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Nabayinda J, Witte SS, Kizito S, Nanteza F, Nsubuga E, Sensoy Bahar O, Nabunya P, Ssewamala FM. The impact of an economic empowerment intervention on intimate partner violence among women engaged in sex work in southern Uganda: A cluster randomized control trial. Soc Sci Med 2024; 348:116846. [PMID: 38581814 DOI: 10.1016/j.socscimed.2024.116846] [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: 09/18/2023] [Revised: 02/20/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Abstract
Women engaged in sex work (WESW) are at heightened risk of experiencing intimate partner violence (IPV) compared to women in the general population. This study examines the impact of an economic empowerment intervention on IPV among WESW in Southern Uganda. We used data from 542 WESW in Southern Uganda recruited from 19 HIV hotspots between June 2019 and March 2020. Eligible participants were 18+ years old, engaged in sex work-defined as vaginal or anal sexual intercourse in exchange for money, alcohol, or other goods, reported at least one episode of unprotected sexual intercourse in the past 30 days with a paying, casual, or regular sexual partner (spouse, main partner). We analyzed data collected at baseline, 6, and 12months of follow up. To examine the impact of the intervention on IPV, separate mixed-effects logistic regression models were run for each type of IPV (physical, emotional, and sexual) as experienced by participants in the last 90 days. Results show that the intervention was efficacious in reducing emotional and physical IPV as evidenced by a statistically significant intervention main effect for emotional IPV, χ2(1) = 5.96, p = 0.015, and a significant intervention-by-time interaction effect for physical IPV, χ2(2) = 13.19, p < 0.001. To qualify the intervention impact on physical IPV, pairwise comparisons showed that participants who received the intervention had significantly lower levels of physical IPV compared to those in the control group at six months (contrasts = -0.12 (95% CI: -0.22, -0.02), p = 0.011). The intervention, time, and intervention-by-time main effects for sexual IPV were not statistically significant. Our findings suggest economic empowerment interventions as viable strategies for reducing emotional IPV among WESW. However, it is also essential to understand the role of interventions in addressing other forms of IPV especially for key populations at high risk of violence, HIV, and STI. The study was registered at ClinicalTrials.gov, ID: NCT03583541.
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Affiliation(s)
- Josephine Nabayinda
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Susan S Witte
- Columbia University, School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Samuel Kizito
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Flavia Nanteza
- International Center for Child Health and Development (ICHAD), Masaka Office, Uganda
| | - Edward Nsubuga
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Ozge Sensoy Bahar
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Proscovia Nabunya
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Fred M Ssewamala
- Washington University in St. Louis Brown School, International Center for Child Health, and Development (ICHAD), 1 Brookings Drive, St. Louis, MO, 63130, USA.
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Miller AP, Dean SS, Court L, Mvududu R, Mashele N, Wara NJ, Myer L, Shoptaw S, Davey DLJ. "So that's why I found PrEP to be safest way to protect yourself": exploring IPV experiences and impact on HIV prevention among pregnant and postpartum women in Cape Town, South Africa. BMC Public Health 2024; 24:481. [PMID: 38360616 PMCID: PMC10870618 DOI: 10.1186/s12889-024-17871-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] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
Intimate partner violence (IPV) occurs at alarmingly high rates towards pregnant women in South Africa. Experiences of emotional, physical, and sexual IPV in pregnancy can adversely impact the health and safety of mother and fetus. Furthermore, IPV is associated with increased risk of HIV, exacerbating the public health impact of violence among pregnant women in this HIV endemic setting. In-depth understanding of cultural and contextual drivers of experiences of IPV is a critical precursor to development of interventions effectively addressing this issue among pregnant women in South Africa. The present study examines factors contributing to IPV among pregnant women to identify potential points of intervention. We conducted twenty in-depth interviews with postpartum women who used oral pre-exposure prophylaxis (PrEP) in pregnancy and reported recent experiences of IPV and/or ongoing alcohol use in a township near Cape Town, South Africa that experiences a heavy burden of both HIV and IPV. Interpretive thematic analysis was used. Several patterns of IPV during pregnancy were identified and violence was frequently described as co-occurring with male partner alcohol use. A majority of women referenced oral PrEP as their preferred method for HIV prevention, highlighting the agency and discretion it provided as beneficial attributes for women experiencing IPV. Fear of judgement from peers for remaining with an abusive partner and a lack of clear community messaging around IPV were identified as barriers to disclosure and support-seeking. Addressing the lack of social support received by women experiencing IPV during pregnancy in South Africa is essential to comprehensive IPV programming.
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Affiliation(s)
- Amanda P Miller
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA.
| | - Sarah Schoetz Dean
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lara Court
- Division of Socio-behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rufaro Mvududu
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nyiko Mashele
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nafisa J Wara
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Steven Shoptaw
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Dvora L Joseph Davey
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Lin K, Zhou P, Liu M, Chen B, Zhou Z, Zhang Y, Zhou Y, Jiang Y, Bao S, Chen D, Zhu Y, Xing Y. The relationship between intimate partner violence and child malnutrition: a retrospective study in 29 sub-Saharan African countries. Front Public Health 2024; 11:1231913. [PMID: 38249369 PMCID: PMC10796995 DOI: 10.3389/fpubh.2023.1231913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/21/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction and background Intimate partner violence (IPV) and child malnutrition are global public health issues. Assessing the association between IPV and child anthropometric failures (stunting, underweight, and wasting) in 29 Sub-Saharan African (SSA) countries can provide significant global health solutions. Some studies have found an association between IPV against women and child malnutrition, but the conclusions are inconsistent. The physical and psychological conditions, living environment, and rights of the mother may be involved. Methods We collected and analyzed the Demographic and Health Surveys data (2010-2021) of 29 SSA countries. The main exposure variables were various types of IPV, classified as physical, sexual, and emotional violence. The outcome was the child's development index, which can be roughly divided into stunting, wasting, and underweight. An adjusted binary logistic regression model was used to test the relationship between IPV and children's nutritional status. Results A total of 186,138 children under 5 years of age were included in the analysis; 50,113 (27.1%) of the children were stunted, 11,329 (6.1%) were wasted, and 39,459 (21.3%) were underweight in all regions. The child's gender, age, duration of breastfeeding, complementary feeding, and vitamin A supplements intake in the past 6 months were associated with their nutritional status (p < 0.001). Sexual violence was the strongest factor associated with stunting, which remained statistically significant after controlling all variables (AOR = 1.11; 95% CI: 1.02, 1.21; p = 0.012). We also found a small negative association between wasting and IPV. For underweight, there were no associations with IPV after controlling for all variables (p > 0.05). Conclusion IPV is positively associated with child stunting in SSA countries. Sexual violence showed a strong positive correlation with stunting. Wasting was unexpectedly negatively associated with IPV. There was no clear correlation between underweight and violence.
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Affiliation(s)
- Kunhong Lin
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Pengxiang Zhou
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China
| | - Mengyuan Liu
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Botian Chen
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zibei Zhou
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Yijia Zhang
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Ying Zhou
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Yanan Jiang
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Shuyun Bao
- Peking University Health Science Center, Beijing, China
| | - Dijia Chen
- Peking University Health Science Center, Beijing, China
| | - Yu Zhu
- Peking University Health Science Center, Beijing, China
| | - Yan Xing
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
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Sack DE, Seabi TM, Frisby MB, Diemer MA, Ndlovu GH, Wagner RG, Audet CM. Exploratory validation of relationship functioning and non-pregnant partner behavior scales in pregnant people living with HIV in Mpumalanga Province, South Africa. Glob Health Action 2023; 16:2210882. [PMID: 37171405 PMCID: PMC10184612 DOI: 10.1080/16549716.2023.2210882] [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: 05/13/2023] Open
Abstract
Partner engagement in antenatal care can improve care for pregnant people living with HIV. However, concerns about engaging unsupportive non-pregnant partners warrant further study to avoid engaging partners who pressure their pregnant partner to refuse testing or treatment and/or perpetuate intimate partner violence. We adapted established relationship functioning and partner behaviour questionnaires among pregnant people living with HIV initiating antenatal care in rural South Africa. We identified 13 previously validated psychometric scales with 255 items that assess relationship functioning and partner behaviour, but, to our knowledge, had not been used in Southern Africa. After item translation and cognitive interviewing with 30 pregnant people, we recruited an additional 208 pregnant people living with HIV receiving antenatal care. We conducted an exploratory factor analysis with maximum-likelihood extraction and oblique promax rotation with the 58 items and 10 scales that remained after translation and cognitive interviewing. We used parallel analysis, scree plots, and the Kaiser criterion to guide factor retention and assessed internal factor consistency via Cronbach's alpha. Of the 208 participants recruited, 197 (95%) answered each question and were included in the analysis. Exploratory factor analysis revealed 7 factors that assessed partner social support, sexual relationship power, emotional intimacy, threatened or enacted violence, sexual intimacy, violence in relationships, and partner engagement in pregnancy care via 37 items. Factor absolute Spearman correlations ranged from 0.012 to 0.518 and Cronbach's alpha ranged from 0.84 to 0.92. This preliminary analysis will guide further scale development. Future developments will also include relevant clinical outcomes to assess the predictive validity of the resulting measures. These steps will further refine these questions into a succinct screening tool to assess relationship functioning and partner behaviour. This screening tool may eventually guide the selection of partner-based interventions during pregnancy to improve outcomes for pregnant people and their partners.
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Affiliation(s)
- Daniel E Sack
- Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tshegofatso M Seabi
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michael B Frisby
- Department of Educational Policy Studies and the Research, Measurement, and Statistics Program, College of Education and Human Development, Georgia State University, Atlanta, GA, USA
| | | | - Godfrey H Ndlovu
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ryan G Wagner
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Carolyn M Audet
- Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
- Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Alawode OA, Bolarinwa OA, Hajjar JM, Chukwudeh SO, Yaya S. Is intimate partner violence vertically transmitted among women in sub-Saharan Africa? Evidence from demographic health surveys between 2010 and 2019. Int J Equity Health 2023; 22:262. [PMID: 38102618 PMCID: PMC10725031 DOI: 10.1186/s12939-023-02074-3] [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: 07/28/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Violence against women is a major human rights violation, and the continuous occurrence of this can have many implications for women's social and health outcomes. The experience of violence from an intimate partner could be more intriguing, especially if such women experienced their mother's intimate partner violence (IPV) issues. Thus, this study examined the vertical transmission of IPV among women in sub-Saharan Africa (SSA). METHODS A total of 97,542 eligible women were drawn from 27 countries in SSA using a retrospective secondary dataset from Demographic Health Surveys conducted between 2010 and 2019. Multivariable analysis was employed to determine the association between the vertical transmission of IPV from mother to daughter and the covariates associated with IPV in SSA at p < 0.05. RESULTS The results showed that 40% of the respondents had experienced lifetime IPV, whilst 25% of those women reported that their mothers experienced it in childhood in SSA. Country-specific variations showed the highest prevalence of IPV experienced in Sierra Leone (60%) and the lowest in Comoros (9%). Results from model 1 showed that women who reported that their mothers experienced IPV were found to be significantly more than two times more likely to have experienced any form of IPV compared to those whose mothers did not (aOR = 2.66; 95% CI: 2.59-2.74), after adjusting for cofounders in Model 2, the result still showed that women who reported that their mothers experienced IPV were found to be significantly more than two times more likely to have experienced any form of IPV compared to those whose mothers did not (aOR = 2.56; 95% CI: 2.48-2.63). On the other hand, women with higher-educated partners, women in rural areas, and those from female-headed households were less likely to experience IPV. CONCLUSION This study concluded that women whose mothers experienced IPV were more likely to have experienced IPV. Our study also identified that education, rural areas, and female-headed households were protective factors against experiencing IPV. To address the groups of women at higher risk for experiencing IPV, we recommend ensuring that girls complete their education to promote greater wealth and resources.
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Affiliation(s)
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health, York St John University, London, UK.
- Department of Demography and Population Studies, University of Witwatersrand, Johannesburg, South Africa.
| | - Julia Marie Hajjar
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Tenkorang EY, Owusu AY, Zaami M, Langmagne S, Gyan S. Intimate Partner Violence and Health Outcomes Among Women Living With HIV/AIDS in Ghana: A Cross-Sectional Study. HEALTH EDUCATION & BEHAVIOR 2023; 50:347-358. [PMID: 36744741 DOI: 10.1177/10901981231152425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Intimate partner violence (IPV) is known to have negative health consequences for victims. For women living with HIV/AIDS, whose health may be compromised, exposure to IPV can be devastating. Yet few (if any) studies have explored the health implications of exposure to IPV among HIV-positive women. We begin to fill this gap by examining the effects of various dimensions of IPV (physical, sexual, psychological/emotional, and economic) on the cardiovascular, psychosocial, and sexual reproductive health outcomes of HIV-positive women in Ghana. Data were collected from a cross-section of 538 HIV-positive women aged 18 years and older in the Lower Manya Krobo District in the Eastern Region. We used logit models to explore relationships between IPV and health. The findings indicate high prevalence of IPV in our sample: physical violence (61%), sexual violence (50.9%), emotional/psychological violence (79.6%), and economic violence (66.8%). Generally, participants with experiences of IPV reported cardiovascular health problems, unwanted pregnancies and pregnancy loss, and poor psychosocial health. Our findings suggest the importance of screening for IPV as part of HIV care in Ghana.
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Affiliation(s)
- Eric Y Tenkorang
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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Masiano SP, Tembo TA, Yu X, Wetzel E, Mphande M, Chitani M, Mkandawire A, Khama I, Mazenga A, Abrams E, Ahmed S, Kim MH. The prevalence, incidence, and recurrence of intimate partner violence and its association with adverse childhood experiences among pregnant and breastfeeding women living with HIV in Malawi. Ther Adv Infect Dis 2023; 10:20499361221148875. [PMID: 36654873 PMCID: PMC9841851 DOI: 10.1177/20499361221148875] [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: 07/12/2022] [Accepted: 12/15/2022] [Indexed: 01/15/2023] Open
Abstract
Background Intimate partner violence (IPV) is associated with suboptimal HIV treatment outcomes, but its distribution and risk factors among certain subpopulations of people living with HIV in resource-limited settings are not well known. We examined the prevalence, incidence, and recurrence of IPV and its association with adverse childhood experiences (ACEs) among pregnant/breastfeeding women living with HIV in Malawi. Methods This study used longitudinal data for 455 pregnant women living with HIV continuously enrolled in the VITAL Start trial. IPV was assessed at baseline and months 1, 6, and 12 using the widely validated WHO IPV survey. Forms of IPV assessed were physical IPV, emotional IPV, and sexual IPV measured as prevalence, incidence, and recurrence. ACE histories were assessed using WHO's ACE International Questionnaire (ACE-IQ) tool. Logistic and log-binomial regressions were used in multivariable analyses that controlled for factors such as depression and alcohol use. Results Participants' mean age was 27.6 ± 5.7 years. Forty-three percent (43%) reported IPV prevalence, 13% reported IPV incidence, and another 13% reported IPV recurrence, with emotional IPV being the most commonly reported IPV type. Over 96% reported experiencing ⩾1 ACE. In regression analysis, cumulative ACE scores were significantly associated with IPV prevalence and IPV recurrence and in both cases, the magnitude of association was greatest for sexual IPV compared with physical IPV and emotional IPV. ACE scores were not significantly associated with IPV incidence. Conclusions IPV is highly prevalent among pregnant women living with HIV and continues to occur throughout the pregnancy and postpartum period; its graded relationship with ACEs is a concern in resource-limited settings where HIV/AIDS remains a public health concern. Strategies aimed to address the needs of pregnant/breastfeeding women living with HIV may benefit from the regular screening of this population for IPV and ACE, including in antenatal care clinics.
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Affiliation(s)
- Steven P. Masiano
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
- Healthcare Delivery and Implementation Science Center, Cleveland Clinic, Cleveland, OH, USA
| | - Tapiwa A. Tembo
- Baylor College of Medicine Children’s Foundation Malawi, PBag B397, Lilongwe 3, Malawi
| | - Xiaoying Yu
- Department of Biostatistics & Data Science, School of Public and Population Health, The University of Texas Medical Branch, Galveston, TX, USA
| | - Elizabeth Wetzel
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
- Baylor International Pediatric AIDS Initiative, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Mtisunge Mphande
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Mike Chitani
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Angella Mkandawire
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Innocent Khama
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Alick Mazenga
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Elaine Abrams
- ICAP, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Pediatrics, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Saeed Ahmed
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
- Baylor International Pediatric AIDS Initiative, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Maria H. Kim
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
- Baylor International Pediatric AIDS Initiative, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA
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Lyons MJ, Swahn MH, Culbreth R, Reidy D, Musuya T, Bukuluki P. A Comparative Analysis of Gender Discrepancy Stress, Attitudes toward Intimate Partner Violence, and Perpetration among Young Adults in the USA and Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13373. [PMID: 36293954 PMCID: PMC9602678 DOI: 10.3390/ijerph192013373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is a dearth of data on the modifiable factors that contribute to violence in low- and middle-income countries, including attitudes regarding intimate partner violence (IPV) and perceptions of gender identity. We examined these factors using a cross-cultural comparison between young adults in Uganda and the United States. METHODS A cross-sectional survey was distributed to young adults aged 18 to 25 in Uganda (n = 300) and the U.S. (n = 300). Survey questions assessed demographics, attitudes toward IPV, IPV victimization and perpetration, gender discrepancy, discrepancy stress, and alcohol use. We conducted chi-square tests, as well as bivariable and multivariable logistic regression analyses, separately for participants in each country. RESULTS The prevalence of IPV perpetration differed significantly by country for men (58.06% in the U.S. vs. 42.73% in Uganda; p = 0.03) and women (40.00% in the U.S. vs. 14.00% in Uganda; p < 0.01). IPV victimization differed by country for men (67.74% in the U.S. vs. 51.82% in Uganda; p = 0.02) but not for women. Gender discrepancy and discrepancy stress also varied by country and by sex and were higher in the U.S. for both men and women. IPV victimization was a common risk factor for adults in both Uganda (Adj. OR = 23.47; 95% CI: 7.79, 70.22) and the U.S. (Adj. OR = 27.40; 95% CI: 9.97, 75.32). In Uganda, male sex was significantly associated with IPV perpetration in multivariable analyses (Adj. OR = 6.23; 95% CI: 2.45, 15.86), and so were IPV attitudes (Adj. OR = 2.22; 1.20, 4.10). In the U.S., a likely alcohol use disorder (AUD) was also significantly associated with IPV perpetration (Adj. OR = 7.11; 95% CI: 2.25, 22.54). CONCLUSIONS Permissive IPV attitudes were associated with IPV perpetration among Ugandan participants, while likely AUD was associated with perpetration in U.S. PARTICIPANTS Overall, IPV perpetration was significantly higher for U.S. males compared with Ugandan males. These findings indicate that cultural adaptations to global IPV interventions may be necessary to respond to differing needs in different countries.
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Affiliation(s)
- Matthew J. Lyons
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Monica H. Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Rachel Culbreth
- American College of Medical Toxicology, Phoenix, AZ 85028, USA
| | - Dennis Reidy
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Tina Musuya
- Social Development Direct, Kampala 759125, Uganda
| | - Paul Bukuluki
- Department of Social Work and Social Administration, Makerere University, Kampala 759125, Uganda
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