The effect of solution-focused approach on attitudes to violence against women in high school students.

PURPOSE: This study was conducted to examine the Effect of Solution-Oriented Approach on Attitudes of Violence Against Women in High School Students. MATERIALS AND METHODS: The research was designed as a pretest-posttest and repeated-measurement randomized controlled experimental study. The population of the research consisted of 1473 students studying at 5 high schools randomly selected from a city center. Out of these students, 166 students who did not accept the study or did not meet the research criteria were excluded, and the school numbers of the remaining 1307 students were numbered separately for girls and boys, and 90 (45 girls and 45 boys) students were included in the study by simple randomization method. Personal Information Form and Violence Against Women Attitude Scale (ISKEBE) were used to collect data. RESULTS: Before the program, the personal characteristics of the control and experimental group students were similar in terms of ISKEBE and subscale scores. Significant differences were found between the groups in the Attitude Toward Identity, Attitude Toward Body sub-dimensions, and the total scores of ISKEBE of the scale used to collect data in the post-program and follow-up test (p < 0.05). CONCLUSION: It was seen that the solution-oriented approach applied to high school students had positive effects on the students' attitudes toward violence against women. In this context, it is thought that this study will develop a new perspective in breaking the cycle of violence against women.

Gender socialization and adolescent pregnancies in Togo.

The aim of this article is to understand the significance of the gender socialisation of adolescents and its impact on sexuality. This socio-anthropological study is based on qualitative surveys conducted as part of two action-research programmes implemented between 2018 and 2022 in Togo. The empirical data comes from individual semi-directed interviews, group interviews and life stories relating to the themes of sexuality, early pregnancy and gender-based violence. The results show that in these patriarchal societies, the socialisation of adolescents is structured around gender relations. The social construction of masculinity is based on a position of decision-making power for young boys, while that of femininity inculcates submissive behaviour in young girls. In these contexts, many young girls, even if they do attend school, find it difficult to express their opinions on matters of love and sex.

L'objectif de cet article consiste à appréhender la prégnance de la socialisation des adolescents.es et son impact sur la sexualité. Cette étude socio-anthropologique s'appuie sur des enquêtes qualitatives conduites dans le cadre de deux programmes de recherche action mis en œuvre entre 2018 à 2022 au Togo. Les données empiriques sont issues d'entretiens individuels semi-directifs, d'entretiens de groupes et de récits de vie relatifs aux thèmes de la sexualité, des grossesses précoces et des violences basées sur le genre. Les résultats indiquent que dans ces sociétés patriarcales, la socialisation des adolescents.es est structurée sur des rapports de genre. La construction sociale de la masculinité s'établit sur une position de pouvoir de décision des jeunes garçons tandis que celle de la féminité inculque aux jeunes filles des conduites de soumission. Dans ces contextes, de nombreuses jeunes filles, bien que scolarisées éprouvent des difficultés à exprimer leurs avis sur les questions amoureuses et sexuelles.

Analysis of care for adolescent victims of gender-based violence in Senegal: a qualitative study.

In Senegal, many adolescent victims of gender-based violence (GBV) do not receive care. The aim of this study was to analyse the care circuit for adolescent victims of GBV, taking gender differences into account. This was a qualitative case study. A thematic analysis of the data was carried out using Nvivo 12 software. The study showed that society attached less importance to the rape of boys. The study also showed that the main attitude of adolescents to GBV was silence, encouraged by under-reporting. The structural barriers to providing care were the insensitivity of health and judicial structures towards adolescents, as well as geographical and financial obstacles. In conclusion, it is important for policies to tackle these structural barriers in order to promote a system of care suited to cases of GBV among adolescents.

Au Sénégal, de nombreux adolescents victimes de violences basées sur le genre ne sont pas pris en charge. L'objectif de cette étude est d'analyser le circuit de prise en charge des adolescent(es) victimes de VBG en tenant compte des différences de genre. Il s'agissait d'une étude qualitative de type étude de cas. Une analyse thématique des données avait été faite avec le logiciel Nvivo 12. L'étude a montré que la société accordait peu d'importance aux viols des garçons. L'étude a également montré que la principale attitude des adolescents face aux VBG était le silence, favorisant la sous-dénonciation. Les barrières structurelles à la prise en charge étaient l'insensibilité des structures sanitaires et judiciaires envers les adolescents, ainsi que les obstacles géographiques et financières. En conclusion, il est important que les politiques s'attaquent à ces barrières structurelles pour promouvoir un système de prise en charge adapté aux cas de VBG chez les adolescents.

A qualitative exploration of the impact of the COVID-19 pandemic on gender-based violence against women living with HIV or tuberculosis in Timor Leste.

Violence against women or gender-based violence (GBV) is a significant public health issue facing women and girls in different settings. It is reported to have worsened globally during the COVID-19 pandemic. Despite the impact of the COVID-19 pandemic on increased violence against women in general, which has been reported in many settings globally, there is a paucity of evidence of its impact on violence against highly vulnerable women living with HIV or tuberculosis (TB). Using a qualitative design, this study aimed to explore the views and experiences of women living with HIV (n = 19) or TB (n = 23) in Timor Leste regarding the GBV they faced during the COVID-19 pandemic. They were recruited using the snowballing sampling technique. Data were collected using one-on-one, in-depth interviews and focus group discussions. The five steps of qualitative data analysis suggested in Ritchie and Spencer's analysis framework were employed to guide the analysis of the findings. Findings indicated that women in this study experienced intensified physical, verbal, sexual and psychological violence by their partners, spouses, in-laws, and parents or other family members during the COVID-19 pandemic. Several prominent risk factors that worsened violence against women during the pandemic were (i) HIV or TB-positive status, (ii) traditional gender roles or responsibilities and expectations, (iii) economic and financial difficulties reflected in the loss of jobs and incomes due to the pandemic, and (iv) individual factors such as jealousy and increased alcohol drinking developed during the lockdowns. The women's experience of GBV during the pandemic also led to various negative psychological impacts. The findings underscore the urgent need for multifaceted interventions to address GBV, which should encompass challenging traditional gender norms, addressing economic inequalities, and targeting individual-level risk factors. The findings also indicate the need for the development of robust monitoring and evaluation systems to assess the effectiveness of policies and interventions addressing GBV where the results can inform future improvement. The findings also indicate the need to include GBV in the protocol or guidelines for HIV and TB management. Future large-scale quantitative studies to capture the magnitude and specific drivers of GBV against women living with HIV and TB during the pandemic are recommended.

Exploring the barriers, facilitators, and opportunities to enhance uptake of sexual and reproductive health, HIV and GBV services among adolescent girls and young women in Zambia: a qualitative study.

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.

"Hope is being stirred up": Critical consciousness in gender-based violence interventions.

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.

Sexual and Reproductive Healthcare Needs of Refugee Women Exposed to Gender-Based Violence: The Case for Trauma-Informed Care in Resettlement Contexts.

This paper assesses literature regarding the sexual and reproductive healthcare (SRH) needs of resettled refugee women who experienced gender-based violence (GBV) and trauma-informed care (TIC) principles utilized among SRH service providers. A systematic search identified relevant studies published between 2000 and 2021; no articles found reflected both SRH and TIC principles among refugee women. The search was therefore separated into two aims: to review the literature about SRH needs for refugee women in resettlement countries who experienced GBV (Aim 1) and to examine the use of TIC principles in SRH care among women who experienced GBV (Aim 2). Thematic analysis of the articles identified key themes. Twenty-six articles were included in the analysis across both aims (Aim 1 = 8, Aim 2 = 18). Aim 1 articles shared three factors shaping the SRH needs of resettled refugee women: the centrality of violence and trauma; structural barriers to SRH care; and actions, practices, and resources for service providers. Aim 2 articles illustrated seven key principles of TIC used in SRH service provision, such as empowerment; trauma-specific services and integrated care; connection; safety; collaboration; identity culture and context; and trustworthiness. Resettled refugee women's experiences of violence necessitate trauma-informed SRH health care. While there is limited peer-reviewed literature regarding TIC-SRH care for refugee women, the findings regarding the SRH needs of refugee women and the findings regarding the implementation of TIC in SRH collectively frame recommendations for how SRH can be infused with TIC. An example from practice, in the form of the Refugee Women's Health Clinic, is included as an exemplar of TIC SRH principles in action for the health of resettled refugee women who have survived gendered violence.

"I suffered in silence and certainly all women are like that" - Silenced: reproduction of, and breaking with, violence against women living in rural areas. / "Eu sofria calada e certamente toda mulher é assim" - Silenciamentos: reproduções e rupturas da violência contra as mulheres que vivem em contextos rurais.

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.

Gender-based violence and harassment at work and health and occupational outcomes. A systematic review of prospective studies.

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.

'Important, but difficult': Swedish primary care professionals' perceptions and experiences of dealing with violence against women: an interview study.

BACKGROUND: Men's violence against women is a global health problem causing physical, mental, sexual and reproductive ill-health. The World Health Organisation has estimated that every third woman in the world has been exposed to physical and/or sexual violence. Swedish primary care is central for victims of violence, as it is normally the first port of call for seeking healthcare. This requires professional competence on violence, and its causes. It also requires resources for working with violence prevention, disclosure and supportive actions. The aim of this study is to deepen the understanding of how primary care professionals in Sweden deal with violence against women. We analyse their viewpoints, experiences and practices of working with violence as a health problem, and especially if, and if so how, they ask patients about violence. METHODS: A qualitative, explorative research design was adopted. Research interviews were conducted with 18 health professionals at eight primary care clinics. These clinics were located in four different regions, from the south to the north, in large urban areas, middle-size cities and rural areas. The interviews were voice recorded and transcribed verbatim. Thematic analysis was used to analyse the interviews. RESULTS: Three themes, with a total of ten related sub-themes, were developed. These themes are: (a) Varying understandings and explanations of violence against women; (b) The tricky question of asking about violence; and (c) Multiple suggestions for improving primary care's work with violence against women. The awareness of violence varied considerably, with some practitioners being highly knowledgeable and having integrated violence into their everyday practice, whereas others were less knowledgeable and had not paid much attention to violence. The very naming of violence seemed to be problematic. Several suggestions for improvements at professional, managerial and organisational levels were articulated. CONCLUSIONS: The results shed important light on the professionals' problems and struggles when dealing with violence against women in primary care. Better support and resources from the healthcare organisation, clearer leadership and more detailed policy would improve and facilitate everyday practice. All of these factors are indispensable for primary care's work with victims of men's violence against women.

Online Gendered Violence Victimization Among Adults: Prevalence, Predictors and Psychological Outcomes.

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.

Social scripts of violence among adolescent girls and young women in Zambia: Exploring how gender norms and social expectations are activated in the aftermath of violence.

Adolescent girls and young women ages 15-24 experience high rates of gender-based violence (GBV), underpinned by gender and social norms that shape their transitions to adulthood. For interventions that seek to leverage and build on existing infrastructure for health service provision, it is important to understand how gender norms operate in the background and how they shape service engagement or non-engagement. In formative work for our project, Screen & Support, outside of Lusaka, Zambia, we engaged in community conversations with adolescent girls and young women to understand common types and experiences of violence, perceptions of what causes violence, and pathways to post-violence service access. This manuscript explores emerging findings surrounding social and gender norms. We engaged n = 12 adolescent girls and young women ages 15-24, including survivors of GBV, young women living with HIV, and young married women in separate conversations conducted in a mix of Nyanja, Bemba, and English. Arts-based activities accompanied guided focus group discussions. Translated transcripts were coded and thematically analysed by two authors using Dedoose software. Key themes emerged around two major themes-understanding the norms underpinning violence, and observing how these norms were activated in the aftermath of violence. Sub-themes focused on power differentials supporting violence, social expectations and community-enacted sanctions, and understanding dominant norms and assumptions. Considering what unfolded in the aftermath of violence, young women participants considered key reference groups upholding norms, explored the contexts where norms may be contested or become more complicated, and described how accepting silence was a common means of closure. We discuss the implications of these findings for programme design, delivery, and evaluation, as well as the potential, and roadmap, for shifting norms that negative affect adolescent girls and young women.

Impacts of an abbreviated personal agency training with refugee women and their male partners on economic empowerment, gender-based violence, and mental health: a randomized controlled trial in Rwanda.

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.

Women's Experiences of Gender-Based Interpersonal Violence in Sport: A Qualitative Meta-Synthesis.

Violence against women in sport is pervasive. Prevalence rates of interpersonal violence range from 26% to 74% across psychological, physical, and sexual violence. This review synthesizes adult women's experiences of gender-based interpersonal violence in sport. A systematic review of qualitative studies was conducted. Five databases were searched, including CINAHL, Web of Science, SPORTDiscus, PsycINFO, and Sociological Abstracts. In total, 1,617 records were retrieved and screened. Twenty-five records representing 24 studies were eligible for inclusion. Following a meta-ethnographic approach, both authors synthesized first- (participants) and second-(researcher) order constructs to create a new interpretation (third-order construct) beyond the individual studies reviewed. A feminist socio-ecological lens was applied. Five themes were constructed: women's safety work, the normalization of abusive behaviors in the sports context, sport family violence, organizational impotence and hostility, and women's status in a patriarchal system. Women's experiences of abuse are mapped within and across the individual, relational, organizational, and cultural levels of the socio-ecological model, with (lack of) power being a central factor within each level as well as flowing between the levels. A fifth socio-ecological level was developed pertaining to the unique context of sport-that of the sport family. This sits between the relational and organizational levels of the model and covers both intense familial relationships and patriarchal familial organizational structures in sport that facilitate and silence the abuse. Sporting bodies must co-design interventions encompassing all socio-ecological levels to address gender-based violence in sport.

Correlation between gender-based violence and poor treatment outcomes among transgender women living with HIV in Brazil.

BACKGROUND: Transgender women are disproportionately affected by both HIV and gender-based violence (GBV), defined as physical, sexual, or emotional violence perpetrated against an individual based on their gender identity/expression. While a growing body of evidence demonstrates that GBV leads to poor HIV care and treatment outcomes among cisgender women, less research has examined this association among transgender women. We assessed the impact of lifetime experiences of GBV on subsequent retention in HIV care and laboratory confirmed viral suppression among a sample of transgender women living with HIV (TWH) in Brazil. METHODS: A pilot trial of a peer navigation intervention to improve HIV care and treatment among TWH was conducted in São Paulo, Brazil between 2018 and 2019. TWH were recruited and randomized into the intervention or control arm and participated in a baseline and 9-month follow-up survey and ongoing extraction of clinical visit, prescribing, and laboratory data. Generalized linear model regressions with a Poisson distribution estimated the relative risk (RR) for the association of lifetime physical and sexual violence reported at baseline with treatment outcomes (retention in HIV care and viral suppression) at follow-up, adjusting for baseline sociodemographic characteristics. RESULTS: A total of 113 TWH participated in the study. At baseline, median age was 30 years, and the prevalence of lifetime physical and sexual violence was 62% and 45%, respectively. At follow-up, 58% (n = 66/113) were retained in care and 35% (n = 40/113) had evidence of viral suppression. In adjusted models, lifetime physical violence was non-significantly associated with a 10% reduction in retention in care (aRR: 0.90, 95% CI: 0.67, 1.22) and a 31% reduction in viral suppression (aRR: 0.69; 95% CI: 0.43, 1.11). Lifetime sexual violence was non-significantly associated with a 28% reduction in retention in HIV care (aRR: 0.72, 95% CI: 0.52, 1.00) and significantly associated with a 56% reduction in viral suppression (aRR: 0.44; 95% CI: 0.24, 0.79). CONCLUSION: Our findings are among the first to demonstrate that lifetime experiences with physical and sexual violence are associated with poor HIV outcomes over time among transgender women. Interventions seeking to improve HIV treatment outcomes should assess and address experiences of GBV among this population. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03525340.

Measuring Healing and Recovery After Gender-Based Violence: A Scoping Review.

Healing after gender-based violence (GBV) is multidimensional, with varying instruments used in the scientific literature to capture this phenomenon quantitively in survivor populations. The purpose of this scoping review was to (a) describe quantitative measures used to evaluate recovery after GBV, (b) compare these findings with domains uncovered in a qualitative metasynthesis about survivors' perspectives about healing after GBV, and (c) summarize recovery relationships found. We searched Pubmed, PsycInfo, and Violence/Criminology/Family Studies Abstracts. Studies were included for review if they (a) used quantitative methods, (b) evaluated healing or recovery in survivors of GBV, (c) were available in English, and (d) were empirical articles in peer-reviewed journals. Two thousand nine hundred thirty-five articles were reviewed by title and abstract, and 92 articles were reviewed by full text. Twenty-six articles were included in this review. Eight studies used an alleviation of adverse symptomology as a proxy for recovery, eight used growth-related outcomes, and ten used a combination of both types of measures. While the quantitative instruments synthesized in this review seemed to map onto some of the recovery domains identified through qualitative metasynthesis, no study synthesized measured all domains simultaneously. Studies synthesized identified that recovery-related outcomes may be influenced by social support, symptom burden, disclosure, and various therapeutic intervention programs tested in the literature to date. Synthesizing research on recovery after GBV is an essential step to understand gaps in measurement and understanding. Streamlining and using holistic recovery outcome measurement can aid in the development of evidence-based interventions to promote healing in survivor populations.

Systemic Occupational Health Needs of Gender-Based Violence Advocates: Findings From the Early Months of the Pandemic.

OBJECTIVE: This study explores occupational health burdens faced by domestic and sexual violence advocates, many of which intensified during the COVID-19 pandemic. It identifies key stressors and offers advocate-driven recommendations to improve their wellbeing, addressing the lack of system-level interventions in the occupational health literature. METHODS: Semistructured interviews were conducted with 22 advocacy professionals. Thematic content analysis guided transcript coding, and researchers shared initial results with participants in two member checking sessions to validate the preliminary findings. RESULTS: Advocates experienced logistical, emotional, and systemic stressors, including loss of peer support and unempathetic workplace cultures. Recommendations prioritize advocate wellbeing and call for systemic changes. CONCLUSIONS: Advocates' occupational stressors highlight the need for system-level solutions to enhance their occupational wellbeing, particularly during large-scale emergencies. Collaborative efforts among employers, funders, and staff are essential to address system deficiencies.

Gender-based violence among healthcare students: Prevalence, description and associated factors.

OBJECTIVES: The aims of the current study were 1) to provide the prevalence of five types of gender-based violence (GBV) among male and female healthcare students; 2) to describe perpetrators' status, where the GBV occurred, and psychological and behavioural impacts of the GBV; and 3) to identify factors associated with GBV. DESIGN: A cross-sectional study was conducted among voluntary healthcare students in France. SETTING: Health Campus at Rouen and nursing schools in Normandy, France. PARTICIPANTS: Volunteer healthcare students of 18 years and over. DATA COLLECTED: Five types of GBV were recorded: GBV1: damage to a person's image due to a sexual connotation on social networks, GBV2: sexist remarks and behaviour, GBV3: comments with sexual connotations, GBV4: sexual assaults and GBV5: rape or attempted rape. Perpetrators' status, where the GBV occurred, psychological and behavioural impacts of GBV were also recorded. RESULTS: One thousand one hundred and fifty-two students were included. The mean age was 20.8 years (SD = 2.26), 82.6% of students were women (0.4% non-binary). Since the beginning of their healthcare study, 41.2% of students CI 95% [39.7-42.6] were victim of at least one type of GBV: 15.8% among men CI 95% [13.2-18.4] and 46.0% CI 95% [44.4-47.6] among women (p < 0.001). The perpetrators were student peers, regardless of the type of GBV, healthcare workers for the GB2 and GBV3, and patients except for GBV5. The main consequences of GBV on health was psychological and eating related. After multivariate analysis, being a woman, LGBTQ+ (Lesbian, Gay, Bi, Trans, Queer and other), a nurse, a physiotherapist student, having a job, living with roommates and year of study were risk factors for GBV. CONCLUSION: GBV is so common at healthcare universities and could have such severe consequences for students that more work is needed to generate a culture change and ensure safe learning environments.

Utilizing User Preferences in Designing the AGILE (Accelerating Access to Gender-Based Violence Information and Services Leveraging on Technology Enhanced) Chatbot.

INTRODUCTION: Technology advancements have enhanced artificial intelligence, leading to a user shift towards virtual assistants, but a human-centered approach is needed to assess for acceptability and effectiveness. The AGILE chatbot is designed in Kenya with features to redefine the response towards gender-based violence (GBV) among vulnerable populations, including adolescents, young women and men, and sexual and gender minorities, to offer accurate and reliable information among users. METHODS: We conducted an exploratory qualitative study through focus group discussions (FGDs) targeting 150 participants sampled from vulnerable categories; adolescent girls and boys, young women, young men, and sexual and gender minorities. The FGDs included multiple inquiries to assess knowledge and prior interaction with intelligent conversational assistants to inform the user-centric development of a decision-supportive chatbot and a pilot of the chatbot prototype. Each focus group comprised 9-10 members, and the discussions lasted about two hours to gain qualitative user insights and experiences. We used thematic analysis and drew on grounded theory to analyze the data. RESULTS: The analysis resulted in 14 salient themes composed of sexual violence, physical violence, emotional violence, intimate partner violence, female genital mutilation, sexual reproductive health, mental health, help-seeking behaviors/where to seek support, who to talk to, and what information they would like, features of the chatbot, access of chatbot, abuse and HIV, family and community conflicts, and information for self-care. CONCLUSION: Adopting a human-centered approach in designing an effective chatbot with as many human features as possible is crucial in increasing utilization, addressing the gaps presented by marginalized/vulnerable populations, and reducing the current GBV epidemic by moving prevention and response services closer to people in need.

Comentários nas mídias sociais e a banalização da violência psicológica contra as mulheres / Comments on social media and the trivialization of psychological violence against women / Comentarios en las redes sociales y la banalización de la violencia psicológica contra las mujeres

A violência psicológica é frequente, porém, de difícil detecção, muitas vezes presente em relacionamentos abusivos e confundida com ciúmes e cuidado. Nas mídias sociais isso pode ser incentivado através de postagens, assim como pode servir de espaço de suporte e compartilhamento de experiências. Objetivou-se analisar comentários publicados em mídias sociais relacionados à violência contra a mulher e sua associação à violência psicológica. Utilizou--se o método da netnografia, através de análise textual dos comentários de um vídeo publicado na rede social Facebook chamado: "Não confunda amor com abuso". Foram transcritos 571 comentários da publicação, sendo o corpus analisado pelo software Iramuteq. Os comentários analisados mostram que questões culturais contribuem para a banalização da violência contra a mulher, principalmente da violência psicológica, pois geralmente só é considerado como violência quando há agressão física. Percebe-se a importância de um trabalho de psicoeducação, como por exemplo através de vídeos orientativos, visando a conscientização da população e possível redução da violência. (AU)

Psychological violence is frequently encountered but often difficult to detect, as it is commonly present in abusive relationships and can be mistaken for jealousy and care. In the realm of social media, it can either be encouraged through posts or serve as a space for support and the sharing of experiences. The objective of this study was to analyze comments posted on social media platforms related to violence against women and its association with psychological violence. The netnography method was employed, involving textual analysis of comments on a video posted on the social media platform Facebook, titled "Não confunda amor com abuso" (Do Not Confuse Love with Abuse). A total of 571 comments from the post were transcribed and analyzed using the Iramuteq software. The analyzed comments reveal that cultural factors contribute to the trivialization of violence against women, particularly psychological violence, since the term violence is often only recognized when it escalates to physical aggression. The significance of psychoeducational efforts, such as informative videos, becomes apparent in raising awareness among the population and potentially reducing instances of violence. (AU)

La violencia psicológica es frecuente, sin embargo, difícil de detectar, a menudo presente en relaciones abusivas y confundida con celos y cuidados. En las redes sociales, esto se puede fomentar a través de publicaciones, así como un espacio de apoyo e intercambio de experiencias. El objetivo fue analizar los comen-tarios publicados en las redes sociales relacionados con la violencia contra las mujeres y su asociación con la violencia psicológica. Se utilizó el método de la netnografía, mediante el análisis textual de los comentarios de un video publicado en la red social Facebook denominado: "Não confunda amor com abuso". Se transcribieron 571 comentarios de la publicación, siendo analizado el corpus por el software Iramuteq. Los comentarios analizados muestran que las cuestiones culturales contribuyen a la banalización de la violencia contra a mujer, especialmente la psicológica, ya que generalmente solo se considera violencia cuando hay agresión física. Uno se da cuenta de la importancia del trabajo psicoeducativo, por ejemplo, a través de videos de orientación, desti-nados a sensibilizar a la población y posible reducción de la violencia. (AU)