A systematic review of training interventions addressing sexual violence against marginalized at-risk groups of women

A Qualitative Study of Female Migrant Domestic Workers’ Experiences of and Responses to Work-Based Sexual Violence in Cyprus

Domestic workers face increased risk for sexual harassment and assault in the workplace but are often reluctant to disclose abuse or seek retribution. We report on a study looking at migrant domestic workers’ responses to sexual violence, reasons behind their responses, and factors enhancing or diminishing vulnerability to abuse. We carried out qualitative, in-depth, individual and group interviews with 15 female domestic workers from the Philippines and Sri Lanka working in the Republic of Cyprus. Descriptive thematic analysis was used to analyse data using QSR NVivo 10.0. Sexual violence against migrant domestic workers was reported to be rampant, particularly among women living with their employer. Perpetrators took advantage of women’s precarious legal, social, and economic circumstances to coerce women into a sexual relationship. All participants reported taking action to stop attacks despite the significant barriers they faced: racism and discrimination, social isolation, and hostile legal, labour, and immigration systems. Fear of losing their job, being deported, and facing racism and discrimination from the police were the biggest barriers to seeking retribution. Access to informational, e.g., legal, practical, and emotional support, facilitated positive outcomes following abuse, such as finding a new employer. Systemic racism, hostile labour and immigration systems, and lack of support increase risk of sexual violence and place barriers against accessing safe working spaces, protection, and justice. Women need to be informed of the risks involved in domestic work and empowered to identify abuse and access help and support when needed.

Prevalence and incidence of HIV among female sex workers and their clients: modelling the potential effects of intervention in Rwanda

BACKGROUND

Rwanda has identified several targeted HIV prevention strategies, such as promotion of condom use and provision of antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) for female sex workers (FSWs). Given this country's limited resources, understanding how the HIV epidemic will be affected by these strategies is crucial.

METHODS

We developed a Markov model to estimate the effects of targeted strategies to FSWs on the HIV prevalence/incidence in Rwanda from 2017 to 2027. Our model consists of the six states: HIV-; HIV+ undiagnosed/diagnosed pre-ART; HIV+ diagnosed with/without ART; and death. We considered three populations: FSWs, sex clients and the general population. For the period 2017-2027, the HIV epidemic among each of these population was estimated using Rwanda's demographic, sexual risk behaviour and HIV-associated morbidity and mortality data.

RESULTS

Between 2017 and 2027, with no changes in the current condom and ART use, the overall number of people living with HIV is expected to increase from 344,971 to 402,451. HIV incidence will also decrease from 1.36 to 1.20 100 person-years. By 2027, a 30% improvement in consistent condom use among FSWs will result in absolute reduction of HIV prevalence among FSWs, sex clients and the general population by 7.86%, 5.97% and 0.17%, respectively. While recurring HIV testing and improving the ART coverage mildly reduced the prevalence/incidence among FSWs and sex clients, worsening the two (shown by our worst-case scenario) will result in an increase in the HIV prevalence/incidence among FSWs and sex clients. Introduction of PrEP to FSWs in 2019 will reduce the HIV incidence among FSWs by 1.28%.

CONCLUSIONS

Continued efforts toward improving condom and ART use will be critical for Rwanda to continue their HIV epidemic control. Implementing a targeted intervention strategy in PrEP for FSWs will reduce the HIV epidemic in this high-risk population.

Factors associated with sexual violence among female administrative staff of Mekelle University, North Ethiopia

Objective

To assess factors associated with sexual violence among female administrative staffs of Mekelle University, North Ethiopia.

Results

From the total number of participants, 188 (52.8%) had shift work and 110 (30.9%) of these had day and night shift. About half 180 (50.2%) of the participants face sexual violence similarly, 53 (14.9%) of the victims of violence performed by their boss. In multiple logistic regression analysis young age [AOR: 2.319 (1.059–5.075)], educational status of secondary school or less [AOR: 1.981 (1.126–3.485)], office and students related workplace [AOR: 4.143 (1.975–8.687), 2.887 (1.396–5.973)], having night shift [AOR: 2.131 (1.258–3.611)], having multiple partner (AOR: 8.916 (3.052–26.047)] and knowing other female violated in office [AOR: 3.920 (2.326–6.606)] were the factors associated with sexual violence.

Re-thinking health literacy: using a capabilities approach perspective towards realising social justice goals

Health literacy has gained popularity as a useful concept to promote and protect health. Even though health literacy research has been prolific it has also been fragmented, facing challenges in achieving its empowerment and social justice-related aims. Crucial limitations make the application of its principles to the health of vulnerable and underrepresented groups problematic, even though these groups are disproportionately affected by ill health. Efforts to refine and make the concept more relevant have tended to expand health literacy models and situate health literacy 'in context' to reflect environmental and social factors shaping health literacy. Context-related factors however, have not been consistently embedded in operationalisation and measurement efforts.This paper argues for health literacy to be re-conceptualised through a capabilities approach lens. It proposes that the capabilities approach can uniquely address the conceptual and methodological criticisms applied to health literacy, whilst encompassing its critical conceptual understandings of health. The advantage of this approach over and above other developments in health literacy theory and practice is its focus on both people's opportunities or freedoms to achieve desired health-related aims, and their ability to do so. It enables shifting the focus away from health literacy as individual skills and competencies and towards the enabling or inhibiting factors shaping health literacy. A participatory approach is seen as essential for realising this conceptual shift.