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Kelly NK, Bhushan NL, Gottfredson O’Shea N, Gómez-Olivé FX, Aiello AE, Wagner LD, Mall S, Kahn K, Pettifor AE, Stoner MCD. Trajectories of intimate partner violence and their relationship to stress among young women in South Africa: An HPTN 068 study. Int J Soc Psychiatry 2024; 70:904-914. [PMID: 38563376 PMCID: PMC11323414 DOI: 10.1177/00207640241239535] [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] [Indexed: 04/04/2024]
Abstract
BACKGROUND One in four South African women will experience intimate partner violence (IPV) in their lifetime, potentially increasing their biological stress. In South Africa, limited IPV and stress research has utilized multiple timepoints or examined modifying factors. Cash transfers (CTs) are associated with reduced IPV and stress and may be an intervention target. AIMS We used data-driven methods to identify longitudinal IPV trajectory groups among South African adolescent girls and young women (AGYW), estimate each group's association with stress, and assess modification by a CT. METHODS A total of 2,183 South African AGYW ages 13 to 24 years from the HIV Prevention Trials Network 068 study were randomized to a CT or control group. Physical IPV was measured five times (2011-2017), and stress was captured once (2018-2019). Stress measures included the Cohen Stress Scale and stress biomarkers (C-reactive protein (CRP), cytomegalovirus (CMV), herpes simplex virus type-1 (HSV-1)). Group-based trajectory modeling identified IPV trajectories; ordinal logistic regression estimated the association between trajectory group and stress. RESULTS A two-group quadratic trajectory model was identified (higher trajectory group = 26.7% of AGYW; lower trajectory group = 73.3%). In both groups, the probability of IPV increased from ages 13 to 17 years before declining in early adulthood. However, the higher group's probability peaked later and declined gradually. The higher trajectory group was associated with an increased odds of elevated CRP (OR: 1.41, 95% CI [1.11, 1.80]), but not with other stress measures. The CT modified the relationship with CMV: a positive association was observed among the usual care arm (OR: 1.59, 95% CI [1.11, 2.28]) but not the CT arm (OR: 0.85, 95% CI [0.61, 1.19]). CONCLUSIONS Sustained IPV risk during adolescence was associated with elevated CRP in young adulthood. The relationship between IPV and elevated CMV was attenuated among those receiving a CT, suggesting that CTs could possibly reduce biological stress due to IPV.
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Affiliation(s)
- Nicole K Kelly
- Department of Epidemiology, University of North Carolina, Chapel Hill, USA
| | - Nivedita L Bhushan
- Center for Communication and Engagement Research, RTI International, Research Triangle Park, NC, USA
| | - Nisha Gottfredson O’Shea
- Substance Use Prevention, Evaluation, and Research Program, RTI International, Research Triangle Park, NC, USA
| | - F Xavier Gómez-Olivé
- MRC/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
| | - Allison E Aiello
- Department of Epidemiology, Robert N Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Sumaya Mall
- Department of Epidemiology and Biostatistics, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- MRC/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
- Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Audrey E Pettifor
- Department of Epidemiology, University of North Carolina, Chapel Hill, USA
- MRC/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
| | - Marie CD Stoner
- Women’s Global Health Imperative, RTI International, Berkeley, CA, USA
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Closson K, Dong E, Zulu B, Dietrich JJ, Zharima C, Jesson J, Pakhomova T, Beksinska M, Kaida A. 'Life became harder with COVID-19': exploring the experiences of the COVID-19 pandemic among youth living in eThekwini district, South Africa. BMC Public Health 2024; 24:1922. [PMID: 39020372 PMCID: PMC11256542 DOI: 10.1186/s12889-024-19238-7] [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: 11/10/2023] [Accepted: 06/24/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND In South Africa, pervasive age and gender inequities have been exacerbated by the COVID-19 pandemic and public health response. We aimed to explore experiences of the COVID-19 pandemic among youth in eThekwini district, South Africa. METHODS Between December 2021-May 2022 we explored experiences of the COVID-19 pandemic on youth aged 16-24 residing in eThekwini, South Africa. We collated responses to the open-ended question "Has the COVID-19 pandemic affected you in any other way you want to tell us about?" in an online survey focused on understanding the pandemic's multi-levelled health and social effects. We used a thematic analysis to summarise the responses. RESULTS Of 2,068 respondents, 256 (12.4%, median age = 22, 60.9% women) completed the open-ended survey question (11% in isiZulu). Results were organized into three main themes encompassing (1) COVID-19-related loss, fear, grief, and exacerbated mental and physical health concerns; (2) COVID-19-related intensified hardships, which contributed to financial, employment, food, education, and relationship insecurities for individuals and households; and (3) positive effects of the pandemic response, including the benefits of government policies and silver linings to government restrictions. CONCLUSIONS We found that South African youth experienced significant grief and multiple losses (e.g., death, income, job, and educational) during the COVID-19 pandemic. Trauma-aware interventions that provide economic and educational opportunities must be included in post-COVID recovery efforts.
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Affiliation(s)
- Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
- Center of Gender Equity and Health, University of California San Diego, La Jolla, CA, United States.
| | - Erica Dong
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Bongiwe Zulu
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Janan J 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), Wits Health Consortium, Johannesburg, South Africa
| | - 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
| | - 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, Burnaby, BC, Canada
| | - Mags Beksinska
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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Wickrama T, Merten MJ, Terrell A. Adverse Childhood Experiences and Intimate Partner Violence Among Recent Adults: Mental Health and Race. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:399-409. [PMID: 38938967 PMCID: PMC11199472 DOI: 10.1007/s40653-023-00597-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 06/29/2024]
Abstract
Previous research has linked childhood exposure to family dysfunction and violence with long-term health outcomes, including mental health and later exposure to violence. However, fewer studies have modeled depressive symptoms (stemming from childhood adversity) as a key linking variable with later intimate partner violence (IPV) - particularly among diverse youth. The present study investigated (a) the direct effect of adverse childhood events (ACEs) on intimate partner violence, (b) the indirect effect of ACEs on intimate partner violence through depressive symptoms, and (c) the moderation of these associations by race. Method: Data were drawn from 702 participants (80% female) 18 years of age from panel data collected in 2019 from the 18 & Life Project. Participants self-reported adverse childhood experiences, intimate partner violence, and depressive symptoms using multiple items for each measure. Additional demographic variables assessed included gender, race, and sexual orientation. Structural equation modeling using Mplus Version 8 software was used to test hypothesized associations. Results: While results indicate a direct association between ACEs and IPV. Evidence for an indirect link through depressive symptoms was only found for White youth. The findings of this study provide evidence for the persistent long-term influence of ACEs on mental health and relationship experiences in later life. Conclusions: Our results suggest a need for early family and community-level interventions to protect children from exposure to early adverse experiences in order to protect their mental health and ensure successful relationship experiences.
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Affiliation(s)
- Thulitha Wickrama
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 330 Carolyn Pope Edwards Hall, Lincoln, NE 68588 USA
| | - Michael J. Merten
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 330 Carolyn Pope Edwards Hall, Lincoln, NE 68588 USA
| | - Amanda Terrell
- School of Human Environmental Sciences, University of Arkansas-Fayetteville, 118 Home Economics Building, Fayetteville, AR 72701 USA
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da Costa Siqueira LL, de Melo Batista K, Marabotti Costa Leite F. Association between perceived stress and history of intimate partner violence throughout life and during the COVID-19 pandemic. Front Public Health 2023; 11:1330451. [PMID: 38170101 PMCID: PMC10759215 DOI: 10.3389/fpubh.2023.1330451] [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: 10/30/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Intimate Partner Violence (IPV) is a significant public health issue, characterized by being a highly stressful experience for its victims. The relationship between IPV and stress creates a harmful cycle with broad health implications, affecting individuals and society at large. Despite its significance, there's a noticeable lack of research on this topic, especially regarding IPV throughout one's life and during the pandemic. Objective To verify the association between perceived stress and the history of intimate partner violence throughout life and during the COVID-19 pandemic. Materials and methods Analytical cross-sectional epidemiological study with a sample of 1,086 women. Sociodemographic information and violence history, assessed using the World Health Organization Violence Against Women (WHO VAW STUDY), along with perceived stress measured by the short version of the Perceived Stress Scale (PSS), were collected. The sampling process unfolded through multiple stages. For bivariate analyses, the t-test and ANOVA were performed, whereas for multivariate analyses simple and multiple linear regression were performed. The software Stata® version 15.1 and R® were used. Results Women who reported having suffered intimate partner violence throughout their lives had higher means of stress (18.49), with an average increase of 4 points without adjustments and 3.5 points after adjustments for sociodemographic variables. Similarly, during the COVID-19 pandemic (19.01), stress increased by an average of 3.3 points, which was reduced to 2.8 points after adjustments. Conclusion The results indicate an association between intimate partner violence and an increase in women's perceived stress, both throughout life and during the pandemic. The importance of preventive approaches, promoting gender equality and preventing IPV from the early stages of life is highlighted. In addition, they underscore the urgency of evidence-based interventions of a comprehensive nature to deal with this complex issue in a careful and effective manner. The cross-sectional nature of this study limits the inference of causality, and an additional limitation is acknowledged concerning information bias. This bias relates to the multifaceted issues surrounding the concept of violence, potentially influencing the accuracy of participants' information and complicating the measurement of violence.
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Affiliation(s)
- Loys Lene da Costa Siqueira
- Graduate Program in Collective Health, Department of Nursing, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Karla de Melo Batista
- Department of Nursing, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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Getinet W, Azale T, Getie E, Salelaw E, Amare T, Demilew D, Lemma A, Kibret D, Aklilu A, Tensae T, Srahbzu M, Shumet S. Intimate partner violence among reproductive-age women in central Gondar zone, Northwest, Ethiopia: a population-based study. BMC Womens Health 2022; 22:109. [PMID: 35397559 PMCID: PMC8994176 DOI: 10.1186/s12905-022-01685-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/29/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Violence against women is the most widespread kind of human rights violation, and it has been linked to a wide range of consequences. The most prominent psychosocial and mental health concern that has serious effects for women's physical and mental well-being. This study assessed the prevalence and associated factors of women's violence by intimate partner among women in the reproductive age group (15-49). METHODS Multistage community-based cross-sectional study was conducted among reproductive age group women in the central Gondar zone. We recruited 845 participants and interviewed by health extension workers using face-to-face interviews. We used a Women's Abuse Screening test to outcome variable; it has a total score ranges 0-16, a score > 1 indicates positive for the presence of intimate partner violence within a year. Variables were coded and entered to Epi data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics and multivariate logistic regression analysis was run for data analysis. Adjusted odds ratios (AOR) with a 95% confidence level (CI) were declared significant. RESULT Among a total of 845 participants 804 responded to the interviews with a response rate of 95%. The prevalence rate of intimate partner violence is 391(48.6%). From multivariate logistic regression analysis women being married [AOR:3.85; 95% CI (2.38, 6.22)], high school and above educational status [(AOR: 0.43; 95% CI (0.30, 0.61), women's having > 3children [(AOR: 1.82, 95% CI (1.0, 3.1)], having a household food insecurity[(AOR: 2.09, 95% CI (1.51, 2.91)], having life threatening events [(AOR: 2.09; 95% CI (1.51, 2.91)], moderate social support [(AOR: 0.60; 95% CI (0.41, 0.83)], depression [(AOR: 3.12; 95% CI (1.60, 6.07) were significantly associated with violence by intimate partner at 95% CI . CONCLUSION Intimate partner violence is common among reproductive-age women. Married, women with several children, food insecurity, life-threatening events, and depression were all found to be significant predictors of violence. Measures should be taken to raise community awareness, particularly among intimate partners, their families, and government officials.
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Affiliation(s)
- Wondale Getinet
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Telake Azale
- Institute of Public Health College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Eskedar Getie
- Institute of Public Health College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Endalamaw Salelaw
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadele Amare
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Demeke Demilew
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Alemu Lemma
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Destaw Kibret
- Central Gondar Zonal Health Office, Gondar, Ethiopia
| | - Abayneh Aklilu
- School of Midwifery College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techalo Tensae
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mengesha Srahbzu
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Shegaye Shumet
- Department of Psychiatry College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Adebiyi BO, Mukumbang FC. Perspectives of Policymakers and Service Providers on Why Fetal Alcohol Spectrum Disorders Remain Unabated in South Africa: a Qualitative Study. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00679-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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