serious enough to constitute SV and appeared to be tolerant of it. Men perceived "sex for grades" as exploitative and rooted in the power asymmetry between privileged male lecturers and vulnerable female students. They were disdainful of non-partner rape, describing it as acts exclusively perpetrated by men from outside campus. Most men felt entitled to have sex with their girlfriends, although an alternative discourse challenged both this entitlement and the dominant masculinity linked to it. Gender-transformative work with male students is needed to support them to think and do things differently while they are on campus.
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Affiliation(s)
- Yandisa Sikweyiya
- Gender and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Mercilene Machisa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Pinky Mahlangu
- Gender and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Ncediswa Nunze
- Gender and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
| | - Elizabeth Dartnall
- Sexual Violence Research Initiative, 28 High Street, Pretoria 1045, South Africa
| | - Managa Pillay
- Office of the Deputy Director General, Care and Support Services, Department of Basic Education, 222 Struben Street, Pretoria 0001, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Pretoria 0001, South Africa
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Miedema SS, Le VD, Chiang L, Ngann T, Shortt JW. Adverse Childhood Experiences and Intimate Partner Violence Among Youth in Cambodia: A Latent Class Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1446-NP1472. [PMID: 35471130 PMCID: PMC10263171 DOI: 10.1177/08862605221090573] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Adverse childhood experiences (ACEs) are a global public health problem, including in low- and middle-income country settings, and are associated with increased risk of intimate partner violence (IPV) during young adulthood. However, current measurement of ACEs may underestimate sequelae of different combinations, or classes, of ACEs and mask class-specific associations with adult exposure to IPV. We used data among ever-partnered young women and men aged 18-24 years from the Cambodia Violence Against Children Survey (Nw = 369; Nm = 298). Participants retrospectively reported on seven ACEs and lifetime physical and/or sexual IPV victimization and perpetration. Latent classes comprised of ACEs were used as predictors of physical and/or sexual IPV perpetration and victimization, controlling for household wealth. Identified latent classes for women were "Low ACEs" (60%), "Community Violence and Physical Abuse" (23%), and "Physical, Sexual and Emotional Abuse" (17%). Latent classes for men were "Low ACEs" (48%) and "Household and Community Violence" (52%). Among women, those in the Physical, Sexual and Emotional Abuse class were more likely to experience and perpetrate physical and/or sexual IPV in their romantic relationships compared to the reference group (Low ACEs). Women in the Community Violence and Physical Abuse class were more likely to perpetrate physical and/or sexual IPV, but not experience IPV, compared to women in the Low ACEs class. Among men, those in the Household and Community Violence class were more likely to perpetrate physical and/or sexual IPV against a partner, compared to men in the Low ACEs class. Overall, patterns of ACEs were differently associated with IPV outcomes among young women and men in Cambodia. National violence prevention efforts might consider how different combinations of childhood experiences shape risk of young adulthood IPV and tailor interventions accordingly to work with youth disproportionately affected by varied combinations of ACEs.
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Affiliation(s)
- Stephanie S. Miedema
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vi Donna Le
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura Chiang
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thanak Ngann
- Gender and Development for Cambodia (GAD/C), Phnom Penh, Cambodia
| | - Joann Wu Shortt
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Mastonshoeva S, Shonasimova S, Gulyamova P, Jewkes R, Shai N, Chirwa E, Myrttinen H. Quantitative evaluation of Zindagii Shoista (Living with Dignity) intervention to prevent violence against women in Tajikistan. Glob Health Action 2022; 15:2122994. [PMID: 36441089 PMCID: PMC9894538 DOI: 10.1080/16549716.2022.2122994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Violence against women and girls (VAWG) is a major problem in Tajikistan, driven by conservative gender norms, the culturally ascribed position of young women, and poverty. OBJECTIVE We evaluated Zindagii Shoista (Living with Dignity), an intervention developed with the aim of reducing VAWG through a combination of gender norm change, communication skills, and income-generating activities (IGA) over a period of 30 months. METHODS The evaluation used a mixed-methods approach, combining quantitative and qualitative data collection. Eighty families from four villages were enrolled in the intervention and surveyed at baseline and on three subsequent occasions. From these families, 134 women and 102 men were interviewed at baseline, 153 women and 89 men 8 months later, 153 women and 93 men 15 months later, and 143 women and 82 men, 30 months after the baseline. Generalised random effects regression models were used to assess the trend in proportions or mean score over time. RESULTS Over the 30 months, the proportion of women and men earning in the past month rose from 17.9% to 56.6% and 44.1% to 72%, respectively. Women and men's gender attitudes became significantly less patriarchal, and they reported less harmful gender norms in the community. Women and men reported less male controlling behaviour and greater woman involvement in decision-making. Women's reports of experience of emotional, physical, and sexual IPV significantly reduced. Depressive symptoms and suicidal thoughts reduced significantly for men and women, and self-rated health improved. CONCLUSIONS The quantitative findings are confirmed by the findings of the qualitative research and monitoring data. They demonstrate that Zindagii Shoista is a very promising intervention for strengthening gender relations, reducing IPV, and improving mental health and socio-economic circumstances for younger married women and their families in Tajikistan.
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Affiliation(s)
- Subhiya Mastonshoeva
- International Alert, Dushanbe, Tajikistan,CONTACT Subhiya Mastonshoeva International Alert, Dushanbe, Tajikistan; Rue de Grand-Pré 53, 1202 Geneve, Switzerland
| | | | | | - Rachel Jewkes
- Office of the Executive Scientist, South African Medical Research Council, Pretoria, South Africa,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nwabisa Shai
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Gender & Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Esnat Chirwa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Gender & Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Henri Myrttinen
- Gender Associations International Consulting, Berlin, Germany
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Howard JA, Gibson MA. Testing evolutionary conflict theories for sexual and physical intimate partner violence in Sub-Saharan Africa. EVOLUTIONARY HUMAN SCIENCES 2022; 5:e6. [PMID: 37587946 PMCID: PMC10426027 DOI: 10.1017/ehs.2022.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 12/23/2022] Open
Abstract
Intimate partner violence (IPV) refers to physical, sexual and psychological violence. Here an evolutionary approach is used to compare risk factors for male-to-female IPV perpetration, analysing physical and sexual IPV separately. Two hypotheses based on sexual conflict theory have been applied to IPV perpetration, but they remain largely untested using empirical data: (a) men perpetrate IPV in response to a perceived threat to their paternity certainty; and (b) IPV is caused by men pursuing a higher fertility optima than their partners, either within marriage (reproductive coercion) or outside marriage (paternal disinvestment). Demographic Health Survey data from couples in 12 sub-Saharan African countries (n = 25,577) were used to test these evolutionary hypotheses, using multilevel models and controlling for potential social and environmental confounds. The results show that evolutionary theory provides important insight into different risk factors by IPV type. Indicators of paternity concern are associated with an increased risk of both physical and sexual IPV, indicators of paternal disinvestment are associated with an increased risk of physical IPV only, while reproductive coercion is not associated with either IPV type. The risk factors identified here correspond with proximate-level explanations for IPV perpetration, but an evolutionary interpretation explains why these particular factors may motivate IPV in certain contexts.
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Affiliation(s)
- Janet A. Howard
- Department of Anthropology and Archaeology, University of Bristol, 43 Woodland Road, Bristol BS8 1UU, UK
| | - Mhairi A. Gibson
- Department of Anthropology and Archaeology, University of Bristol, 43 Woodland Road, Bristol BS8 1UU, UK
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A Descriptive Systematic Review of Food Insecurity and Intimate Partner Violence in Southern Africa. WOMEN 2022. [DOI: 10.3390/women2040036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Food insecurity and intimate partner violence are important determinants of health and wellbeing in southern Africa. However, very little research has attempted to investigate the association between them even though food insecurity is anticipated to increase in the region, mostly owing to climate change. The objective of this paper was to descriptively review peer reviewed studies that investigated the relationship between food insecurity and intimate partner violence in southern Africa. Literature searches were carried out in Scopus, Web of Science and PubMed databases without any time restriction. A total of five studies that investigated the association between food insecurity and intimate partner violence were identified in South Africa and Swaziland. Of these four studies used a cross-sectional design, and one employed a longitudinal design. Samples varied from 406 to 2479 individuals. No empirical studies were found for the remaining southern African countries of Angola, Botswana, Malawi, Namibia, Zambia, Zimbabwe, Lesotho, and Mozambique. Moreover, the reported findings indicated that there was an association between food insecurity and interpersonal violence (i.e., physical, psychological, and emotional) in the sub-region regardless the fact that the five studies used diverse measurements of both food insecurity and intimate partner violence.
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Laslett AM, Kuntsche S, Wilson IM, Taft A, Fulu E, Jewkes R, Graham K. The relationship between fathers' heavy episodic drinking and fathering involvement in five Asia-Pacific countries: An individual participant data meta-analysis. Alcohol Clin Exp Res 2022; 46:2137-2148. [PMID: 36524922 PMCID: PMC10108151 DOI: 10.1111/acer.14955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND This study aims to increase understanding of the relationship between heavy episodic drinking (HED) and fathers' involvement in parenting in five countries. The potential moderating effect of fathers' experiences of childhood trauma is also studied, controlling for the possible confounding of the effect of HED by father's attitudes toward gender equality, father's age and father's education. METHOD United Nations Multi-Country Study on Men and Violence (UNMCS) survey data from 4562 fathers aged 18-49 years from Cambodia, China, Indonesia and Papua New Guinea (PNG) and Sri Lanka were used to assess the relationship between fathering involvement (e.g., helping children with their homework) and self-reported HED of 6+ drinks in one occasion vs. non-HED and abstaining. Moderating effects of a 13-item fathers' childhood trauma (FCT) scale were tested and analyses were adjusted for gender-inequitable attitudes using the Gender-Equitable Men scale score. Bivariate and adjusted individual participant meta-analyses were used to determine effect estimates for each site and across all sites. RESULTS Fathers' HED was associated with less positive parental involvement after adjusting for gender-equitable attitudes, FCT, age and education. No overall interaction between HED and FCT was identified. Gender equitable attitudes were associated with fathering involvement in some countries but not overall (p = 0.07). CONCLUSIONS Heavy episodic drinking was associated with reduced positive fathering involvement. These findings suggest that interventions to increase fathers' involvement in parenting should include targeting reductions in fathers' HED. Structural barriers to fathers' involvement should be considered alongside HED in future studies of fathers' engagement with their children.
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Affiliation(s)
- Anne-Marie Laslett
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia.,National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.,Melbourne School of Global and Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sandra Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia
| | - Ingrid M Wilson
- Singapore Institute of Technology, Singapore, Singapore.,Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia.,Department of Sociology, Social Policy and Criminology, University of Liverpool in Singapore, Singapore, Singapore
| | - Angela Taft
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Emma Fulu
- The Equality Institute, Melbourne, Victoria, Australia
| | - Rachel Jewkes
- Office of the Executive Scientist, South African Medical Research Council (SAMRC), Pretoria, South Africa
| | - Kathryn Graham
- Centre for Addiction and Mental Health, Toronto/London, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Kutin JJ, Russell R, Reid M. ‘I didn’t even know it was a thing’: Australian young adults’ experience of economic abuse. Health Promot Int 2022; 37:6823567. [DOI: 10.1093/heapro/daac152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Summary
Economic abuse is a form of intimate partner violence that involves one partner controlling or restricting, exploiting or sabotaging the economic resources of the other partner. Little is known how economic abuse manifests in young people’s relationships or how to prevent it. This study explored young adults’ experiences of economic abuse and identified the factors associated with economic abuse in their relationships. Twenty-four young adults (18 women and 6 men) aged 18–29, were interviewed in-depth using both unstructured narrative and semi-structured interview questions. Thematic analysis was used to identify forms of economic abuse. Common experiences of economic abuse included: exploitation of financial and other resources, controlling access to money, damage to property and sabotage of employment and study. The contextual factors included lack of awareness of economic abuse, valuing love and relationships over money and fear of conflict and rejection. We argue that economic abuse prevention strategies should target young adults in their relationship formation stage and take into account the context of relationships and the issues young people face when venturing into cohabitation.
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Affiliation(s)
- Jozica Johanna Kutin
- School of Economics, Finance and Marketing, RMIT University , Melbourne, VIC , Australia
| | - Roslyn Russell
- School of Economics, Finance and Marketing, RMIT University , Melbourne, VIC , Australia
| | - Mike Reid
- School of Economics, Finance and Marketing, RMIT University , Melbourne, VIC , Australia
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Shrestha SK, Thapa S, Vicendese D, Erbas B. Women's attitude towards intimate partner violence and utilization of contraceptive methods and maternal health care services: an analysis of nationally representative cross-sectional surveys from four South Asian countries. BMC Womens Health 2022; 22:215. [PMID: 35676686 PMCID: PMC9178873 DOI: 10.1186/s12905-022-01780-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background Intimate partner violence (IPV) adversely affects women’s reproductive health outcomes but to what extent women’s justification of IPV affects maternal health care service utilization is unexplored. Methods The secondary cross-sectional datasets from multiple indicator cluster surveys of Afghanistan, Bhutan, Nepal and Pakistan conducted between 2010 and 2015 were used. We used a generalized linear mixed model with random effects, at both cluster- and country-level, to determine the odds ratio of maternal health service utilization at the regional level and a multivariable logistic regression model adjusting for complex survey design at the country level. Interaction between women’s justification of IPV and residential location, and linear trend in the utilization of maternal health care services associated with increasing levels of women's justification of IPV, were examined using the Likelihood Ratio Test (LRT). Results A total of 26,029 women aged 15–49 years, living with their partners and had a pregnancy outcome 2 years prior to the survey were included. Women justifying IPV were less likely to utilize contraceptive methods (aOR) = 0.86, 95% CI 0.84, 0.88), at-least one Antenatal Care (ANC) visit (aOR = 0.80, 95% CI 0.72, 0.88), four or more ANC services (aOR = 0.81, 95% CI 0.76, 0.86), institutional delivery (aOR = 0.87, 95% CI 0.80, 0.94) and Post-natal Care (aOR = 0.76, 95% CI 0.62, 0.95) services. A decreasing linear trend was observed for four or more ANC visits (LRT P = 0.96) and institutional delivery (LRT P = 0.80) with increasing levels of IPV justification. Women justifying IPV were less likely to have at least one ANC visit in urban (aOR 0.67, 95% CI 0.60, 0.75) compared to rural areas (aOR 0.83, 95% CI 0.73, 0.94). Conclusions Women’s justification of IPV was associated with decreased odds of utilizing a wide range of maternal health care services at the regional level. Although further research that may help establish a causal link is important before formulating public health interventions, our study indicates interventions targeting women’s condoning attitude toward IPV, delivered sooner rather than later, could potentially help to improve women’s utilization of essential maternal health care services in the South Asian region that comprises Afghanistan, Bhutan, Nepal, and Pakistan. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01780-4.
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Howard JA, Gibson MA. No relationship found between female genital cutting and intimate partner violence across six sub-Saharan African countries. Glob Public Health 2022; 17:2704-2719. [PMID: 34743651 DOI: 10.1080/17441692.2021.1991974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Female genital cutting (FGC) and intimate partner violence (IPV) are highly prevalent forms of violence against women, and the UN has encouraged strengthening policy linkages between FGC and IPV programme work (UN Women, Female genital mutilation/cutting and violence against women and girls. Strengthening the policy linkages between different forms of violence. UN Women, 2017a). However few studies have examined the relationship between these behaviours. This study addresses two research gaps identified by the UN; (a) whether women with FGC are more likely to experience physical or sexual IPV, and (b) whether women's IPV experiences are associated with their support for FGC. Multilevel multivariate logistic regression models were run using Demographic and Health Survey data from 6 sub-Saharan African countries (Burkina Faso, Ethiopia, The Gambia, Ivory Coast, Kenya and Nigeria, n33,170). Our results show no association between FGC and IPV. Women with FGC are not at greater risk of experiencing IPV, and women who experienced IPV in the preceding year are not more likely to support FGC. Further, the importance of individual and community factors differ; IPV experience is influenced by individual factors, whereas FGC support is more influenced by ethnic group characteristics. Although the proposition that FGC and IPV could be tackled collaboratively is attractive for policy makers, these results are important because they indicate that eradication programmes will be more effective when targeted at specific behaviours.
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Affiliation(s)
- Janet A Howard
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
| | - Mhairi A Gibson
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
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Bandara P, Knipe D, Munasinghe S, Rajapakse T, Page A. Socioeconomic and Geographic Correlates of Intimate Partner Violence in Sri Lanka: Analysis of the 2016 Demographic and Health Survey. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP20569-NP20601. [PMID: 34854795 DOI: 10.1177/08862605211055146] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Intimate partner violence (IPV) is a serious public health issue and violation of human rights. The prevalence of IPV in South Asia is especially pronounced. We examined the associations between socioeconomic position (SEP), geographical factors and IPV in Sri Lanka using nationally representative data. Data collected from Sri Lanka's 2016 Demographic and Health Survey were analysed using multilevel logistic regression techniques. A total of 16,390 eligible ever-partnered women aged 15-49 years were included in the analysis. Analyses were also stratified by ethnicity, type of violence, neighbourhood poverty and post-conflict residential status for selected variables. No schooling/primary educational attainment among women (OR 2.46 95% CI 1.83-3.30) and their partners (OR 2.87 95% CI 2.06-4.00), financial insecurity (OR 2.17 95% CI 1.92-2.45) and poor household wealth (OR 2.64 95% CI 2.22-3.13) were the socioeconomic factors that showed the strongest association with any IPV, after adjusting for age and religion. These associations predominately related to physical and/or sexual violence, with weak associations for psychological violence. Women living in a post-conflict environment had a higher risk (OR 2.96 95% CI 2.51-3.49) of IPV compared to other areas. Ethnic minority women (Tamil and Moor) were more likely to reside in post-conflict areas and experience poverty more acutely compared to the majority Sinhala women, which may explain the stronger associations for low SEP, post-conflict residence and IPV found among Tamil and Moor women. Policies and programs to alleviate poverty, as well as community mobilisation and school-based education programs addressing harmful gender norms may be beneficial. Trauma informed approaches are needed in post-conflict settings. Further exploratory studies investigating the complex interplay of individual, household and contextual factors occurring in this setting is required.
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Affiliation(s)
- Piumee Bandara
- Translational Health Research Institute, 371448Western Sydney University, Campbelltown, NSW, Australia
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration, 54692University of Peradeniya, Peradeniya, Sri Lanka
| | - Duleeka Knipe
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration, 54692University of Peradeniya, Peradeniya, Sri Lanka
- Population Health Sciences, Bristol Medical School, 152331University of Bristol, Bristol, UK
| | - Sithum Munasinghe
- Translational Health Research Institute, 371448Western Sydney University, Campbelltown, NSW, Australia
| | - Thilini Rajapakse
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration, 54692University of Peradeniya, Peradeniya, Sri Lanka
- Department of Psychiatry, Faculty of Medicine, 54692University of Peradeniya, Peradeniya, Sri Lanka
| | - Andrew Page
- Translational Health Research Institute, 371448Western Sydney University, Campbelltown, NSW, Australia
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48
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Kilgallen JA, Schaffnit SB, Kumogola Y, Galura A, Urassa M, Lawson DW. Positive Correlation Between Women's Status and Intimate Partner Violence Suggests Violence Backlash in Mwanza, Tanzania. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP20331-NP20360. [PMID: 34802316 DOI: 10.1177/08862605211050095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Urbanization in low and middle-income nations is characterized by economic and demographic shifts largely understood to be beneficial to women's empowerment. These changes include increased education and wage-labor opportunities, a disruption of traditional patrilocal residence systems, and reductions in spousal age gap and fertility. However, such changes may drive a "violence backlash," with men increasing intimate partner violence (IPV) in efforts to challenge women's shifting status. To date, tests of this idea primarily relate to women's changing economic status, with less known about the demographic correlates of IPV in urbanizing settings. Addressing this, we conducted a cross-sectional study of IPV behavior and attitudes in an urbanizing community in Mwanza, northern Tanzania (n = 317). Consistent with a violence backlash, IPV was reported more often among women educated at higher levels than their husband, and women earning similar, rather than lower, wages to their husband were more likely to report that he condones IPV. These findings were independent of women's absolute education and income. Furthermore, less frequent paternal kin contact, and relatively small spousal age gaps, generally understood to boost women's empowerment, were associated with an increased risk of experiencing IPV. Less frequent paternal kin contact was also associated with an increased likelihood that a husband condones IPV. Contrary to our predictions, relatively lower fertility, generally linked to higher women's empowerment, did not predict IPV behavior and women with high, rather than low, fertility were more likely to report that their husband condones IPV. Overall, our results support the notion of a violence backlash corresponding to economic changes for women that accompany urbanization. In contrast, demographic changes associated with urbanization have more variable relationships. Drawing on these results, we suggest future research avenues for better understanding the vulnerability of women to IPV in urbanizing settings.
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Affiliation(s)
- Joseph A Kilgallen
- Department of Anthropology, 8786University of California, Santa Barbara, CA, USA
| | - Susan B Schaffnit
- Department of Anthropology, 8786University of California, Santa Barbara, CA, USA
| | - Yusufu Kumogola
- 119151National Institute for Medical Research, Mwanza, Tanzania
| | - Anthony Galura
- Department of Anthropology, 8786University of California, Santa Barbara, CA, USA
| | - Mark Urassa
- 119151National Institute for Medical Research, Mwanza, Tanzania
| | - David W Lawson
- Department of Anthropology, 8786University of California, Santa Barbara, CA, USA
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Mahlangu P, Machisa M, Sikweyiya Y, Nunze N, Dartnall E, Pillay M, Jewkes R. Preliminary evidence of promise of a sexual violence risk reduction intervention for female students in South African tertiary education institutions. Glob Public Health 2022; 17:2720-2736. [PMID: 34775925 DOI: 10.1080/17441692.2021.1998574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Campus sexual violence risk reduction and resistance interventions have been developed and tested among female students in the global North and proven effective. Evidence-based interventions to prevent sexual violence tested amongst female students in the global South and in South African campuses are lacking. We present preliminary evidence of promise of Ntombi Vimbela! (NV!), a sexual violence prevention intervention piloted amongst first year female students in eight purposively selected campuses in South Africa. Focus group discussions were conducted with 118 female students who participated in NV! workshops. Most students found the content of NV! relevant and reported having experienced its positive effects. They perceived that NV! empowered them with skills to assess and deal with sexual assault risky situations. NV! changed their attitudes and beliefs about gender, shifted their acceptance of rape myths and beliefs, improved communication skills, enhanced self-esteem, and confidence to defend oneself in risky sexual assault situations. Few participants were unsure whether they will be able to use the skill in real life. These findings indicate a range of short-term positive outcomes which we anticipate would reduce the risk of sexual assault among first year female students. This suggests that NV! should be subject to further evaluation.
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Affiliation(s)
- Pinky Mahlangu
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Mercilene Machisa
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Yandisa Sikweyiya
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Ncediswa Nunze
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | | | - Managa Pillay
- Department of Basic Education, Care Support Services, Pretoria, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa.,School of Public Health, University of Witwatersrand, Johannesburg, South Africa
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Levtov RG, Doyle K, Bingenheimer JB, Lahiri S, Kazimbaya S, Karamage E, Sayinzoga F, Mutoni M, Rubayita CH, Barker G. Improved Relationship Quality, Equitable Gender Attitudes, and Reduced Alcohol Abuse as Key Mechanisms to Reduce Intimate Partner Violence in the Bandebereho Couples' Randomized Trial in Rwanda. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1495-1506. [PMID: 36219325 DOI: 10.1007/s11121-022-01445-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 10/17/2022]
Abstract
Over the past decade, there has been rapid growth in the evidence for programs to prevent or reduce intimate partner violence (IPV)-the most common form of men's violence against women. IPV interventions targeting heterosexual couples have shown significant impact. However, our understanding of how these interventions achieve their impacts on violence-the mechanisms through which change occurs-remains limited. Using data from two follow-up rounds of a randomized controlled trial of the Bandebereho intervention in Rwanda, we constructed conceptually driven structural equation models to represent the processes by which hypothesized mediating variables linked treatment assignment to IPV. We found significant differences in the expected direction between the intervention and control participants on all mediating variables, including men's alcohol use, communication frequency, emotional closeness, frequency of quarreling, and men's attitudes related to gender and violence. Several mechanisms-more positive couple dynamics including emotional closeness and communication frequency; men's gender-equitable attitudes; men's alcohol use-accounted for the largest proportions of the effect of assignment to the Bandebereho intervention on IPV. Overall, our findings highlight that no one particular component is driving the reductions in violence; instead, the multiple components and pathways account for the intervention's effects, suggesting that the holistic nature of the intervention may be integral to its positive impact. The Bandebereho trial from which data was used in this analysis was registered on ClinicalTrials.gov prior to completion ( NCT02694627 ).
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Affiliation(s)
| | - Kate Doyle
- Equimundo: Center for Masculinities and Social Justice, Washington, DC, USA
| | - Jeffrey B Bingenheimer
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Shaon Lahiri
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.,Philosophy, Politics and Economics Program, University of Pennsylvania, PA, Philadelphia, USA.,Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, PA, Philadelphia, USA
| | - Shamsi Kazimbaya
- Equimundo: Center for Masculinities and Social Justice, Washington, DC, USA
| | | | - Felix Sayinzoga
- Rwanda Biomedical Center, Maternal Child and Community Health Division, Kigali, Rwanda
| | - Merab Mutoni
- Rwanda Biomedical Center, Maternal Child and Community Health Division, Kigali, Rwanda
| | | | - Gary Barker
- Equimundo: Center for Masculinities and Social Justice, Washington, DC, USA
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