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Machisa MT, Mahlangu P, Chirwa E, Nunze N, Sikweyiya Y, Dartnall E, Pillay M, Jewkes R. Ntombi Vimbela! Sexual violence risk reduction intervention: pre and one-year post assessments from a single arm pilot feasibility study among female students in South Africa. BMC Public Health 2023; 23:1242. [PMID: 37370055 DOI: 10.1186/s12889-023-16149-x] [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: 03/20/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The extremely high prevalence of sexual violence victimisation reported among female students in South African public higher education demands urgent action to develop, rigorously evaluate and scale effective prevention interventions. This article details findings from a pilot feasibility study of Ntombi Vimbela! a campus sexual violence risk reduction intervention developed to tackle the high burden of sexual violence in higher education institutions in South Africa. METHODS Ntombi Vimbela! (NV!) is a sexual violence risk reduction intervention that comprises sexuality empowerment, gender and social norm change, early-risk identification, self-defence, resistance and mental wellbeing components. NV! is comprised of ten workshop sessions running for 3.5 h each. Workshops are co-delivered by two trained peer facilitators per group of at most 20 first-year female students. One-year post-intervention quantitative outcome assessments were remotely completed by 98 participants who participated in the NV! pilot workshops. Qualitative assessments were conducted with 35 participants through in-depth telephone interviews (IDTIs). FINDINGS One year after attending NV! workshops, most participants reported improved awareness of sexual rights, assertive communication, shifts in gender equitable beliefs, reductions in rape myth acceptance, improved expressed sexual relationship power sexual decision-making, and improved negotiation within their intimate relationships. Participants' depressive symptoms also significantly decreased. Many participants improved awareness of sexual assault risk and vigilance, including using self-protection strategies such as removing themselves from environments where alcohol intoxication posed sexual assault risks. Some participants used assertive communication to withstand peer pressure to engage in risky sexual behaviours. Most participants scored highly on the self-defence efficacy scale. Some participants were exposed to and successful in using verbal and physical resistance strategies in potential sexual assault risky situations. CONCLUSION These findings indicate the potential beneficial effects of NV! as a campus sexual violence risk reduction intervention at one-year post-intervention, which must be evaluated in a future rigorous randomised control trial. PILOT TRIAL REGISTERED AT ClinicalTrials.gov NCT04607564 on 29/10/2020.
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Affiliation(s)
- Mercilene Tanyaradzwa Machisa
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa.
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
| | - Pinky Mahlangu
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Esnat Chirwa
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Ncediswa Nunze
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
| | - Yandisa Sikweyiya
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | | | - Managa Pillay
- Department of Basic Education, Pretoria, South Africa
| | - Rachel Jewkes
- South African Medical Research Council Gender and Health Research Unit, Pretoria, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, 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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Agrawal P, Post LA, Glover J, Hersey D, Oberoi P, Biroscak B. The interrelationship between food security, climate change, and gender-based violence: A scoping review with system dynamics modeling. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000300. [PMID: 36962962 PMCID: PMC10021784 DOI: 10.1371/journal.pgph.0000300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/01/2023] [Indexed: 03/26/2023]
Abstract
Gender-based violence (GBV) is a global public health and human rights problem that is exacerbated by social and environmental stressors for a multitude of interpersonal, cultural, and economic reasons. Through sudden disruptions in the microclimate of a region, climate shocks often have a negative impact on food security, which correlates with increases in GBV. Associations between the various combinations of GBV, climate change, and food insecurity have been documented in the growing international literature, but questions remain about these associations that require further clarification. The impact of the COVID-19 pandemic caused by SARS-CoV-2 provides insight through a real time demonstration into these interactions. This review of the global literature examines the interplay between GBV, climate change, and food insecurity-including recent literature regarding the COVID-19 pandemic. This review covers original research studies employing both quantitative and qualitative methodology, those that conducted secondary analyses of existing data sources and perspective pieces derived from observed evidence. An additional analytic layer of system dynamics modeling allowed for the integration of findings from the scoping review and discovery of additional insights into the interplay between disasters, food insecurity, and GBV. Findings from this review suggest that the development and adaptation of evidence-based, focused interventions and policies to reduce the effects of climate shocks and bolster food security may ultimately decrease GBV prevalence and impact.
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Affiliation(s)
- Pooja Agrawal
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Lori Ann Post
- Buehler Center for Health Policy and Economics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Janis Glover
- Cushing/Whitney Medical Library, Yale University, New Haven, Connecticut, United States of America
| | - Denise Hersey
- Dana Medical Library, University of Vermont, Burlington, Vermont, United States of America
| | - Piya Oberoi
- Piya Oberoi, Wesleyan University, Middletown, Connecticut, United States of America
| | - Brian Biroscak
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America
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Machisa MT, Chirwa E, Mahlangu P, Nunze N, Sikweyiya Y, Dartnall E, Pillay M, Jewkes R. Suicidal Thoughts, Depression, Post-Traumatic Stress, and Harmful Alcohol Use Associated with Intimate Partner Violence and Rape Exposures among Female Students in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137913. [PMID: 35805572 PMCID: PMC9266174 DOI: 10.3390/ijerph19137913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022]
Abstract
While ample evidence from high-income country settings indicates the prevalence and risk factors for multiple mental ill-health symptoms in student populations, evidence from low- and middle-income higher education settings remains limited. We determined the frequency, associations, and structural pathways between mental health outcomes and possible risk factors among a sample of 1292 predominantly Black African and female students ages 18–30 years, enrolled at nine purposefully selected public universities and Technical Vocational Education and Training (TVET) campuses. We measured and created a mental ill-health latent outcome consisting of depressive symptoms, post-traumatic stress disorder (PTSD), and suicidal thoughts. We also measured traumatic exposures including childhood trauma, recent intimate partner violence (IPV), non-partner rape, and other life traumatic events. We used structural equation modelling to analyse data. We found that 50% of the surveyed students binge drank, 43% reported depressive symptoms, 9% reported PTSD symptoms, and 21% had suicidal thoughts. Students’ experiences of childhood trauma, food insecurity, other traumatic events, non-partner rape, and IPV impacted the mental ill-health latent. IPV experiences mediated the relationships between experiences of childhood trauma or other trauma and the mental ill-health latent, and the relationship between binge drinking and other life traumatic events. Non-partner rape mediated the relationship between food insecurity and the mental ill-health latent. Binge drinking directly impacted non-partner rape experience. The findings substantiate the need for campus-based mental health promotion, psychosocial services and treatments, and implementation of combined interventions that address the intersections of violence against women and mental health among students in South Africa.
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Affiliation(s)
- Mercilene Tanyaradzwa Machisa
- South African Medical Research Council Gender and Health Research Unit, 1 Soutpansberg Road, Pretoria Private Bag x385, Pretoria 0001, South Africa; (E.C.); (P.M.); (N.N.); (Y.S.); (R.J.)
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, 60 York Road, Parktown, Johannesburg 2193, South Africa
- Correspondence:
| | - Esnat Chirwa
- South African Medical Research Council Gender and Health Research Unit, 1 Soutpansberg Road, Pretoria Private Bag x385, Pretoria 0001, South Africa; (E.C.); (P.M.); (N.N.); (Y.S.); (R.J.)
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, 60 York Road, Parktown, Johannesburg 2193, South Africa
| | - Pinky Mahlangu
- South African Medical Research Council Gender and Health Research Unit, 1 Soutpansberg Road, Pretoria Private Bag x385, Pretoria 0001, South Africa; (E.C.); (P.M.); (N.N.); (Y.S.); (R.J.)
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, 60 York Road, Parktown, Johannesburg 2193, South Africa
| | - Ncediswa Nunze
- South African Medical Research Council Gender and Health Research Unit, 1 Soutpansberg Road, Pretoria Private Bag x385, Pretoria 0001, South Africa; (E.C.); (P.M.); (N.N.); (Y.S.); (R.J.)
| | - Yandisa Sikweyiya
- South African Medical Research Council Gender and Health Research Unit, 1 Soutpansberg Road, Pretoria Private Bag x385, Pretoria 0001, South Africa; (E.C.); (P.M.); (N.N.); (Y.S.); (R.J.)
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, 60 York Road, Parktown, Johannesburg 2193, South Africa
| | - Elizabeth Dartnall
- Sexual Violence Research Initiative, 28 High Street, Waterkloof, Pretoria 0145, South Africa;
| | - Managa Pillay
- Department of Basic Education, 222 Struben Street, Pretoria Central, Pretoria 0001, South Africa;
| | - Rachel Jewkes
- South African Medical Research Council Gender and Health Research Unit, 1 Soutpansberg Road, Pretoria Private Bag x385, Pretoria 0001, South Africa; (E.C.); (P.M.); (N.N.); (Y.S.); (R.J.)
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, 60 York Road, Parktown, Johannesburg 2193, South Africa
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