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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.

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INTRODUCTION: Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia. METHODS: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis. RESULTS: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services. CONCLUSION: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population.

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BACKGROUND: Many people experience forms of gender-based violence and harassment (GBVH) in the context of their work. This includes a wide range of experiences, from subtle expressions of hostility to physical assault, that can also be of a sexual nature (e.g., sexual harassment or assault). This systematic review aimed to summarize findings about the prospective associations of work-related GBVH with people's health and occupational situation. METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Scopus, Web of Science, MEDLINE and PsycINFO were searched for prospective studies in English from 1990 to May 24, 2023. Studies were included if they concerned a working population, exposure to any form of GBVH in the work context, and a health outcome or manifest occupational outcome. Quality was assessed with a modified version of the Cochrane 'Tool to Assess Risk of Bias in Cohort Studies', and studies assessed as low quality were excluded from the narrative synthesis. For the narrative synthesis, we grouped the results by similar exposures and outcomes and reported the strength and statistical significance of the associations. RESULTS: Of the 1 937 screened records, 29 studies were included in the narrative synthesis. Studies were mainly conducted in the USA and northern Europe and investigated exposure to sexual violence or harassment (SVH). Only two included studies investigated non-sexual kinds of GBVH. Consistently, studies showed associations of work-related SVH with poor mental health and there were indications of an association with hazardous substance use. There was no consistent evidence for an association of SVH with subsequent sickness absence, and there were too few studies concerning physical health and occupational outcomes to synthesize the results. CONCLUSIONS: There is consistent evidence of work-related SVH as a risk factor for subsequent poor mental health. There is no indication that the health consequences of SVH differ between women and men, although women are more often affected. There is a need for conceptual consistency, the consideration of non-sexual behaviors and prospective studies that test clear hypotheses about the temporal sequence of events.

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BACKGROUND: Women in low- and middle-income countries (LMICs) are primary producers of subsistence food and significant contributors to the agricultural economy. Gender Based Violence (GBV) adversely impacts their capacity to contribute and sustain their families and undermines social, economic, and human capital. Addressing GBV, therefore, is critical to creating safe and inclusive environments for women as primary producers to participate fully in rural communities. The aim of this scoping review is to explore the existing evidence on GBV in the context of women primary producers in LMICs to inform research gaps and priorities. METHODS: A scoping review was conducted using PubMed, Web of Science, Ebscohost and Google Scholar using keywords related to GBV and women producers in LMICs. Peer-reviewed journal articles published between January 2012 and June 2022 were included in the review. Duplicates were removed, titles and abstracts were screened, and characteristics and main results of included studies were recorded in a data charting form. A total of 579 records were identified, of which 49 studies were eligible for inclusion in this study. RESULTS: Five major themes were identified from our analysis: (1) extent and nature of GBV, (2) the impact of GBV on agricultural/primary production livelihood activities, (3) sociocultural beliefs, practices, and attitudes, (4) aggravating or protective factors, and (5) GBV interventions. Addressing GBV in agriculture requires inclusive research approaches and targeted interventions to empower women producers, promote gender equality, enhance agricultural productivity, and contribute to broader societal development. Despite attempts by researchers to delve into this issue, the pervasive under-reporting of GBV remains a challenge. The true extent and nature of GBV perpetrated against women is far from fully understood in this context. CONCLUSION: Despite the significant challenges posed by GBV to the health, economy and livelihoods of women primary producers in LMICs, there is a paucity in the current state of knowledge. To make meaningful progress, more research is required to understand the relationship between GBV and agricultural settings, and to gain nuanced insight into the nature and impact of GBV on women primary producers in different regions and contexts.

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Violence against women is characterised by male symbolic domination underpinned by patriarchy and expressing gender inequality in society. This study examined reporting of interpersonal violence against cisgender and transgender women 20 to 59 years old in Brazilian municipalities, from 2015 to 2021. This repeat panel study used data from the information system, and time-trend analysis by the Prais-Winsten method. A total of 605,983 notifications were eligible, 1.8% of which involved transgender women. Notifications regarding cisgender women were recorded in 84.8% of the municipalities and transgender women, in 31.7%. Notifications involved predominantly women who were younger (71.9%) and black (55.3%), and proportionally more transgender women (p<0.001). Most notifications were of physical violence (84.8%), followed by psychological violence (40.1%), which was higher among cisgender women (p<0.001) and at shorter intervals among transgender women (ß=-0.71; p=0.005). Notifications of violence still do not reflect the realities, particularly as regards transgender women. Psychological violence, however, which usually starts the cycle of aggression, now ranks second among notifications in Brazil, despite conservative reverses of recent years.

A violência contra mulher caracteriza-se pela dominação simbólica masculina com pilares no patriarcado, expressando a desigualdade de gênero existente na sociedade. O objetivo deste estudo é analisar a notificação de violência interpessoal em mulheres cisgêneras e transgêneras, de 20 a 59 anos, nos municípios brasileiros, no período de 2015 a 2021. Trata-se de estudo do tipo painéis repetidos, utilizando dados do sistema de informação, e análise de tendência temporal pelo método Prais-Winsten. Foram elegíveis 605.983 notificações, sendo 1,8% de transgêneras. As notificações foram registradas em 84,8% dos municípios para mulheres cisgêneras e 31,7% para transgêneras. Houve predomínio em jovens (71,9%) e negras (55,3%), sendo proporcionalmente maior entre as transgêneras (p<0,001). A maioria das notificações foi de violência física (84,8%); seguida de violência psicológica (40,1%), sendo maior nas cisgêneras (p<0,001) e com redução no período para as transgêneras (ß=-0,71; p=0,005). A notificação de violência ainda não reflete a realidade, em particular para mulheres transgêneras. A violência psicológica, entretanto, que costuma ser o início do ciclo de agressão, já ocupa o segundo lugar entre as notificações no país, apesar dos retrocessos vivenciados nos últimos anos.

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By way of life stories drawn from 20 interviews of women in two municipalities of Rio Grande do Sul, this qualitative study examined how violence against women living in rural areas is silenced and the challenges involved in breaking that silence. Narrative Analysis arrived at two categories: "I suffered in silence and certainly all women are like that" (Violence silenced) and "We take care of her" (Breaking the silence). The first relates to the oppression of imposed silence and how women were affected by violence and isolation. The second shows the challenges facing women who break the silence and leave abusive relationships and how, through their narratives, to access the stories of other women who suffer violence. The narratives stress that the imposition of silence, which arose from gender roles and constraints on freedom, contributed to their continuing in the abusive relationship. The violence was sustained by the rural setting, where women were even more isolated, alone and unsupported, which heightened their fears, guilt, shame and financial dependence. An inter-sector approach, with more information and care for rural women, is fundamental to addressing this problem.

Este estudo se dedica, através de histórias de vida, a analisar a violência contra as mulheres que vivem em contextos rurais, seu silenciamento e os desafios de rompê-lo. Trata-se de uma pesquisa qualitativa a partir de 20 entrevistas com mulheres rurais em dois municípios do Rio Grande do Sul. Através da Análise de Narrativas chegamos a duas categorias: "Eu sofria calada e certamente toda mulher é assim" - A violência e o silenciamento; e "A gente cuida dela" - Rompendo o silêncio. A primeira, faz referência a opressão do silenciamento e como as mulheres foram afetadas através da violência e do isolamento. A segunda, apresenta os desafios enfrentados pelas mulheres ao romper o silenciamento e sair da relação abusiva, e como, através de suas narrativas, acessamos a histórias de outras mulheres que sofrem violência. As narrativas reforçam que o silenciamento, advindo dos papeis de gênero e do cerceamento de liberdade, contribuiu para a permanência na relação abusiva. A violência teve sustentáculo no contexto rural, no qual as mulheres ficavam ainda mais isoladas, sozinhas e sem apoio, acentuando seus medos, culpa, vergonha, dependência financeira. É fundamental haver um trabalho intersetorial para o enfrentamento a essa problemática com mais informação e assistência às mulheres rurais.

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BACKGROUND: The aim of this study was to analyze the prevalence, age and gender differences, and psychological outcomes (anxiety, depression and self-esteem) related to being a victim of different forms of online gendered violence (OGV), namely: digital sexual harassment; physical appearance-based violence; gender role-based violence; and anti-feminism violence. METHOD: 2,471 respondents (71.1 % women) aged 18-79 years (M = 27.28, SD = 10.08) completed self-report measures. RESULTS: The results showed that 82.6 % of respondents had experienced at least one form of OGV in the last 12 months. The most frequent form of OGV was digital sexual harassment (66.7%), followed by physical appearance-based violence (60.7%), anti-feminism violence (60.7%) and gender role-based violence (25.4%). OGV was significantly higher among women (88%) than men (68.6%), as well as among younger adults. Finally, the results showed that these forms of violence were associated with worse psychological outcomes, especially for younger respondents and for women. CONCLUSIONS: OGV is a common phenomenon that may be related to lower psychological well-being. This study provides relevant information that can shape the design of prevention and intervention programs for this form of digital violence.

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BACKGROUND: While research has demonstrated associations between experiencing violence from intimate and non-intimate partners and non-fatal drug overdose among women who inject drugs, existing studies focus predominantly on the Global North and are analytically limited. Guided by syndemics theory, this study examined whether different forms of gender-based violence exert independent and interactive effects on non-fatal drug overdose among women who inject drugs in Indonesia. METHODS: We recruited 731 cisgender adult women who injected drugs in the preceding year via respondent-driven sampling. We used multivariate logistic regressions to examine associations between self-reported intimate partner violence (IPV), police sexual violence, and police extortion, and non-fatal drug overdose, with covariance adjustment for factors drawn from the risk environment. We tested for interaction effects among violence measures by calculating metrics for attributable proportion (AP), relative excess risk due to interaction (RERI), and synergy index (S). RESULTS: Experiencing IPV (AOR 2.5; 95 % CI 1.2, 5.1; p = 0.012), police extortion (AOR 2.2; 95 % CI 1.5, 3.2; p ≤ 0.001), and police sexual violence (AOR 3.7; 95 % CI 1.5, 9.4; p = 0.005) each independently predicted non-fatal overdose, after adjusting for potential confounders. A significant positive interaction was detected between IPV and police sexual violence on drug overdose (AP=0.6, p = 0.001; S = 3.8, p = 0.015) such that the joint effect of these two forms of violence was associated with a nearly fourfold increase in non-fatal overdose risk compared to the main effects of each violence exposure. CONCLUSION: This is the first study to show that concurrent IPV and police sexual violence exert an amplifying effect on non-fatal overdose beyond the additive effects of each exposure. Supporting the value of gender-responsive harm reduction services that integrate violence and overdose responses, results suggest that eliminating one form of violence when multiple forms of GBV are present could magnify the expected reduction in overdose.

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Women with disabilities are more likely to experience violence than women without disabilities and there is a critical gap in research regarding this topic. This study uses Demographic and Health Survey (DHS) data to analyse the association between disability and experiences of gender-based violence (GBV) and help-seeking behaviour among women in Haiti, Pakistan, Timor Leste, and Uganda. These countries were chosen because they are representative of the regions where the DHS is conducted and include questions about GBV and disability. The data was analysed based on recommendations from the Washington Group using a disability severity indicator. Logistic regression was the primary method of analysis. Generally, we found women with disabilities had the same or greater odds of experiencing GBV and had the same or lower odds of help-seeking. Given women with disabilities are at least at equal risk of experiencing GBV, it is imperative that programs be developed that are accessible to all women regardless of functional limitations. Also, additional research is needed to determine if there are differences by disability type, if intersectionality is relevant, and to include more unmarried women.

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OBJECTIVE: To analyze the temporal trend of completeness and consistency of data on notifications of violence against indigenous women in the health macro-region of Dourados, state of Mato Grosso do Sul, Brazil, between 2009 and 2020. METHODS: An ecological time series study was conducted using data from the Notifiable Health Conditions Information System; Prais-Winsten regression was used to analyze the trend of data completeness and consistency, as well as the proportion of completed and coherent fields. RESULTS: A total of 2,630 cases were reported; completeness was found to be very poor in the variable "occupation" (48.9%) and poor in the variables "schooling" (68.3%) and "time of occurrence" (67.9%); in the analysis of temporal trends, only the variable "occupation" showed a decreasing trend (p = 0.045). CONCLUSION: The data analyzed demonstrated the need for improvement in the completeness of the variables "schooling", "occupation" and "time of occurrence" of the violent act. MAIN RESULTS: There was a progressive increase in notifications over the years. Most of the variables showed regular or excellent completeness and consistency. In the analysis of temporal trend, only the "occupation" variable showed a decreasing trend. IMPLICATIONS FOR SERVICES: Care for victims of violence is part of the daily routine of health services, and it is essential for health professionals to provide adequate compulsory notification for a comprehensive understanding of the victims' profile, thus assisting in addressing this issue. PERSPECTIVES: Further studies are needed to understand the factors associated with violence against indigenous women, which could help the development of health promotion actions and violence prevention strategies targeting these women.

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INTRODUCTION: We assessed the impact of a personal agency-based training for refugee women and their male partners on their economic and social empowerment, rates of intimate partner violence (IPV), and non-partner violence (NPV). METHODS: We conducted an individually randomized controlled trial with 1061 partnered women (aged 18-45) living in a refugee camp in Rwanda. Women received two days of training, and their partners received one day of training. The follow-up survey where all relevant outcomes were assessed was carried out at 6-9 months post-intervention. RESULTS: At follow up, women in the intervention arm were more likely to report partaking in income generating activities (aIRR 1.27 (1.04-1.54), p < 0.05) and skill learning (aIRR 1.59 (1.39-1.82), p < 0.001) and reported a reduction in experience of physical or sexual NPV in the past six months (aIRR 0.65 (0.39-1.07), p < 0.09). While improved, no statistically significant impacts were seen on physical or sexual IPV (aIRR 0.80 (0.58-1.09), p = 0.16), food insecurity (ß 0.98 (0.93 to 1.03), p = 0.396), or clean cookstove uptake (aIRR 0.95 (0.88 to 1.01), p = 0.113) in the past six months. We found statistically significant reduction in physical and sexual IPV amongst those experiencing IPV at baseline (aIRR 0.72 (0.50 to 1.02), p < 0.07). Small improvements in self-efficacy scores and our indicator of adapting to stress were seen in the intervention arm. Some challenges were also seen, such as higher prevalence of probable depression and/or anxiety (aIRR 1.79 (1.00-3.22), p = 0.05) and PTSD (aIRR 2.07 (1.10-3.91), p < 0.05) in the intervention arm compared to the control arm. CONCLUSION: Our findings echo previous research showing personal agency training can support economic well-being of women. We also find potentially promising impacts on gender-based violence. However, there is some evidence that integration of evidence-based mental health support is important when enhancing agency amongst conflict-affected populations. TRIAL REGISTRATION NUMBER: The trial was registered with ClinicalTrials.gov, Identifier: NCT04081441 on 09/09/2019.

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Objetivo: Analizar los discursos de jóvenes y profesionales sobre la violencia contra la mujer y explorar las posibles estrategias para su prevención en España.Método: Estudio cualitativo basado en entrevistas semiestructuradas a 16 jóvenes (18-24 años) y 23 profesionales que trabajan en la prevención de la violencia contra la mujer. Se llevó a cabo un análisis del discurso para identificar los principales repertorios interpretativos.Resultados: Los cuatro repertorios interpretativos de este estudio reflejan cómo las personas jóvenes perciben la violencia física en el ámbito doméstico como el tipo de violencia contra la mujer más visible. En sus discursos, tanto hombres como mujeres jóvenes describen el carácter bidireccional de la violencia en el ámbito de la pareja. Emerge la alusión a la responsabilidad de los agentes sociales en la perpetuación de la violencia contra la mujer. Por último, las personas jóvenes y profesionales destacan el papel clave de los chicos en la prevención de la violencia contra la mujer.Conclusiones: La violencia física continúa siendo el principal tipo de violencia percibido por la población joven, pero mayoritariamente las chicas fueron capaces de identificar otras formas de violencia más sutiles y normalizadas. Los agentes sociales tienen una fuerte influencia en el imaginario sobre la violencia contra la mujer de la población joven. Por último, las futuras estrategias contra la violencia contra la mujer deben contar con la participación de los hombres jóvenes desde estrategias comunitarias que trabajen en la promoción de actitudes y relaciones positivas e igualitarias.(AU)

Objective: To analyze the discourses of young people and professionals on violence against women and to explore possible strategies for its prevention in Spain.Method: Qualitative study based on semi-structured interviews with 16 young people (18–24 years old) and 23 professionals working in violence against women prevention. A discourse analysis was carried out to identify the main interpretative repertoires.Results: The four interpretative repertoires of this study reflect how young people perceive physical violence in the domestic sphere as the most visible type of violence against women. In their discourses, both young men and women describe the bidirectional nature of intimate partner violence. The allusion to the responsibility of social agents in the perpetuation of violence against women emerges. Finally, young people and professionals emphasize the key role of boys in the prevention of violence against women.Conclusions: Physical violence continues to be the main type of violence perceived by the young population, but most girls were able to identify other more subtle and normalized forms of violence. Social agents have a strong influence on the imaginary of violence against women in the young population. Finally, future strategies against violence against women must involve young men in community-based strategies that work to promote positive and egalitarian attitudes and relationships.(AU)

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Despite high gender equality ratings, Sweden shows a high prevalence of intimate partner violence against women (IPVAW). Suggested factors underlying this apparent paradox include backlash effects against women's empowerment. This study explores stories of backlash in interviews with 23 IPVAW survivors in Sweden. Thematic analysis identified categories of narrative segments referring to phenomena provoking violence; the victims' resources, agency, breaking with gender norms and resistance, and the partner's feelings of subordination, while case-centered narrative analysis pointed to divergences between how these categories appear in the stories. The study underscores the complexity of links between gender (in)equality and IPVAW in Sweden.

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La violencia por cuestiones de género es un fenómeno histórico, complejo y prevalente a nivel mundial. Definida por la Organización de las Naciones Unidas como 'todo acto de violencia basado en la pertenencia al sexo femenino, que tenga o pueda tener como resultado un daño o sufrimiento físico, sexual o psicológico para la mujer, así como las amenazas detales actos, la coacción o la privación arbitraria de la libertad, tanto si se producen en la vida pública como en la privada', la violencia contra la mujer constituye una violación de los derechos humanos y por lo tanto, una cuestión de Estado. Las autoras de este artículo repasan el marco legal que aborda este problema en la Argentina, las dificultades del sistema sanitario (a nivel institucional e individual) en la detección y asistencia de las personas que lo padecen y la necesidad desensibilización y capacitación de los profesionales de la salud. (AU)

Gender-based violence is a historical, complex and prevalent phenomenon worldwide. Defined by the United Nations as 'any act of female-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, as well as threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life', violence against women is a violation of human rights, and therefore a matter of State. The authors of this article review the legal frame that addresses this problem in Argentina, the difficulties of the health system (at institutional and individual level) in the detection and care of people who suffer from it, and the need for raising awareness and training healthcare professionals. (AU)

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Objetivo: descrever o perfil sociodemográfico dos casos notificados de violência sexual (VS) e a distribuição dos serviços de atendimento ao agravo em Minas Gerais, Brasil, 2019. Métodos: estudo descritivo dos casos notificados no Sistema de Informação de Agravos de Notificação e dos serviços registrados no Cadastro Nacional dos Estabelecimentos de Saúde. Resultados: foram identificadas 4.418 notificações de VS no período, correspondendo a mais de 12 notificações/dia; houve maior frequência de notificações no sexo feminino (87,0%) e entre crianças e adolescentes (72,0%); a distribuição dos serviços mostrou vazios assistenciais em quatro das 14 macrorregiões de saúde do estado; as distâncias máximas percorridas para atendimento em serviços de referência variaram de 93 a 327 km. Conclusão: a escassez de serviços de atendimento a pessoas em situação de VS nas microrregiões e macrorregiões de Minas Gerais sinalizam a necessidade de planejamento de políticas públicas visando aumentar o acesso a esses serviços.

Objetivo: describir el perfil sociodemográfico de los casos notificados de violencia sexual (VS) y la distribución de los servicios para esta condición. Métodos: estudio observacional descriptivo basado en datos del Sistema de Información de Enfermedades de Declaración Obligatoria y servicios registrados en el Registro Nacional de Estabelecimientos de Salud, en Minas Gerais, Brasil, en 2019. Resultados: se identificaron 4.418 notificaciones de SV que representan más de 12 notificaciones por día; los registros se centraron en el sexo femenino (87,0%), niños y adolescentes (72,0%); la distribución de los servicios mostró brechas de atención en cuatro macrorregiones entre las 14 existentes; la distancia máxima recorrida para asistencia en un servicio de referencia osciló entre 93 y 327 km. Conclusión: la escasez de servicios de atención a personas en situación de SV en las micro y macro regiones, indican la necesidad de planificación de políticas públicas para ampliar el acceso.

Objective: to describe the sociodemographic profile of reported cases of sexual iolence (SV) and the distribution of care services for this health condition in the state of Minas Gerais, Brazil, 2019. Methods: this was a descriptive study of the cases of sexual violence reported on the Notifiable Health Conditions Information System and care services registered in the National Health Establishment Registry. Results: a total of 4,418 notifications of SV were identified during the study period, representing more than 12 notifications per day; the majority of notifications were among females (87.0%) and among children and adolescents (72.0%); the distribution of care services showed care gaps in four of the 14 health macro-regions of the state of Minas Gerais; the maximum distances traveled to access referral services ranged from 93 to 327 km. Conclusion: the scarcity of care services for people subjected to sexual violence in the micro-regions and macro-regions of Minas Gerais highlights the need for planning public policies aimed at increasing access to these services.

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OBJECTIVE: to analyze the time trend and the spatial distribution of the cases of lethal violence against women in Brazil, according to age group and to race/skin color. METHOD: an ecological study of time series, with spatial distribution of the deaths of women victims of aggression, registered in the Mortality Information System, resident in Brazil, Brazilian geographic regions and states. Due to underreporting of deaths in some states, correction factors of the mortality rates were employed. For the trend analysis, we adopted the polynomial regression model. In addition to that, the mean rates and annual upward/downward trends were distributed considering the Brazilian federative units as analysis units. RESULTS: the mean rate was 6.24 cases of lethal violence per 100,000 women, with a significant variation across the Brazilian regions and states. The main victims of violent death in Brazil are young, black-/brown-skinned and indigenous women, with a growing trend in these population segments. The North and Northeast regions stood out with the most significant mean annual increases (0.33; r2= 0.96 and 0.26; r2= 0.92, respectively). CONCLUSION: there was a stable trend regarding lethal violence against women, with significant regional differences. Young, black-/brown-skinned and indigenous women are more vulnerable to violent death in Brazil.

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BACKGROUND: Adolescence is characterized by identity formation, exploration and initiation of intimate relationships. Much of this occurs at school, making schools key sites of sexual harassment. Schools often lack awareness and understanding of the issue, and UK research on the topic is scarce. We explored prevalence and perceptions of sexual harassment in a school-based mixed-methods study of 13-17 year-old Scottish adolescents. METHODS: A student survey (N = 638) assessed past 3-months school-based victimization and perpetration prevalence via 17 behavioral items based on the most commonly used school-based sexual harassment measure ('Hostile Hallways'). Eighteen focus groups (N = 119 students) explored which of 10 behaviors were perceived as harassing/unacceptable and why. RESULTS: Two-thirds reported any victimization: 64.7% 'visual/verbal' (e.g. sexual jokes) and 34.3% 'contact/personally-invasive' behaviors (e.g. sexual touching; most of whom also reported experiencing visual/verbal types) in the past 3-months. Data suggested a gateway effect, such that contact/personally-invasive behaviors are more likely to be reported by those also reporting more common visual/verbal behaviors. Some survey participants reported being unsure about whether they had experienced certain behaviors; and in focus groups, participants expressed uncertainty regarding the acceptability of most behaviors. Ambiguities centered on behavioral context and enactment including: degree of pressure, persistence and physicality; degree of familiarity between the instigator-recipient; and perception of the instigator's intent. In attempting to resolve ambiguities, students applied normative schemas underpinned by rights (to dignity, respect and equality) and 'knowingness', usually engendered by friendship. CONCLUSIONS: Our study confirms school-based sexual harassment is common but also finds significant nuance in the ways in which students distinguish between acceptable and harassing. School-based strategies to tackle sexual harassment must engage with this complexity.

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La situación creada por la pandemia por COVID-19 y el confinamiento han dado lugar a una disminución del número de homicidios por violencia de género en 2020 con 45 homicidios, el número más bajo de toda la serie histórica. El análisis de las circunstancias generadas por el confinamiento y la limitación de la movilidad en las fases posteriores, unidas al deterioro de la situación económica, son factores relacionados con el aumento de la violencia durante el segundo trimestre (meses del confinamiento), expresado en un incremento del 49,6% en el número de llamadas al 016, y en una disminución de las denuncias del 14,6% en esos mismos meses. Esta situación refleja el aumento del control y la disminución de oportunidades para salir de la violencia, que ha incidido en la disminución del número de homicidios, con 4 homicidios durante los meses de confinamiento, un número que nunca había sido tan bajo para un trimestre. La situación surgida es compatible con un incremento del riesgo de letalidad, factor que puede estar relacionado con el aumento de homicidios limitado al mes de agosto, coincidiendo con la recuperación de las circunstancias de movilidad y oportunidades socio-laborales. El estudio de las circunstancias sociales ocasionadas por la pandemia a lo largo de 2020 permite describir 3 patrones de impacto sobre la violencia de género. (AU)

Circumstances under COVID-19 pandemic and lockdown have reduced the number of gender-based violence homicides in 2020, with a total number of 45, the lowest in the historical statistics. Analysis of these circumstances generated by the lockdown and mobility reduction, together the economical negative impact, has produced an increment of 49.6% in the number of calls to 016 (telephone for victims’ assistance), and a reduction of 14.6% in the complaints of violence during the months of lockdown. This situation reflects a higher control of victims and more difficulties to exit from violence, that has decreased the number of homicides to 4 during these months, the lowest within Spanish statistics. These circumstances are compatible with an increment of risk of aggressions and lethality, factor that can be related with the increment of homicides limited to August, when the mobility and socio-labor opportunities were recovered. The study of the social circumstances originated by the pandemic allows to describe three different patterns in the impact on gender-based violence. (AU)

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INTRODUCTION: High-quality forensic documentation can improve justice outcomes for survivors of sexual and gender-based violence, but there are limited tools to assess documentation data quality. This study aimed to develop and validate a data quality assessment index to objectively assess clinician documentation across the 26 key elements of the standardized forensic evidence forms used in Kenya. METHODS: Informed by prior quality assessment tools, an initial draft of the index was developed. Feedback from Kenya- and U.S.-based clinicians and human rights experts was solicited and incorporated into the draft index in an iterative fashion. Two raters independently employed the finalized Physicians for Human Rights Data Quality Index to assess and score the quality of documentation across 31 clinician-completed forms. Inter-rater reliability was determined using Cohen kappa (к) coefficients. RESULTS: The Index was found to have substantial overall reliability. Of the 26 documentation items, the Index had a perfect (к = 1.0) and almost perfect (к = 0.81-0.99) level of inter-rater agreement across 17 (65.4%) and 5 (19.2%) items, respectively. On a low-to-high documentation quality scale of 0 to 2, the majority of items (n = 19, 73.1%) had a mean documentation quality score >1.5-2. CONCLUSION: Quality assurance of forensic documentation is an essential component of post-sexual assault care. To our knowledge, this is the first validated quality-assessment tool in the peer-reviewed literature for sexual assault documentation and may be a promising strategy to enhance the quality of sexual assault documentation in other settings, locally, regionally, and internationally.

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