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1.
Pan Afr Med J ; 47: 213, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39247775

RESUMEN

Introduction: sexual violence is currently a serious public health problem affecting women´s health. Globally, 1 in 3 women faces sexual violence in their lifetime. Female industry workers are at an increased risk of sexual violence. Assessing the magnitude and factors associated with sexual violence among female industrial workers is important for interventions. The objective was to assess the prevalence and factors associated with sexual violence among female large-scale industries workers in Bahir Dar, Ethiopia, 2021. Methods: institution-based cross-sectional study was conducted on 807 female industry workers from September to October 2021. Participants were selected by systematic random sampling. The data were collected by a structured questionnaire. Data entry and analysis were done by Epi data v.3.1 and SPSS v.23, respectively. Multivariable logistic regression analysis was done to identify factors. Adjusted odds ratios were computed at 95%CI. A P-value below 0.05 was used to declare association. Results: the prevalence of sexual violence were 59.4% (95% CI; 56.0%-62.6%). The significantly associated factors include; age less than twenty-five (AOR=4.01, 95%CI; 2.81, 10.83), never-married women (AOR=3.07, 95%CI; 1.11, 8.46), being secondary education (AOR=2.65, 95%CI; 1.51, 4.66), being contract employee (AOR=4.65, 95%CI; 1.92, 11.22), drinking alcohol (AOR=3.01, 95%CI; 1.49, 6.09), and night work shift (AOR=9.01, 95%CI; 4.53, 17.93). Conclusion: high rate (59.4%) of sexual violence was reported. Age, marital status, educational status, contract type of work agreement, drinking alcohol, and working night work shift were risk factors. Hence, emphasis on creating safe working environment & transportation, education on reproductive rights and reporting of sexual violence.


Asunto(s)
Delitos Sexuales , Humanos , Etiopía/epidemiología , Femenino , Estudios Transversales , Adulto , Prevalencia , Adulto Joven , Encuestas y Cuestionarios , Factores de Riesgo , Delitos Sexuales/estadística & datos numéricos , Persona de Mediana Edad , Adolescente , Industrias/estadística & datos numéricos , Factores de Edad
2.
Afr J Reprod Health ; 28(8s): 130-136, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39283603

RESUMEN

This article bases its argument on the social representations that justify sexual violence against adolescent girls and women and make it commonplace. It looks at the constructions of masculinity and femininity and their potential effects on the occurrence of sexual violence among adolescent girls. This is a socio-anthropological study carried out in the plateau regions of Togo. The empirical data came from individual semi-directive interviews (55), life stories (4) of adolescent rape victims and group interviews (40) with several stakeholders (adolescents, parents of adolescents, educators, community leaders and religious leaders). The results show that despite the efforts of the State and non-governmental organisations, local sexuality logics often have an impact on the persistence of sexual violence. (.


Cet article fonde son argumentaire sur les représentations sociales qui justifient et rendent ordinaires les violences sexuelles sur les adolescentes et les femmes. Il appréhende les constructions de la masculinité et de la féminité et leurs effets potentiels sur la survenue des violences sexuelles chez les adolescentes. Il s'agit d'une étude socio-anthropologique réalisée dans la région des plateaux au Togo. Les données empiriques proviennent d'entretiens individuels semi-directifs (55), des histoires de vie (4) d'adolescentes victimes de viol et des entretiens de groupes (40) avec plusieurs acteurs (adolescent(e)s, parents d'adolescent(e)s, éducateurs, leaders communautaires et leaders religieux). Les résultats révèlent que, malgré les efforts des acteurs de l'Etat et des Organisations Non Gouvernementales, les logiques locales de la sexualité ont souvent des incidences sur la persistance des violences sexuelles.


Asunto(s)
Delitos Sexuales , Humanos , Togo , Femenino , Adolescente , Delitos Sexuales/psicología , Socialización , Masculino , Masculinidad , Violación/psicología , Violación/estadística & datos numéricos , Feminidad , Adulto , Entrevistas como Asunto , Investigación Cualitativa
3.
Brain Behav ; 14(9): e70029, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39262181

RESUMEN

INTRODUCTION: Maternal stress and trauma during pregnancy have been shown to influence cortisol levels and epigenetic patterns, including DNA methylation, in the offspring. This study aimed to determine whether a tailor-made family intervention could help reduce cortisol levels in children born to traumatized mothers, and to determine whether it effected offspring DNA methylation. The secondary aim was to determine whether the family intervention influenced DNA methylation aging, a marker of biological aging. METHODS: A needs-based family intervention was designed to help address relational difficulties and family functioning, and included a focus on family strengths and problem-solving patterns. Women survivors of sexual violence during the Kosovar war in 1998-1999, and their families (children with or without partners) were randomly assigned to 10 sessions of a family therapy over a 3-5-month period, or to a waitlist control group. Both mothers and children completed assessments prior to and after the intervention phase. Children's blood samples collected at these two time points were used to measure cortisol and epigenome-wide DNA methylation patterns (Illumina EPIC array). Cortisol levels, and genome-wide DNA methylation changes pre-/postintervention were compared between children in the intervention and the waitlist groups. DNA methylation age and accelerated biological aging were calculated. RESULTS: Sixty-two women-child dyads completed the study, 30 were assigned first to the intervention group, and 32 to the waitlist control group. In adjusted linear regression, the family intervention was associated with a significant decline in cortisol levels compared to the waitlist control (ß = -124.72, 95% confidence interval [CI]: -197.4 to -52.1, p = .001). Children in the intervention group, compared to the waitlist control group, showed >1% differential methylation degree at 5819 CpG (5'-C-phosphate-G-3') sites across the genome (p < .01), with the largest methylation difference being 21%. However, none of these differences reached genome-wide significant levels. There was no significant difference in DNA methylation aging between the two groups. CONCLUSION: We find evidence that a tailored family-based intervention reduced stress levels in the children (based on cortisol levels), and modified DNA methylation levels at a number of sites across the genome. This study provides some preliminary evidence to suggest the potential for tailored interventions to help break the intergenerational transmission of trauma, however, large studies powered to detect associations at genome-wide significant levels are needed.


Asunto(s)
Metilación de ADN , Terapia Familiar , Hidrocortisona , Humanos , Femenino , Hidrocortisona/sangre , Masculino , Kosovo , Adulto , Niño , Terapia Familiar/métodos , Madres , Epigenoma , Embarazo , Epigénesis Genética , Efectos Tardíos de la Exposición Prenatal/genética , Delitos Sexuales/prevención & control
4.
Eur J Psychotraumatol ; 15(1): 2398961, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39267605

RESUMEN

Background: Physical and sexual violence against pregnant women have been associated with detrimental mental health outcomes for victims. Few studies have examined both positive (wellbeing) and negative (illbeing) mental health indicators in the same sample. Additionally, the literature assessing mental health based on different forms of violence is limited.Objective: To compare both wellbeing (life satisfaction) and illbeing (anxiety and depression) trajectories between non-victimized and victims of physical, sexual and both forms of violence that occurred during or shortly before pregnancy. Further, we analyse whether social support moderates these trajectories.Method: This longitudinal study is based on the Norwegian Mother, Father and Child Cohort, including the period from early pregnancy to toddlerhood (3 years). We compared wellbeing and illbeing trajectories of non-victims (n = 73,081), victims of physical abuse (n = 1076), sexual abuse (n = 683), and both forms of abuse (n = 107) using Growth Curve Modelling. Finally, social support was included as a moderator of wellbeing and illbeing trajectories.Results: Results indicated that victims scored systematically lower in wellbeing and higher in illbeing. Exposure to violence did not significantly change the wellbeing trajectory, pointing to similar developments in wellbeing among victims and non-victims for the considered period. On the other hand, different trajectories in illbeing occurred between victims and non-victims, as well as between victimized groups. Victims experienced greater change in illbeing scores, with a steeper decrease in illbeing compared to non-victims. Both victims and non-victims returned to respective baseline scores 3 years after birth. All women benefited from social support, but victims of physical abuse were particularly protected by social support.Conclusions: There is an alarming persistence of mental health problems in women exposed to violence during peripregnancy. Different forms of violence differentially impact women's mental health. Social support is beneficial among all pregnant women.


Victims of peripregnancy violence score systematic lower in wellbeing over time than non-victims. However, the wellbeing trajectories among victims and non-victims are similar.On the other hand, illbeing (anxiety and depression) trajectories differ for non-victims and victims of physical, sexual and both forms of violence. All women decreased their levels of illbeing from pregnancy to the first 6 months postpartum, but victims had a steeper decrease during this period compared to non-victims.All women benefited from social support, but victims of physical abuse were particularly protected by social support.


Asunto(s)
Apoyo Social , Humanos , Femenino , Estudios Longitudinales , Noruega , Adulto , Embarazo , Delitos Sexuales/psicología , Delitos Sexuales/estadística & datos numéricos , Salud Mental , Depresión/psicología , Satisfacción Personal , Ansiedad/psicología , Mujeres Embarazadas/psicología , Víctimas de Crimen/psicología , Víctimas de Crimen/estadística & datos numéricos , Abuso Físico/psicología , Abuso Físico/estadística & datos numéricos
5.
BMJ Open ; 14(9): e087810, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39277200

RESUMEN

BACKGROUND: In England, voluntary sector specialist (VSS) services are central to supporting victim-survivors of sexual violence (SV). However, empirical evidence is lacking about the scope, range and effectiveness of VSS provision for SV in England. OBJECTIVES: To undertake national surveys to map SV VSS service provision and describe arrangements for funding and commissioning. DESIGN: Cross-sectional surveys. SETTING: VSS services for SV and commissioners from multiple organisations across England (January-June 2021). METHODS: Senior staff working in VSS services and commissioners from multiple organisations were surveyed electronically. Surveys explored SV service commissioning, funding and delivery, partnerships between organisations, perceived unmet need for services, and views about facilitators and challenges. Data were analysed descriptively to characterise VSS service provision for SV and commissioning across England. RESULTS: 54 responses were received from VSS providers and 34 from commissioners. Data demonstrated a complex and evolving funding and commissioning landscape in which providers typically secured funding from multiple sources, impacting consistency and scope of service provision. It was common for multiple organisations to co-commission services, demonstrating trends towards larger contracts that may disadvantage smaller specialist providers. Numerous examples of partnership working between organisations were identified, although developing partnerships was noted as challenging, particularly between VSS organisations. There was clear evidence of unmet need for services, with some groups of victim-survivors such as those from black and minority ethnic groups, often underserved by specialist services. However, there was also evidence of innovative service development and commissioning approaches to meet the needs of victim-survivors who face challenges accessing services. CONCLUSIONS: This study provides novel insights into SV service provision and commissioning in England, including unmet needs among victim-survivors.


Asunto(s)
Víctimas de Crimen , Delitos Sexuales , Humanos , Inglaterra , Estudios Transversales , Femenino , Encuestas y Cuestionarios , Masculino
6.
Afr J Reprod Health ; 28(8s): 51-61, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39269897

RESUMEN

This study assessed multi-level factors that shape young people's attitudes towards gender biases about rape, sexual, and domestic violence in intimate relationships. This cross-sectional study was undertaken in three urban and three rural communities in Ebonyi State, southeast Nigeria. Data were collected from 1,020 young people using an interviewer-administered questionnaire. Descriptive and logistic regression analyses were performed using STATA. Findings revealed that most(64%) young people agree that when a girl doesn't physically fight back, you cannot really say it was rape. Many agreed that a girl who is raped is promiscuous or has a bad reputation (50%) and usually did something careless to put herself in that situation(45%). Young girls were approximately 2 times more likely to have positive attitudes towards sexual violence, rape, and domestic violence in intimate relationships than young boys (OR=1.5;P<0.01). Multi-level strategies to effectively address adverse gender norms and inequalities in intimate relationships are highly recommended.


Cette étude a évalué les facteurs à plusieurs niveaux qui façonnent les attitudes des jeunes à l'égard des préjugés sexistes concernant le viol, la violence sexuelle et domestique dans les relations intimes. Cette étude transversale a été entreprise dans trois communautés urbaines et trois communautés rurales de l'État d'Ebonyi, au sud-est du Nigeria. Les données ont été recueillies auprès de 1 020 jeunes à l'aide d'un questionnaire administré par un intervieweur. Des analyses de régression descriptive et logistique ont été effectuées à l'aide de STATA. Les résultats ont révélé que la plupart (64 %) des jeunes conviennent que lorsqu'une fille ne se défend pas physiquement, on ne peut pas vraiment dire qu'il s'agit d'un viol. Beaucoup conviennent qu'une fille violée est une promiscuité ou a une mauvaise réputation (50%) et a généralement fait quelque chose de négligent pour se mettre dans cette situation (45%). Les jeunes filles étaient environ 2 fois plus susceptibles d'avoir des attitudes positives à l'égard de la violence sexuelle, du viol et de la violence domestique dans les relations intimes que les jeunes garçons (OR=1,5 ; P<0,01). Des stratégies à plusieurs niveaux pour lutter efficacement contre les normes de genre défavorables et les inégalités dans les relations intimes sont fortement recommandées.


Asunto(s)
Violencia Doméstica , Violación , Sexismo , Humanos , Femenino , Masculino , Nigeria , Violación/psicología , Violación/estadística & datos numéricos , Estudios Transversales , Adolescente , Adulto Joven , Violencia Doméstica/psicología , Encuestas y Cuestionarios , Población Rural , Relaciones Interpersonales , Actitud , Violencia de Pareja/psicología , Violencia de Pareja/estadística & datos numéricos , Población Urbana , Adulto , Conducta Sexual/psicología , Delitos Sexuales/psicología
7.
Rev Med Chil ; 152(1): 128-148, 2024 Jan.
Artículo en Español | MEDLINE | ID: mdl-39270105

RESUMEN

BACKGROUND: Sexual violence has a several negative impact on women's health. Thus, the health system is a gateway for the multisector response to victims. In 2018, the Clinical Forensic Hospital Units (UCFH) in Chile were launched for this purpose. OBJECTIVE: To evaluate the state of implementation of the UCFH in the health services (HS) in Chile. METHOD: This is a quantitative descriptive, cross-sectional study. A survey was designed and applied through the Google Forms platform to the managers of the care and prevention network for victims of sexual violence (VSV) of each SS. The contact of each manager was requested by each HS in three ways: transparency law, lobby law, and telephone. Each HS was classified according to the existence or not of UCFH and for each unit the availability of resources was evaluated according to the recommendations of the Technical Standard of Attention to VSV of the Ministry of Health. Also, the functioning of each unit during the pandemic was evaluated. RESULTS: Twenty-four of the 29 HSs responded, of which 12 reported having UCFH. Of the 12 units, 50% had complete infrastructure, 58.3% had complete instruments, none had full human resources, 50% had partial HR, 50% had sampling complete, and 58. 3% had full health benefits. The function during the pandemic was affected in 25% of the units. CONCLUSION: Challenges persist in the implementation of the UCFH, with special limitations in the availability of human resources.


Asunto(s)
Delitos Sexuales , Chile , Humanos , Estudios Transversales , Delitos Sexuales/estadística & datos numéricos , Delitos Sexuales/legislación & jurisprudencia , Femenino , Encuestas y Cuestionarios , Medicina Legal , COVID-19/epidemiología , COVID-19/prevención & control , Unidades Hospitalarias/organización & administración
8.
Multimedia | Recursos Multimedia, MULTIMEDIA-SMS-SP | ID: multimedia-13598

RESUMEN

“Como nós, enquanto amigos, podemos ajudar pessoas que estão passando por uma situação de violência? Nós temos que estar próximos, fornecer apoio, não desacreditar, não desencorajar de procurar ajuda e acreditar naquilo que ela está falando”, Susane Mei Hwang, chefe do serviço de atendimento às vítimas de violência sexual do Hospital Municipal Maternidade-Escola Vila Nova Cachoeirinha, nos explica no #DonadeMim de hoje qual é o papel da sociedade no combate à violência sexual.


Asunto(s)
Delitos Sexuales , Servicios de Salud Reproductiva
9.
J Psychiatr Res ; 178: 50-58, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39121707

RESUMEN

Trauma type moderates the impact of trauma exposure on clinical symptomatology; however, the impact of trauma type on the neural correlates of emotion regulation is not as well understood. This study examines how violent and nonviolent trauma differentially influence the neural correlates of conditioned fear and extinction. We aggregated psychophysiological and fMRI data from three studies; we categorized reported trauma as violent or nonviolent, and subdivided violent trauma as sexual or nonsexual. We examined skin conductance responses (SCR) during a fear conditioning and extinction paradigm. For fMRI data analyses, we conducted region-specific and whole-brain analyses. We examined associations between beta weights from specific brain regions and CAPS scores. The group exposed to violent trauma showed significantly higher SCR during extinction recall. Those exposed to nonviolent trauma showed significantly higher functional activation during late extinction learning. The group exposed to violent trauma showed higher functional connectivity within the default mode network (DMN) and between the DMN and frontoparietal control network. For secondary analyses of sexual vs nonsexual trauma, we did not observe any between-group differences in SCR. During late extinction learning, the group exposed to sexual trauma showed significantly higher activation in the prefrontal cortex and precuneus. During extinction recall, the group exposed to nonsexual trauma showed significantly higher activation in the insular cortex. Violent trauma significantly impacts functional brain activations and connectivity in brain areas important for perception and attention with no significant impact on brain areas that modulate emotion regulation. Sexual trauma impacts brain areas important for internal perception.


Asunto(s)
Condicionamiento Clásico , Extinción Psicológica , Miedo , Respuesta Galvánica de la Piel , Imagen por Resonancia Magnética , Trauma Psicológico , Humanos , Extinción Psicológica/fisiología , Masculino , Miedo/fisiología , Femenino , Adulto , Respuesta Galvánica de la Piel/fisiología , Adulto Joven , Condicionamiento Clásico/fisiología , Trauma Psicológico/fisiopatología , Trauma Psicológico/diagnóstico por imagen , Red en Modo Predeterminado/fisiopatología , Red en Modo Predeterminado/diagnóstico por imagen , Exposición a la Violencia , Delitos Sexuales , Adolescente , Encéfalo/fisiopatología , Encéfalo/diagnóstico por imagen , Red Nerviosa/diagnóstico por imagen , Red Nerviosa/fisiopatología
10.
Child Abuse Negl ; 155: 106958, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39126880

RESUMEN

BACKGROUND: The study aimed to investigate the potential link between a history of childhood sexual abuse (CSA) and the experience of technology-facilitated sexual violence on dating apps (TFSV), considering distinct motivations for app usage among CSA survivors. OBJECTIVE: To explore the association between CSA and TFSV on dating apps, while also examining the potential moderating role of motivations for app usage and differences based on sexual orientation. PARTICIPANTS AND SETTING: The study utilized an online survey among 534 dating app users in Israel. METHODS: Participants completed an online survey assessing history of CSA, experiences of TFSV on dating apps, and motivations for app usage. RESULTS: The study found that individuals with a history of CSA experienced more TFSV on dating apps. Survivors of CSA showed lower motivation for love and higher motivation for self-worth validation, ease of communication, and thrill of excitement. Differences between heterosexual and LGBTQ+ participants were observed, with LGBTQ+ individuals reporting higher levels of CSA prevalence and TFSV on dating apps. Motivations for app usage and sexual orientation were found to moderate the association between CSA history and TFSV on dating apps. Among LGBTQ+ participants, those who experienced CSA had a higher likelihood of encountering TFSV on dating apps, regardless of their motivations. Heterosexual individuals with a history of CSA were more prone to TFSV on dating apps if they had a strong motivation for love. CONCLUSIONS: This study shed light on unique vulnerabilities among individuals with a history of CSA, including increased susceptibility to TFSV on dating apps.


Asunto(s)
Aplicaciones Móviles , Motivación , Humanos , Femenino , Masculino , Adulto , Israel , Adulto Joven , Abuso Sexual Infantil/psicología , Niño , Encuestas y Cuestionarios , Adolescente , Adultos Sobrevivientes del Maltrato a los Niños/psicología , Persona de Mediana Edad , Delitos Sexuales/psicología , Minorías Sexuales y de Género/psicología
11.
Trials ; 25(1): 571, 2024 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-39210388

RESUMEN

BACKGROUND: Globally, women 15-24 years are at heightened risk of sexual violence victimization, a risk factor for adverse mental, physical, and behavioral health outcomes. Sexual violence is common at universities and most often perpetrated by men, yet few evidence-based prevention strategies targeting men have been tested in low- and middle-income countries. GlobalConsent is a six-module, web-based educational program adapted from an efficacious U.S.-based program. Nine months post-treatment in a randomized trial in Vietnam, GlobalConsent reduced men's sexually violent behavior (odds ratio [OR] = 0.71, 95%CI 0.50-1.00) and increased prosocial intervening behavior (OR = 1.51, 1.00-2.28) relative to an attention-control. Evidence regarding optimal implementation strategies for scale up is needed. METHODS: We will randomize six medical universities in North, Central, and South Vietnam to deliver GlobalConsent using two different packages of implementation strategies that vary in intensity. Higher-intensity strategies will include greater (1) pre- and post-implementation engagement with university leaders and faculty and (2) greater pre-implementation outreach, follow-up, and incentives for students to promote engagement and completion of GlobalConsent. Higher intensity universities will receive additional training and support for their added activities. We will compare implementation drivers and outcomes, intervention effectiveness, and cost-effectiveness across the two implementation bundles. Our mixed-methods comparative interrupted time series design includes (1) qualitative interviews and quantitative surveys with university leaders and implementation teams to assess implementation barriers and facilitators; (2) repeated surveys with leaders and faculty, implementation teams, and male students to assess multilevel implementation drivers and outcomes; (3) repeated surveys with male students to assess behavioral outcomes (sexual violence and intervening behavior) and mediating variables (knowledge, attitudes, affect, and capacities); and (4) time diaries and cost tracking to assess cost-effectiveness of the two implementation-strategies bundles. DISCUSSION: This project is the first to assess packages of implementation strategies to deliver an efficacious web-based sexual violence prevention program for undergraduate men across all regions of Vietnam and synergizes with a violence-prevention training initiative (D43TW012188). This approach will produce rigorous evidence about how to disseminate GlobalConsent nationally, which holds promise to reduce gender-based health inequities linked to sexual violence as GlobalConsent is brought to scale. TRIAL REGISTRATION: NCT06443541. Retrospectively registered with ClinicalTrials.gov. Registered on June 05, 2024.


Asunto(s)
Ensayos Clínicos Controlados Aleatorios como Asunto , Delitos Sexuales , Estudiantes , Humanos , Masculino , Delitos Sexuales/prevención & control , Delitos Sexuales/psicología , Vietnam , Adolescente , Adulto Joven , Universidades , Estudiantes/psicología , Intervención basada en la Internet , Estudios Multicéntricos como Asunto , Factores de Tiempo , Análisis Costo-Beneficio
12.
Artículo en Inglés | MEDLINE | ID: mdl-39200614

RESUMEN

Violent social and political conflicts have caused several challenges to internally displaced persons (IDPs), especially girls and young women, among which is sexual violence (SV). Despite extensive records on SV in humanitarian contexts, studies to assess the level, examine the disclosure pattern (DP) and evaluate the availability of abortion care in these settings have received inadequate attention. This scoping review sought to synthesise the current African-based research on SV, DP, and abortion and post-abortion care (APAC) in humanitarian contexts. We conducted a systematic search of five databases: MEDLINE, PubMed, Scopus, Embase and Google Scholar, where the articles retrieved met the criteria for inclusion. The review adhered to PRISMA guidelines and the Critical Appraisal Skills Programme (CASP), containing ten questions to help confirm the validity of the research design and the originality of the results in comparison with similar studies. A series of inclusion and exclusion criteria were applied after the search, and 35 eligible articles from ten African countries with evidence of sexual violence, disclosure patterns, and APAC in camp settings were included in the study. Results described situations of SV in humanitarian settings in Africa as "terrible", "bad", "an epidemic", and "severe" as girls were used as sex objects, for profile enhancement and as a weapon of war. We also found that the illegality of APAC in Africa is causing a high occurrence of clandestine abortions in conflict contexts. Disclosing SV among IDPs in Africa did not follow a clear-cut pattern but was generally determined by socio-demographic characteristics. Sexual health is a fundamental right of all, as enshrined in SDG 3, which makes this topic a major public health issue. We therefore conclude that although disclosure may aggravate stigmatisation in some instances due to adverse reactions, it is still crucial to the healing processes.


Asunto(s)
Aborto Inducido , Refugiados , Delitos Sexuales , Femenino , Humanos , Embarazo , África , Revelación , Campos de Refugiados , Refugiados/psicología , Delitos Sexuales/estadística & datos numéricos
13.
Issues Ment Health Nurs ; 45(9): 917-926, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39110850

RESUMEN

Psychiatric and mental health (PMH) nurses integrate the concept of trauma-informed care into practice, policy, and education. Despite the frequency of PMH nurses practicing in a trauma-informed manner, there is a paucity of literature focused on integrating trauma-informed principles into research methods. Professions outside of the nursing sphere, specifically social work and social sciences, predominate the discourse around trauma-informed research. The authors of this manuscript provide detailed methods on a project using trauma-informed qualitative research methods with a feminist perspective. Semi-structured interviews with ten individuals with an experience of sexual violence answered the research question: what is the retrospective experience of women who encountered sexual violence in post-secondary education? An important part of the research design was an informal debrief with the audio recorder off, after the interview. Field notes were taken within this debrief, and participants reviewed these field notes as part of the member-checking process. By explaining the methods used in detail, referencing the available literature, and using the critical reflection of participants captured in the field notes, the authors of this manuscript explore strengths, conflicts, and boundary issues PMH nurses need to consider when integrating trauma-informed research methods into their research practices.


Asunto(s)
Enfermería Psiquiátrica , Humanos , Femenino , Investigación en Enfermería , Investigación Cualitativa , Delitos Sexuales/psicología , Adulto , Proyectos de Investigación
14.
Issues Ment Health Nurs ; 45(9): 937-947, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39173124

RESUMEN

HIV post-exposure prophylaxis (PEP) can reduce the risk of acquiring HIV infection following sexual assault. However, only about half of people offered HIV PEP will initiate the medication. Factors associated with patient readiness for HIV PEP following sexual assault have been attributed to structural and clinical barriers. This study utilized the Theory of Reasoned Action and Planned Behavior to better understand how personal factors, cognitive factors, mental health, barriers and facilitators that could influence a patient's decision to start HIV PEP post sexual assault. A web-based cross sectional survey was conducted from October 2017 to January 2020 and a total of 228 responses were included from participants that had experienced sexual assault in the previous 3 months. Using linear regression modeling fear of HIV, post-traumatic stress symptoms, validating social responses to disclosure, and having someone else pay for HIV PEP were all associated with feeling better prepared for HIV PEP decision making. Results indicate that structural, social, and individual factors impact patient decision making. These findings highlight opportunities for health systems and providers to improve HIV education and the importance of initiating HIV PEP following sexual assault.


Asunto(s)
Toma de Decisiones , Infecciones por VIH , Profilaxis Posexposición , Humanos , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Femenino , Adulto , Masculino , Estudios Transversales , Adulto Joven , Persona de Mediana Edad , Delitos Sexuales/psicología , Aceptación de la Atención de Salud/psicología , Adolescente , Encuestas y Cuestionarios
15.
Reprod Health ; 21(1): 116, 2024 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-39107772

RESUMEN

BACKGROUND: An essential aspect of human well-being is positive sexual health outcomes. However, the issue of adverse sexual health outcomes continues to be a major public health concern, particularly for women with disabilities in sub-Saharan Africa (SSA). Therefore, this current scoping review mapped studies conducted in the last twenty-nine years on the sexual health of women with disabilities from these five dimensions: sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour, whilst seeking to identify the current state of knowledge and address the study gaps in SSA. METHODS: This current scoping review was informed by the methodological framework proposed by Arksey and O'Malley. Exploratory searches were conducted in PubMed, Web of Science, African Journals Online, etc., to identify studies conducted in SSA that focus on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA since the inception of the International Conference on Population and Development in 1994 to 30th of March 2024. This process resulted in the inclusion of seventeen (17) studies. RESULTS: Of the 1362 identified through various databases, 34 studies were included for the full-text retrieval and screening; only 17 studies met the inclusion criteria. The eligible studies were conducted across six countries in SSA and published between 2008 and 2023. Eight studies used quantitative study type, six utilised qualitative approach, and three employed mixed-methods analysis. Two studies were conducted on sexual activity, ten were conducted on contraceptive use, four were conducted on sexual violence, and one study was conducted on risky sexual behaviour, whilst no study on sexual autonomy met the inclusion criteria. CONCLUSION: This review showed that there were few or scarce studies on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA and even where the studies were substantial (contraceptive use), the majority of the studies were conducted in a country. Future studies should consider examining dimensions of sexual health, such as sexual autonomy, sexual activity and risky sexual behaviour of women with disabilities that were not available or were scarce in the literature.


Sexual health is really important for people's overall well-being, and it includes aspects like how we feel socially, mentally, emotionally, and physically. In sub-Saharan Africa, especially for women with disabilities, sexual health is a big concern. So, this review looked at studies done over the last 29 years about the sexual health of women with disabilities in sub-Saharan Africa. It focused on five areas: sexual activity, contraceptive use, sexual autonomy, sexual violence, and risky sexual behaviour. Databases were searched for relevant studies and found 17 that fit the set criteria. These studies were from six countries in sub-Saharan Africa and were published between 2008 and 2023. Most of the studies were about contraceptive use, with fewer focusing on sexual activity, sexual violence, and risky behaviour. There weren't any eligible studies on sexual autonomy. The review concluded that there's not enough research on these sexual health dimensions among women with disabilities in sub-Saharan Africa, especially on sexual autonomy, and future studies should explore this further.


Asunto(s)
Personas con Discapacidad , Conducta Sexual , Salud Sexual , Humanos , Femenino , África del Sur del Sahara/epidemiología , Personas con Discapacidad/psicología , Delitos Sexuales , Conducta Anticonceptiva/estadística & datos numéricos , Conducta Anticonceptiva/psicología , Salud Reproductiva
16.
Pan Afr Med J ; 47: 196, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39119116

RESUMEN

Introduction: global studies indicate that sexual gender-based violence (SGBV) may increase during pandemics including COVID-19. The Mid-Eastern region in Uganda was of concern due to the high prevalence of intimate partner sexual violence among adolescent girls and young women (AGYW). Due to limited data, we investigated factors associated with SGBV among AGYW during the COVID-19 pandemic in Eastern Uganda, in April 2022. Methods: we listed all AGYW 10-24 years who obtained SGBV services at 10 high-volume health facilities from March 2020 to December 2021, the main COVID-19 period in Uganda. We conducted a case-control study among these AGYW. A case was ≥1 SGBV episode experienced by an AGYW aged 10-24 years residing in the Tororo and Busia districts. For every randomly selected case from the health facility line list, we identified two neighbourhood-matched AGYW controls who reported no SGBV. We interviewed 108 and 216 controls on socio-demographics, socio-economics, and SGBV experiences during COVID-19. We conducted logistic regression to identify associated factors. Results: among 389 SGBV cases, the mean age was 16.4 (SD± 1.6: range 10-24) years, and 350 (90%) were aged 15-19 years. Among 108 cases interviewed, 79 (73%) reported forced sex. Most (n=73; 68%) knew the perpetrator. In multivariate analysis, self-reported SGBV before the COVID-19 period [aOR=5.8, 95%CI: 2.8-12] and having older siblings [aOR=1.9, 95%: CI 1.1-3.4] were associated with SGBV during the period. Living with a family that provided all the basic needs was protective [aOR=0.42, 95%: CI 0.23-0.78]. Conclusion: previous SGBV experiences and family dynamics, such as having older siblings, increased the odds of SGBV during the COVID-19 pandemic in Uganda. Conversely, a supportive family environment was protective. Identifying, supporting, and enacting protective interventions for SGBV victims and socioeconomically vulnerable AGYW could reduce the burden of SGBV during similar events.


Asunto(s)
COVID-19 , Violencia de Pareja , Delitos Sexuales , Humanos , COVID-19/epidemiología , Femenino , Adolescente , Uganda/epidemiología , Estudios de Casos y Controles , Adulto Joven , Niño , Delitos Sexuales/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Violencia de Género/estadística & datos numéricos , Factores de Riesgo , Prevalencia
17.
BMJ Open ; 14(8): e081663, 2024 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-39107025

RESUMEN

INTRODUCTION: Sexual violence is a significant public health concern with severe physical, social and psychological consequences, which can be mitigated by health service utilisation. However, in Uganda and much of sub-Saharan Africa, these services are significantly underused, with 9 out of 10 survivors not seeking care due to a range of psychological, cultural, economic and logistical factors. Thus, there is a strong need for research to improve health service utilisation for survivors of sexual violence. METHODS AND ANALYSIS: The proposed study seeks to address the underutilization of health services for female survivors of sexual violence using a discrete choice experiment (DCE). The study will be conducted in the greater Masaka region of southwestern Uganda and target adult female survivors of sexual violence. We will first undertake qualitative interviews with 56 survivors of sexual violence to identify the key attributes and levels of the DCE. In order to ensure a sufficiently powered sample, 312 women who meet inclusion criteria will be interviewed. Our primary analysis will employ a mixed (random parameters) logit model. We will also model the role of individual-specific characteristics through latent class models. ETHICS AND DISSEMINATION: The study protocol was reviewed and approved by the following ethics review boards in Uganda and the USA: the Uganda Virus Research Institute (UVRI), the Uganda National Council for Science and Technology (HS2364ES), Washington University in St Louis and the University of Michigan. Our methods conform to established guidelines for the protection of human subjects involved in research. Our dissemination plan targets a broad audience, ranging from policymakers and government agencies to healthcare providers, academic communities and survivors themselves.


Asunto(s)
Aceptación de la Atención de Salud , Delitos Sexuales , Sobrevivientes , Humanos , Uganda , Femenino , Sobrevivientes/psicología , Delitos Sexuales/psicología , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , Conducta de Elección , Prioridad del Paciente , Proyectos de Investigación , Investigación Cualitativa
18.
Soc Sci Med ; 357: 117175, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39116699

RESUMEN

Gender-based violence (GBV) research in public health has historically paid close attention to gender as a system of oppression, with less attention paid to the intersections between gender and other oppressive systems such as colonialism, white supremacy, and capitalism. In 2019, we adapted and pilot-tested an individual-level evidence-based sexual violence resistance intervention for university-attending women in Eswatini. We conducted a qualitative assessment of our adapted intervention's acceptability and feasibility using a critical pedagogy lens to explore how power operated in delivering an empowerment intervention, using in-depth interviews with intervention participants and facilitators. We analyzed interview transcripts thematically guided by a critical pedagogy framework and organized emergent themes into a concept map with two primary axes: participant-researcher-driven power and proximal-distal determinants. We located participant experiences with the intervention within three quadrants defined by these axes: 1) "Prescriptive," in which the researcher or facilitator primarily controls the content and delivery, with a principal focus on proximal risk reduction strategies; 2) "Solidarity," which emphasizes fostering critical consciousness among facilitators and intervention participants through dialogue, building collective power through participant-driven discussions of individual experiences; and 3) "Liberation," in which participants critically examined the power structures that underpinned their lived experiences, and expressed a desire to transform these in ways the intervention was not designed to address. These three quadrants suggest the existence of a fourth quadrant, "paternalistic," - in which the interventionist seeks to didactically educate participants about structural drivers of their own experience. Our analysis highlights a fundamental tension in the epistemology of GBV research: While there is a clear consensus that 'empowerment' is a necessary component of successful GBV interventions, "liberatory" approaches that cede power to participants are inherently antithetical to the scripted approach typically required for consistent replication in randomized control trials or other 'gold-standard' approaches for post-positivist evidence generation.


Asunto(s)
Violencia de Género , Investigación Cualitativa , Humanos , Femenino , Violencia de Género/psicología , Violencia de Género/prevención & control , Adulto , Empoderamiento , Universidades/organización & administración , Adulto Joven , Delitos Sexuales/psicología
19.
JMIR Res Protoc ; 13: e57600, 2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39159453

RESUMEN

BACKGROUND: Sexual violence (SV) is a significant problem for sexual minorities, including men who have sex with men (MSM). The limited research suggests SV is associated with a host of syndemic conditions. These factors tend to cluster and interact to worsen one another. Unfortunately, while much work has been conducted to examine these factors in heterosexual women, there is a lack of research examining MSM, especially their SV risk perception. Further, MSM are active users of dating and sexual networking (DSN) mobile apps, and this technology has demonstrated usefulness for creating safe spaces for MSM to meet and engage partners. However, mounting data demonstrate that DSN app use is associated with an increased risk for SV, especially given the higher likelihood of using alcohol and other drugs before sex. By contrast, some researchers have demonstrated that DSN technology can be harnessed as a prevention tool for HIV; unfortunately, no such work has progressed regarding SV. OBJECTIVE: This study aims to (1) use qualitative and quantitative methods to tailor an existing laboratory paradigm of SV risk perception in women for MSM using a DSN mobile app framework and (2) subject this novel paradigm to a rigorous validation study to confirm its usefulness in predicting SV, with the potential for use in future prevention endeavors. METHODS: To tailor the paradigm for MSM, a team of computer scientists created an initial DSN app (G-Date) and incorporated ongoing feedback about the usability, feasibility, and realism of this tool from a representative sample of MSM. We used focus groups and interviews to assist in the development of G-Date, including by identifying relevant stimuli, developing the cover story, and establishing the appropriate study language. To confirm the paradigm's usefulness, we are conducting an experimental study with web-based and face-to-face participants to determine the content, concurrent, and predictive validities of G-Date. We will evaluate whether certain correlates of SV informed by syndemics and minority stress theories (eg, history of SV and alcohol and drug use) affect the ability of MSM to detect SV risk within G-Date and how paradigm engagement influences behavior in actual DSN app use contexts. RESULTS: This study received funding from the National Institute on Alcohol Abuse and Alcoholism on September 10, 2020, and ethics approval on October 19, 2020, and we began app development for aim 1 immediately thereafter. We began data collection for the aim 2 validation study in December 2022. Initial results from the validation study are expected to be available after December 2025. CONCLUSIONS: We hope that G-Date will enhance our understanding of factors associated with SV risk and serve as a useful step in creating prevention programs for this susceptible population.


Asunto(s)
Homosexualidad Masculina , Delitos Sexuales , Humanos , Masculino , Homosexualidad Masculina/psicología , Delitos Sexuales/psicología , Adulto , Aplicaciones Móviles , Medición de Riesgo , Femenino
20.
PeerJ ; 12: e17812, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39193511

RESUMEN

Introduction: COVID-19 preventive measures such as stay at home and isolation leads to violence against women. Intimate partner violence (IPV) is one of the common violence during this pandemic. This study aimed to assess the prevalence of physical, psychological and sexual intimate partner violence among reproductive age women during COVID-19 in Ethiopia. Materials and Methods: Electronic databases such as PubMed, Google Scholar and African journals online and studies available from the occurrence of the pandemic to April 2023 were searched. Two researchers collected the data and independently performed the methodological quality assessment. To pool the collected data for each outcome with 95% confidence interval (CI), DerSimonian-Laird random effects meta-analysis was used. Publication bias was measured by Doi plot LFK index and Egger's test. Stata version 14.0 (StataCorp, College Station, Texas, USA) software was used for statistical analysis. Results: A total of seven studies reported the prevalence of intimate partner violence among women in reproductive age during COVID-19, and the pooled prevalence of physical intimate partner violence was 22% (95% CI [0.12-0.32], I2 = 98.9%, tau2 = 0.0184, p < 0.001). The pooled prevalence of psychological intimate partner violence was 28% (95% CI [0.18-0.37], I2 = 98.1%, tau2 = 0.0142, p < 0.001). The pooled prevalence of sexual intimate partner violence was 23% (95% CI [0.13-0.34], I2 = 99.1%, tau2 = 0.0208, p < 0.001). Conclusions: During COVID-19 reproductive age women in Ethiopia were affected by intimate partner violence. Physical, psychological and sexual intimate partner violence were reported, and their prevalence was high due to the pandemic. Future studies on impact of COVID-19 on IPV among reproductive age women should be conducted in nationwide to make more comprehensive conclusion. PROSPERO registration number: CRD42023417628.


Asunto(s)
COVID-19 , Violencia de Pareja , Adulto , Femenino , Humanos , COVID-19/epidemiología , COVID-19/psicología , Etiopía/epidemiología , Violencia de Pareja/psicología , Violencia de Pareja/estadística & datos numéricos , Abuso Físico/psicología , Abuso Físico/estadística & datos numéricos , Prevalencia , Delitos Sexuales/psicología , Delitos Sexuales/estadística & datos numéricos
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