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Gebresilassie KY, Melesse AW, Birhan TY, Taddese AA. Gender-Based Violence - Magnitude and Types in Northwest Ethiopia. Int J Womens Health 2023; 15:1083-1091. [PMID: 37483886 PMCID: PMC10362876 DOI: 10.2147/ijwh.s409172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023] Open
Abstract
Background Violence Against Women (VAW) becomes a serious public health issue as unnecessary morbidity and mortalities affect women and girls. Women who experience violence had the possibility of another of violence. Although gender-based violence (GBV) is a common problem in Ethiopia, the burden is not well studied. Objective This study determines the magnitude of Gender-Based Violence among women receiving Sexual and Reproductive Health Services in a Specialized Hospital. Methods Institution-based retrospective follow-up study was conducted at the University of Gondar Comprehensive Specialized Hospital among gender-based violence (GBV) service users from January 2017 to January 2022. Data were collected from register logbooks and also medical records for some variables, using a tool prepared by refereeing literature and adapting locally available resources and researchers experiences. Epi-info 7 was used to enter the data and exported it to SPSS V-23 for analysis. Descriptive statistics like frequencies, percentages, means and standard deviations are computed for all variables. Results The lifetime proportion of sexual and physical violence was found to be 81% and 5%, respectively, while 3% of women experienced both sexual and physical violence. One hundred seventy (29.4%) of the incidents were done by an intimate-partners (boyfriend/husband). The majority (86%) had extra genital injuries. After genital examination, about one-fourth (25%) of survivors had fresh hymenal tears. About three-fourths (75.1%) of the survivors visit the health facility within threes day after the incident. Conclusion The study found that GBV is common in Northwest Ethiopia. Future research should involve sensitive methods and grounded approaches to explore survivors' experiences and views on local gender cultures and other contextual factors. Establishing One-stop-center could improve the quality of the services provided to the women.
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Affiliation(s)
| | - Alemakef Wagnew Melesse
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tilahun Yemanu Birhan
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Asefa Adimasu Taddese
- Department of Health Informatics /Biostatistics/, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Reed E, West BS, Frost E, Salazar M, Silverman JG, McIntosh CT, Gómez MGR, Urada LA, Brouwer KC. Economic vulnerability, violence, and sexual risk factors for HIV among female sex workers in Tijuana, Mexico. AIDS Behav 2022; 26:3210-3219. [PMID: 35380288 PMCID: PMC8980205 DOI: 10.1007/s10461-022-03670-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/25/2022]
Abstract
Economic vulnerability is often reported to underlie involvement in sex work among female sex workers (FSW), but may also create urgency in women's work, limiting women's negotiating power with clients and in turn, increasing their vulnerability for violence and HIV. This study assessed economic vulnerability in relation to violence and sexual risk behaviors for HIV among a sample of FSW in Tijuana, Mexico. FSW at least 18 years of age were recruited through venue-based sampling for a survey (n = 228) and in-depth interviews (n = 50) to investigate HIV risk factors in this region. Using crude and adjusted logistic regression models, we assessed lack of financial support from others as well as reports of financial hardship separately in relation to experiencing sexual violence (e.g. by clients, police, relationship partners, in the past 6 months), physical violence (past 6 months), STI diagnosis, and inconsistent condom use (past 30 days). Qualitative interviews (n = 50), conducted with a subsample of the survey participants, were also examined for related themes. FSW who reported no financial support were more likely to report sexual violence (OR = 2.1; 95% CI:1.1-4.2). FSW who reported financial hardship were more likely to experience sexual violence (OR = 1.9; 95% CI:1.1-3.6) and physical violence (OR = 1.9; 95% CI:1.1-3.6), as well as to report past 30-day inconsistent condom use (OR = 2.4; 95%CI: 1.3-4.6) and to test positive for an STI (OR = 1.9; 95% CI:1.1-3.4). Qualitative data substantiated these findings. Findings suggest that interventions to improve economic well-being may be useful to prevent the intersecting concerns of violence and HIV among FSW.
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Affiliation(s)
- Elizabeth Reed
- School of Public Health, San Diego State University, 5500 Campanile Drive, 92182-4162, San Diego, California, USA.
| | - Brooke S West
- School of Social Work, Columbia University, New York, NY, USA
| | - Elizabeth Frost
- School of Public Health, San Diego State University, 5500 Campanile Drive, 92182-4162, San Diego, California, USA
- School of Social Work, Columbia University, New York, NY, USA
| | - Marissa Salazar
- School of Public Health, San Diego State University, 5500 Campanile Drive, 92182-4162, San Diego, California, USA
| | - Jay G Silverman
- University of California, San Diego, La Jolla, California, USA
| | | | - María Gudelia Rangel Gómez
- US-Mexico Border Health Commission, Tijuana, Mexico
- El Colegio de la Frontera Norte (COLEF), Tijuana, Mexico
| | - Lianne A Urada
- University of California, San Diego, La Jolla, California, USA
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3
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Hosseini-Hooshyar S, Mirzazadeh A, Karamouzian M, Sharifi H, Khajehkazemi R, Haghdoost AA, Shokoohi M. Prevalence and Correlates of Sexual Violence Experienced by Female Sex Workers in Iran: Results from a National HIV Bio-Behavioral Surveillance Survey. Violence Against Women 2022; 28:872-889. [PMID: 34057851 PMCID: PMC8785289 DOI: 10.1177/10778012211008992] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Sexual violence increases the risk of adverse health outcomes among female sex workers (FSWs). Using data from the 2015 national bio-behavioral survey, we explored the experience of sexual violence and its associated factors among Iranian FSWs. Lifetime and recent sexual violence were reported by 40.1% and 16.9%, respectively. History of substance use, ever engaging in anal sex, engaging in group sex within the last year, a high number of clients, recent unstable housing, and incarceration increased the likelihood of experiencing recent sexual violence. These findings underscore the need for community-empowerment and policy-level interventions to address violence among FSWs in Iran.
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Affiliation(s)
- Samira Hosseini-Hooshyar
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Razieh Khajehkazemi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali-Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,Social Determinants of Health Research Centre, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Shokoohi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada,Mostafa Shokoohi, Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, Ontario, Canada M5T 3M7.
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4
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Werle JE, Teston EF, Rossi RM, Marcon SS, Sá JSD, Frota OP, Ferreira Júnior MA, Andrade GKSD. HIV/AIDS and the social determinants of health: a time series study. Rev Bras Enferm 2022; 75:e20210499. [DOI: 10.1590/0034-7167-2021-0499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/17/2022] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To analyze the time trend, spatial distribution, and the cases of human immunodeficiency virus/acquired immunodeficiency syndrome cases with social determinants of health. Methods: Ecological and analytical study, carried out based on the cases of human immunodeficiency virus/acquired immunodeficiency syndrome notified in a state in the Brazilian Midwest, from 2009 to 2018. The study used descriptive analysis, polynomial regression, and geospatial analysis. Results: In 10 years, there were 9,157 notifications, growing each year. There was a growing trend for both sexes (p<0.001, r2=0.94). The City Human Development Index was related to the higher number of cases (city of notification, p=0.01; and city where the person lives, p=0.02). The highest concentration was in cities that house health macro-regions. Conclusion: Social determinants have a relationship with the time trend and the spatial distribution of cases and can direct strategies for prevention and care.
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Characterizing the role of intersecting stigmas and sustained inequities in driving HIV syndemics across low-to-middle-income settings. Curr Opin HIV AIDS 2020; 15:243-249. [PMID: 32487815 DOI: 10.1097/coh.0000000000000630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW In 2020, key populations around the world still have disproportionate risks for HIV acquisition and experiencing HIV-related syndemics. This review presents current data around HIV-related syndemics among key populations globally, and on the role of intersecting stigmas in producing these syndemics in low-to-middle-income settings. RECENT FINDINGS Sex workers, sexual and gender minorities, prisoners, and people who use drugs experience high burdens of tuberculosis, sexually transmitted infections, viral hepatitis, and violence linked to heightened HIV-related risks or acquisition. Adverse sexual, reproductive, and mental health outcomes are also common and similarly amplify HIV acquisition and transmission risks, highlighting the need for psychosocial and reproductive health services for key populations. SUMMARY Achieving the promise of biomedical interventions to support HIV care and prevention requires action towards addressing syndemics of HIV, and the stigmas that reproduce them, among those most marginalized globally.
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Bianchi R, Boracchi M, Alfredo Clerici C, Del Gobbo A, Gentile G, Marchesi M, Zoja R. Comparison between prostitutes' and general women's homicides: The experience of the bureau of legal medicine of Milan and Hinterland over 26 years. Med Leg J 2020; 88:14-21. [PMID: 31895001 DOI: 10.1177/0025817219878027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We present a retrospective study of prostitutes' homicide in the Milanese area over a 26-year period (1993-2018), and compare the results with general women's homicides: 294 women were killed of whom 71 were prostitutes. In the general population, the type-victim is an Italian woman aged between 31 and 40 years suffering from no particular pathologies or drug dependence. Prostitutes are 10 years younger, mostly Italian, suffering from pathologies probably related to their activities. Prostitutes remain at high risk of violence, due to gaps in the crime prevention system.
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Affiliation(s)
- Rachele Bianchi
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni - Universitàdegli Studi di Milano, Milano, Italy
| | - Michele Boracchi
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni - Universitàdegli Studi di Milano, Milano, Italy
| | - Carlo Alfredo Clerici
- Dipartimento di Oncologia ed Emato-Oncologia - Università degli Studi di Milano, Milano, Italy
| | - Alessandro Del Gobbo
- Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico Milano, Anatomo Patologo Dirigente Medico - UOC Anatomia Patologica, Milano, Italy
| | - Guendalina Gentile
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni - Universitàdegli Studi di Milano, Milano, Italy
| | - Matteo Marchesi
- Responsabile USS Medicina Legale, Azienda Socio Sanitaria Papa Giovanni XXIII, Ospedale di Bergamo, Italy
| | - Riccardo Zoja
- Dipartimento di Scienze Biomediche per la Salute - Sezione di Medicina Legale e delle Assicurazioni - Universitàdegli Studi di Milano, Milano, Italy
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Mendez‐Lopez A, McKee M, Stuckler D, Granich R, Gupta S, Noori T, Semenza JC. Population uptake and effectiveness of test-and-treat antiretroviral therapy guidelines for preventing the global spread of HIV: an ecological cross-national analysis. HIV Med 2019; 20:501-512. [PMID: 31140715 PMCID: PMC6772052 DOI: 10.1111/hiv.12750] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Although the benefits of adopting test-and-treat antiretroviral therapy (ART) guidelines that recommend initiation of ART regardless of CD4 cell counts have been demonstrated at the individual level, there is uncertainty about how this translates to the population level. Here, we explored whether adopting ART guidelines recommending earlier treatment initiation improves population ART access and viral suppression and reduces overall disease transmission. METHODS Data on ART initiation guidelines and treatment coverage, viral suppression, and HIV incidence from 37 European and Central Asian countries were collected from the European Centre for Disease Prevention and Control and the Global HIV Policy Watch and HIV 90-90-90 Watch databases. We used multivariate linear regression models to quantify the association of ART initiation guidelines with population ART access, viral suppression, and HIV incidence, adjusting for potential confounding factors. RESULTS Test-and-treat policies were associated with 15.2 percentage points (pp) [95% confidence interval (CI) 0.8-29.6 pp; P = 0.039] greater treatment coverage (proportion of HIV-positive people on ART) compared with countries with ART initiation at CD4 cell counts ≤ 350 cells/μL. The presence of test-and-treat policies was associated with 15.8 pp (95% CI 2.4-29.1 pp; P = 0.023) higher viral suppression rates (people on ART virally suppressed) compared with countries with treatment initiation at CD4 counts ≤ 350 cells/μL. ART initiation at CD4 counts ≤ 500 cells/μL did not significantly improve ART coverage compared to initiation at CD4 counts ≤ 350 cells/μL but achieved similar degrees of viral suppression as test-and-treat. CONCLUSIONS Test-and-treat was found to be associated with substantial improvements in population-level access to ART and viral suppression, further strengthening evidence that rapid initiation of treatment will help curb the spread of HIV.
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Affiliation(s)
| | - M McKee
- Department of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - D Stuckler
- Department of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
- Dondena Research CentreUniversity of BocconiMilanItaly
| | - R Granich
- Independent Public Health ConsultantSan FranciscoCAUSA
| | - S Gupta
- Independent Public Health ConsultantDelhiIndia
| | - T Noori
- European Centre for Disease Prevention and ControlStockholmSweden
| | - JC Semenza
- European Centre for Disease Prevention and ControlStockholmSweden
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Abstract
PURPOSE OF REVIEW Adolescents and young people who fit within key populations face some of the greatest barriers to HIV care, but are frequently overlooked. We review the recent literature on these young, vulnerable populations including HIV risk factors, barriers to care, and strategies for engagement. RECENT FINDINGS Common risk factors include age, risky sexual practices, poor education, and high levels of alcohol and drug abuse. Barriers to care include limited data, criminalization, and high levels of stigma. Strategies to increase engagement include incorporating adolescents into biological and behavioral surveys and the use of social media. Digital innovations for HIV prevention and testing show promise, and pre-exposure prophylaxis may be acceptable. At a policy level, decriminalizing same-sex activity and commercial sex work are priorities. Differentiated models of care including HIV self-testing, after-hour services, community-based delivery, and multimonth dispensing of antiretroviral therapy, should be combined into holistic care. SUMMARY There has been limited success in reaching these key adolescent populations largely because of criminalization and stigma. Accurate, generalizable data are needed to inform the development of innovative strategies for holistic care.
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Affiliation(s)
- Morna Cornell
- Centre for Infectious Disease Epidemiology and Research
| | - Kathryn Dovel
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, United States of America
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