RESUMO
Intimate partner violence (IPV) is a worldwide public health problem. Many proposals aiming to eliminate its occurrence include the empowerment of women through their socio-economic development. In this context, some studies suggested that microcredit programs (MP) and cash transfer programs (CTP) are initiatives that can also reduce the risk of IPV. Others pointed to an opposite effect. The objective of this study was to investigate the influence of women's economic empowerment in MP and CTP on the risk of physical, psychological and sexual violence through a systematic review. Papers/documents selection was conducted by two researchers according to the following criteria: published in English, Portuguese or Spanish; primary data; assessing the effect of MP or CTP on IPV; in heterosexual couples; on women beneficiaries of the intervention; using a comparator group eligible for an MP or CTP; and focusing on risk IPV as the outcomes. Our results showed that the impact of MP are mixed when it comes to physical and physical/sexual violence. Even so, the review suggests that the effect of MP on sexual violence is trivial or nonexistent. Regarding the impact of CTPs, the present study showed that the effects on physical, physical/sexual, psychological, and sexual violence were also heterogeneous. Women more empowered and with some autonomy could be at risk. Despite that, participation in the empowerment program should be encouraged for poor women and families. However, parallel interventions to lead with IPV should be addressed to the main actions to reduce the risk of increasing IPV prevalence in certain scenarios.
Assuntos
Emprego/psicologia , Empoderamento , Apoio Financeiro , Violência por Parceiro Íntimo/economia , Mulheres/psicologia , Feminino , Administração Financeira , Humanos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , América Latina/epidemiologia , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana/estatística & dados numéricosRESUMO
OBJECTIVE: To establish the prevalence and characteristics of violence against women living with human immunodeficiency virus infection and to explore factors associated with violence in an HIV care program in the city of Bogotá in 2017. MATERIALS AND METHODS: Analytical cross-sectional study design that identified characteristics associated with violence against women living with HIV in the city of Bogotá. RESULTS: Of the 223 women surveyed, 33.6% (95%CI 27-40%) experienced intimate partner violence of any type, physical or non-physical, only physical violence 21.9% (95% CI 16-27%), and non-physical violence 31.8% (95% CI 26-38%). Non-physical partner violence was found to be related to being separated or in a consensual union (32.4 and 28.2%, respectively, p=0.000), to a nuclear family composition (42.3% p=0.041), or to 100% economic contribution of the woman in the household (33.8% p=0.001). On the other hand, physical violence is more frequent in separated women (46.9%, p=0.000), in couples with children (89.8%, p=0.042), in single-parent families (49%, p=0.000), in single women (42.9%, p=0.013), and in women who make 100% economic contribution at home (38.8%, p=38.8). CONCLUSIONS: The results related to intimate partner violence in these women suggest that screening should be done to detect violence as part of post-HIV counseling, and that violence should be addressed as a routine part of HIV treatment and care to improve the quality of life for women living with HIV.
OBJETIVO: Identificar la prevalencia y características de la violencia contra la mujer cuando convive con la infección por el virus de inmunodeficiencia humana y explorar los factores asociados a la presencia de la violencia, en un programa de atención integral en VIH de la ciudad de Bogotá en el año 2017. MÉTODOS: Diseño analítico transversal que identificó las características que componen la violencia contra la mujer con VIH. RESULTADOS: De las 223 mujeres encuestadas, el 33,6% [IC95% 27-40%] presentaron violencia de pareja de cualquier tipo, física o no física; solo violencia física 21,9% [IC95% 16-27%], y violencia no física 31,8%[IC 95% 26-38%]. Para la violencia de pareja no física se encontró dependencia con ser mujeres separadas o en unión libre (32,4 y 28,2%, p=0,000), con una composición familiar nuclear(42,3% p=0,041), o si la mujer tenía un aporte económico de 100% en el hogar (33,8% p=0,001). Mientras que la violencia física se informa como más frecuente en mujeres separadas (46,9% p=0,000), en parejas con hijos(89,8% p=0,042), familia monoparental(49% p=0,000), en mujeres que se encuentran sin pareja(42,9% p=0,013), y con aporte económico en el hogar del 100%(38,8% p=0.001). CONCLUSIONES: Los resultados en estas mujeres relacionados con violencia de pareja, sugieren que se debe hacer un tamizado en detección de violencia como parte del asesoramiento post prueba del VIH, y que se aborde la violencia como una parte rutinaria del tratamiento y la atención del VIH que conlleven, a mejorar la calidad de vida de las mujeres con VIH.
Assuntos
Infecções por HIV/terapia , Violência por Parceiro Íntimo/estatística & dados numéricos , Adulto , Idoso , Colômbia , Estudos Transversais , Características da Família , Feminino , Infecções por HIV/psicologia , Humanos , Violência por Parceiro Íntimo/economia , Violência por Parceiro Íntimo/psicologia , Pessoa de Meia-Idade , Pesquisa Qualitativa , Qualidade de VidaRESUMO
Intimate partner violence (IPV) is a worldwide public health problem. Many proposals aiming to eliminate its occurrence include the empowerment of women through their socio-economic development. In this context, some studies suggested that microcredit programs (MP) and cash transfer programs (CTP) are initiatives that can also reduce the risk of IPV. Others pointed to an opposite effect. The objective of this study was to investigate the influence of women's economic empowerment in MP and CTP on the risk of physical, psychological and sexual violence through a systematic review. Papers/documents selection was conducted by two researchers according to the following criteria: published in English, Portuguese or Spanish; primary data; assessing the effect of MP or CTP on IPV; in heterosexual couples; on women beneficiaries of the intervention; using a comparator group eligible for an MP or CTP; and focusing on risk IPV as the outcomes. Our results showed that the impact of MP are mixed when it comes to physical and physical/sexual violence. Even so, the review suggests that the effect of MP on sexual violence is trivial or nonexistent. Regarding the impact of CTPs, the present study showed that the effects on physical, physical/sexual, psychological, and sexual violence were also heterogeneous. Women more empowered and with some autonomy could be at risk. Despite that, participation in the empowerment program should be encouraged for poor women and families. However, parallel interventions to lead with IPV should be addressed to the main actions to reduce the risk of increasing IPV prevalence in certain scenarios.
A violência entre parceiros íntimos (VPI) é um problema de saúde pública de alcance global. Muitas propostas para eliminar a VPI incluem o empoderamento das mulheres através do desenvolvimento socioeconômico individual. Nesse contexto, alguns estudos sugerem que programas de microcrédito (PMC) e de transferência de renda (PTR) também podem reduzir o risco de VPI, enquanto outros apontam para um efeito oposto. Através de uma revisão sistemática, este estudo teve como objetivo investigar a influência do empoderamento econômico das mulheres através de PMCs e PTRs sobre o risco de violência física, psicológica e sexual. A seleção de artigos e documentos foi realizada por dois pesquisadores, com base nos seguintes critérios: publicação em inglês, português ou espanhol; dados primários; avaliação do efeito de PMC ou PTR sobre VPI; casais heterossexuais; mulheres beneficiárias da intervenção; uso de um grupo de comparação elegível para um PMC ou PTR e foco sobre o risco de VPI como o desfecho. Nossos resultados mostraram que o impacto dos PMCs é misto no que diz respeito à violência física e física/sexual. Contanto, a revisão sugere que o efeito dos PMCs sobre a violência sexual é trivial ou inexistente. Quanto ao impacto dos PTRs, o estudo mostrou que os efeitos sobre a violência física, física/sexual, psicológica e sexual também foram heterogêneos. As mulheres mais empoderadas e com alguma autonomia poderiam estar em risco maior. Entretanto, a participação no programa de empoderamento deve ser incentivada para as mulheres e famílias pobres. Intervenções paralelas para líder com a VPI devem focar nas principais medidas para reduzir o risco de aumento de prevalência de VPI em determinados cenários.
La violencia doméstica (VPI por sus siglas en portugués) es un problema de salud pública en todo el mundo. Las propuestas para eliminarla incluyen el empoderamiento de las mujeres a través de su desarrollo socioeconómico. Algunos estudios sugieren que los programas de microcrédito (PMCs) y de transferencia de renta (PTRs) son iniciativas capaces de reducir el riesgo de VPI. Otros estudios indican un efecto contrario. Basándonos en una revisión sistemática, el estudio procuró investigar la influencia del empoderamiento económico de las mujeres, a través de PMCs y PTRs, sobre el riesgo de violencia física, psicológica y sexual. Los artículos y documentos fueron seleccionados por dos investigadores, de acuerdo con los siguientes criterios: estudios publicados en inglés, portugués o español; datos primarios; evaluación del efecto del PMC o PTR sobre la VPI; parejas heterosexuales; mujeres beneficiarias de la intervención; un grupo de comparación elegible para un PMC o PTR y centrados en el riesgo de VPI como desenlace. De acuerdo con nuestros resultados, el impacto de los PMCs es mixto en lo que se refiere a la violencia física y física/sexual. No obstante, la revisión sugiere que el efecto de los PMCs sobre la violencia sexual es trivial o inexistente. En relación con el impacto de los PTRs, el estudio mostró que los efectos sobre la violencia física, física/sexual, psicológica y sexual también son heterogéneos. Las mujeres más empoderadas y con alguna autonomía podrían estar en riesgo. Sin embargo, la participación en el programa de empoderamiento debe incentivarse en el caso de las mujeres y familias pobres. Las intervenciones paralelas para combatir VPI deben dar prioridad a medidas para reducir el riesgo de aumento de la prevalencia de esta violencia en determinados contextos.
Assuntos
Humanos , Feminino , Mulheres/psicologia , Apoio Financeiro , Emprego/psicologia , Violência por Parceiro Íntimo/economia , Empoderamento , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos , Prevalência , Inquéritos e Questionários , Fatores de Risco , Administração Financeira , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , América Latina/epidemiologiaRESUMO
BACKGROUND: Intimate partner violence (IPV) is highly prevalent and has detrimental effects on the physical and mental health of women across the world. Despite emerging evidence on the impacts of cash transfers on intimate partner violence, the pathways through which reductions in violence occur remain under-explored. A randomised controlled trial of a cash and in-kind food transfer programme on the northern border of Ecuador showed that transfers reduced physical or sexual violence by 30 %. This mixed methods study aimed to understand the pathways that led to this reduction. METHODS: We conducted a mixed methods study that combined secondary analysis from a randomised controlled trial relating to the impact of a transfer programme on IPV with in-depth interviews and focus group discussions with male and female beneficiaries. A sequential analysis strategy was followed, whereby qualitative results guided the choice of variables for the quantitative analysis and qualitative insights were used to help interpret the quantitative findings. RESULTS: We found qualitative and quantitative evidence that the intervention led to reductions in IPV through three pathways operating at the couple, household and individual level: i) reduced day-to-day conflict and stress in the couple; ii) improved household well-being and happiness; and iii) increased women's decision making, self-confidence and freedom of movement. We found little evidence that any type of IPV increased as a result of the transfers. DISCUSSION: While cash and in-kind transfers can be important programmatic tools for decreasing IPV, the positive effects observed in this study seem to depend on circumstances that may not exist in all settings or programmes, such as the inclusion of a training component. Moreover, the programme built upon rather than challenged traditional gender roles by targeting women as transfer beneficiaries and framing the intervention under the umbrella of food security and nutrition - domains traditionally ascribed to women. CONCLUSIONS: Transfers destined for food consumption combined with nutrition training reduced IPV among marginalised households in northern Ecuador. Evidence suggests that these reductions were realised by decreasing stress and conflict, improving household well-being, and enhancing women's decision making, self-confidence and freedom of movement. TRIAL REGISTRATION: ClinicalTrials.gov NCT02526147 . Registered 24 August 2015.
Assuntos
Mulheres Maltratadas/psicologia , Características da Família , Assistência Alimentar , Abastecimento de Alimentos , Identidade de Gênero , Relações Interpessoais , Violência por Parceiro Íntimo/prevenção & controle , Adolescente , Adulto , Idoso , Tomada de Decisões , Violência Doméstica/economia , Violência Doméstica/prevenção & controle , Violência Doméstica/psicologia , Equador , Feminino , Liberdade , Humanos , Violência por Parceiro Íntimo/economia , Violência por Parceiro Íntimo/psicologia , Masculino , Saúde Mental , Pessoa de Meia-Idade , Estado Nutricional , Autoeficácia , Maus-Tratos Conjugais/economia , Maus-Tratos Conjugais/prevenção & controle , Maus-Tratos Conjugais/psicologia , Estresse Psicológico/complicações , Estresse Psicológico/prevenção & controle , Adulto JovemRESUMO
The 2010 earthquake resulted in the breakdown of Haiti's social, economic and health infrastructure. Over one-quarter of a million people remain internally displaced (ID). ID women experience heightened vulnerability to intimate partner violence (IPV) due to increased poverty and reduced community networks. Scant research has examined experiences of IPV among ID women in post-earthquake Haiti. We conducted a qualitative study to explore the impact of participating in Famn an Aksyon Pou Santé Yo (FASY), a small-group HIV prevention intervention, on ID women's agency in Leogane, Haiti. We conducted four focus groups with ID women, FASY participants (n = 40) and in-depth individual interviews with peer health workers (n = 7). Our study was guided by critical ethnography and paid particular attention to power relations. Findings highlighted multiple forms of IPV (e.g., physical, sexual). Participants discussed processes of intrapersonal (confidence), interpersonal (communication), relational (support) and collective (women's rights) agency. Yet structural factors, including patriarchal gender norms and poverty, silenced IPV discussions and constrained women's agency. Findings suggest that agency among ID women is a multi-level, non-linear and incremental process. To effectively address IPV among ID women in Haiti, interventions should address structural contexts of gender inequity and poverty and concurrently facilitate multi-level processes of agency.