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.

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.

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.

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.

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.

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)

Understanding Body Resistance in El Salvador: A Qualitative Discussion of a Pilot Program for Embodied Empowerment.

This article evaluates a Body Resistance Program in an urban area of El Salvador. The goal of this program is to facilitate women's reclamation of bodily autonomy and recognition of their shared struggle, thereby laying a foundation for solidarity and structural change around gendered body norms. As a pilot project with limited scope, a key objective is to identify meaningful concepts that address the goals, motivations, and worldviews of Salvadoran participants. This article provides insights into their understandings and experiences of trauma, resistance, and embodied empowerment.

Gender-based violence against women during the COVID-19 pandemic: recommendations for future.

BACKGROUND: Gender-based violence (GBV) includes any physical, sexual, psychological, economic harms, and any suffering of women in the form of limiting their freedom in personal or social life. As a global crisis, COVID-19 has exposed women to more violence, which requires serious actions. This work aims to review the most critical dimensions of the GBV against women, effective factors on it, and strategies for combating it during the COVID-19 pandemic in order to provide recommendations for future pandemics. METHODS: This study was conducted based on PRISMA-ScR. First, PubMed, Embase, Scopus, Web of Science, ProQuest, and Google Scholar were searched in April 2021 with no time limitation and location using the related keywords to COVID-19 and GBV. The searched keywords were COVID-19, gender-based violence, domestic violence, sexual violence, women, violence, abuse, and their synonyms in MESH and EMTREE. Duplicates were removed, titles and abstracts were screened, and then the characteristics and main results of included studies were recorded in the data collection form in terms of thematic content analysis. RESULTS: A total of 6255 records were identified, of which 3433 were duplicates. Based on inclusion criteria 2822 titles and abstracts were screened. Finally, 14 studies were eligible for inclusion in this study. Most of these studies were conducted in the United States, the Netherlands, and Iran, mostly with interventional and qualitative methods. CONCLUSIONS: Strengthening ICT infrastructure, providing comprehensive government policies and planning, government economic support, social support by national and international organizations should be considered by countries worldwide. It is suggested that countries provide sufficient ICT infrastructure, comprehensive policies and planning, economic support, social support by collaboration between national and international organizations, and healthcare supporting to manage incidence of GBV against women in future pandemics.

Gender-based violence and its associated factors among internally displaced women in Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Gender-based violence (GBV) is a common human right violence in conflict-affected communities. Women with GBV are prone to experience mental health problems such as post-traumatic stress disorder, depression, and anxiety. However, there is a paucity of evidence as to what extent the problem is affecting internally displaced women (IDW) in Ethiopia. This study aimed to assess the prevalence of GBV and its associated factors among IDW in Northwest Ethiopia. METHODS: A cross-sectional study was conducted among IDW residing at three humanitarian sites from May to June 2022 in Northwest Ethiopia. Study participants were selected using a stratified simple random sampling technique from the three sites. GBV was assessed using a 6-item Assessment Screen to Identify Survivors Toolkit questionnaire for Gender-based violence (ASIST-GBV). Data were analyzed using binary logistic regression. All variables with a p-value of ≤ 0.05 in the multivariable analysis were defined to have a statistically significant association with GBV at a 95% confidence interval (CI). RESULTS: Of 424 approached candidates, 412 (97.2%) of them participated in the study. A one-year prevalence of GBV was 37.9% (95%CI = 33.2-42.6) among IDW in Northwest Ethiopia. The mean age of the participants was 31.3 (± 7.6) years. Young women, 18-24 years old (AOR = 3.52, 95%CI = 2.15-5.34, p ≤ 0.001) and 25-29 years old (AOR = 2.41, 95%CI = 1.57-3.24, p ≤ 0.001) had a statistically significant association with GBV. Moreover, having no social protection (AOR = 3.18, 95%CI = 2.65-6.22, p ≤ 0.001), being current alcohol user (AOR = 2.54, 95%CI = 1.22-4.78, p ≤ 0.001) and being single in marital status (AOR = 1.69, 95%CI = 1.18-2.87, p < 0.01) showed a statistical association with GBV. CONCLUSION: We found a high prevalence of GBV among IDW in Northwest Ethiopia which indicates that IDW are prone to GBV. We call for immediate action and special attention to young women in conflict-affected parts of Ethiopia. It is crucial to establish a system that ensures the safety, security, and well-being of women in humanitarian settings.

Depression, Alcohol Misuse, and Suicide Attempt Among North Korean Refugee Women Exposed to Gender-Based Violence.

North Korean (NK) refugee women report a disproportionately high rate of suicide compared to the general South Korean (SK) population. NK refugee women's exposure to gender-based violence (GBV) is a risk factor for adverse mental health symptoms. However, the association between GBV exposure and mental health has received less scholarly attention. This study examined NK refugee women's exposure to GBV (i.e., sexual violence, human trafficking, and forced sex work) and explored whether it is associated with an increased risk of depression, alcohol misuse, and suicide attempts. A three-way interaction between depression, alcohol misuse, and suicide attempts among GBV-exposed NK refugee women was examined. Data from a snowball sample of 180NK refugee women were analyzed for this study. Findings show that 47.8% experienced GBV in either NK or intermediary countries. Multivariate analyses revealed that depression (OR = 1.13, p < .05) and alcohol misuse (OR = 3.01, p < .01) was significantly associated with suicide attempts in GBV-exposed groups. Results from the three-way interaction (GBV victimization × Depression × Alcohol misuse) suggest that GBV exposure and higher levels of depression were significantly associated with suicide attempts among NK refugee women with greater severity of alcohol misuse (OR = 1.75, p < .05). The findings indicate that NK refugee women with GBV exposure, depression, and alcohol misuse are at increased risk for suicide attempts. Study limitations included the use of snowball sampling and cross-sectional data. This study discusses implications for future research and targeted, trauma-informed treatments focused on GBV and mental health symptoms among NK refugee women.

Health care services for survivors of gender-based violence: a community and clinic-based intervention in Zambézia province, Mozambique

Moçambique introduziu directrizes para serviços integrados de violência baseada no género (VBG) em 2012. Em 2017, formámos prestadores de serviços em serviços empáticos e de apoio aos sobreviventes da VBG e introduzimos serviços domiciliários para sobreviventes que não têm acompanhamento. As proporções de taxas de visitas clínicas foram comparadas antes e depois do início da intervenção, utilizando testes de significância exata. Foram revistos dados de 1.806 sobreviventes da VBG, com um total de 2.005 eventos. A idade mediana foi de 23 anos (IQR 17-30) e 89% eram mulheres. Entre aqueles que relataram violência, 69% relataram violência física, 18% relataram violência sexual (VS) e 12% relataram violência psicológica. As taxas de comportamento de procura de cuidados foram maiores no período de intervenção (razão de taxas 1,31 [IC95%: 1,18-1,46]); p < 0,01. Entre aqueles elegíveis para profilaxia pós-exposição (PEP), 94% iniciaram a PEP. A adesão ao novo teste de HIV melhorou em pontos percentuais em 34% (14% para 48%), 34% (8% para 42%) e 26% (5% para 31%) em 1, 3 e 6 meses, respectivamente . A intervenção levou a um aumento na taxa de sobreviventes de VBG que procuram serviços de saúde e melhorou as taxas de cuidados de acompanhamento entre os sobreviventes de VS que iniciaram a PEP. O reforço do aconselhamento sobre adesão à PEP continua a ser crucial para melhorar os serviços de VBG.

Initial testing of components of the cultural determinants of trauma recovery (CDTR) theory amongst American Gender-Based violence survivors: Structural equation modelling.

AIM: We tested key hypotheses derived from the Cultural Determinants of Trauma Recovery Theory (CDTR) with an American sample. DESIGN: A cross-sectional study using anonymous online surveys. METHODS: This study was conducted with 225 American survivors of gender-based violence (GBV) between August to November 2019. Demographics, distress (depression: PHQ8; PTSD: PCL-5), mental health service utilization (counselling and medication), sense of coherence (SOC), internal barriers to help-seeking (shame, frozen and problem management subscales: BHS-TR Internal) and the GBV healing (GBV-Heal) were used. Structural equation modelling (SEM) was conducted to test the hypotheses. RESULTS: The final SEM model showed that the relationship between distress and mental health service utilization was not mediated by internal help-seeking barriers; the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers; the relationship between internal help-seeking barriers and trauma healing was partially mediated by SOC; mental health service utilization was not significantly associated with trauma healing. Overall, the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers and SOC. CONCLUSIONS: This study confirmed some hypothetical pathways between distress and trauma healing. Further research with larger and international samples should be necessary to test the overall CDTR and compare groups. IMPACT: This study can help us focus on psychological interventions that enhance meaning and mitigate internal help-seeking barriers to promote holistic trauma recovery. Public and public contribution: The sample was gathered from a clinical population registry that alerts patients of potential research opportunities.

A Systematic Review of Interventions to Reduce Gender-Based Violence Among Women and Girls in Sub-Saharan Africa.

Sub-Saharan Africa (SSA) is disproportionately affected by gender-based violence (GBV). We systematically reviewed English language, peer-reviewed, quantitative evaluations of interventions to reduce violence against women and girls (VAWG) in SSA that involved a comparison group and reported GBV incidence, or GBV-related attitudes, norms and symptoms as an outcome. We identified 53 studies published between January 2000 and April 2020 and classified these programmes from an empowerment perspective using the following categories: social, economic, combined social and economic and psychological empowerment interventions. Our review found social empowerment interventions effective for transforming gender attitudes and norms and reducing GBV, and psychological empowerment interventions effective for managing GBV-related symptoms. The evidence for economic empowerment interventions was equivocal. Key elements of successful interventions included participatory group learning, engaging male partners, engaging the community, longer duration and utilising existing platforms. Promising approaches for further research included gender specific programmes, psychological empowerment interventions delivered by lay workers and psychological empowerment interventions focused on GBV reduction.

Health care services for survivors of gender-based violence: a community and clinic-based intervention in Zambézia province, Mozambique.

Mozambique introduced guidelines for integrated gender-based violence (GBV) services in 2012. In 2017, we trained providers on empathetic and supportive services to GBV survivors and introduced home-based services for survivors who are loss-to-follow up. Rate ratios of clinic visits were compared before and after intervention initiation, using exact significance tests. Data of 1,806 GBV survivors were reviewed, with a total of 2005 events. The median age was 23 years (IQR 17-30) and 89% were women. Among those reporting violence, 69% reported physical violence, 18% reported sexual violence (SV), and 12% reported psychological violence. Rates of care-seeking behavior were higher in the intervention period (rate ratio 1.31 [95%CI: 1.18-1.46]); p < 0.01. Among those eligible for post-exposure prophylaxis (PEP), 94% initiated PEP. Uptake of HIV retesting improved in percentage points by 34% (14% to 48%), 34% (8% to 42%) and 26% (5% to 31%) at 1-, 3- and 6-months, respectively. The intervention led to an increase in the rate of GBV survivors seeking health care services, and improved rates of follow-up care among SV survivors initiating PEP. Strengthening of PEP adherence counseling remains crucial for improving GBV services.

Extreme events and gender-based violence: a mixed-methods systematic review.

The intensity and frequency of extreme weather and climate events are expected to increase due to anthropogenic climate change. This systematic review explores extreme events and their effect on gender-based violence (GBV) experienced by women, girls, and sexual and gender minorities. We searched ten databases until February, 2022. Grey literature was searched using the websites of key organisations working on GBV and Google. Quantitative studies were described narratively, whereas qualitative studies underwent thematic analysis. We identified 26 381 manuscripts. 41 studies were included exploring several types of extreme events (ie, storms, floods, droughts, heatwaves, and wildfires) and GBV (eg, sexual violence and harassment, physical violence, witch killing, early or forced marriage, and emotional violence). Studies were predominantly cross-sectional. Although most qualitative studies were of reasonable quality, most quantitative studies were of poor quality. Only one study included sexual and gender minorities. Most studies showed an increase in one or several GBV forms during or after extreme events, often related to economic instability, food insecurity, mental stress, disrupted infrastructure, increased exposure to men, tradition, and exacerbated gender inequality. These findings could have important implications for sexual-transformative and gender-transformative interventions, policies, and implementation. High-quality evidence from large, ethnographically diverse cohorts is essential to explore the effects and driving factors of GBV during and after extreme events.

Reflecting and rejuvenating our work, together: One team's consideration of AJCP publications on gender-based violence.

Community psychology has long valued reflexive praxis as a critical part advancing our research and action. In this Virtual Special Issue (VSI), we, a group of community psychologists and gender-based violence (GBV) researchers at many different points in our careers, reflected on GBV publications that have appeared in AJCP. We examine the ways in which community psychology broadly and articles in AJCP more specifically have conceptualized GBV as a sociocultural issue, how GBV intersects with other oppressions and forms of violence, the tension when systems that aspire to support survivors are inequitable and focused on ameliorative change, and the importance of interventions being locally informed and locally driven. By highlighting selected GBV-focused articles published in AJCP, this VSI discusses (a) understanding and transforming culture via robust research and local partnerships, (b) targeting effective interventions for survivors, (c) invoking systems and targeting change in institutional environments, and (d) making connections between local efforts and broader social movements. To continue to move forward, we conclude we must reflect, embrace methodological plurality, partner, and push for structural change. Reflective questions regarding research and action are offered, to address gender-based violence.

Prevalence and patterns of gender-based violence in Enugu, Nigeria: a cross-sectional study.

Introduction: gender-based violence remains one of the most persistent human rights abuse in the world and with the emergence of the COVID-19 pandemic and its attendant mitigating protocols; Gender-based violence (GBV) could be on the rise with changes in its pattern and presentation. The aim of the study was to determine the prevalence and patterns of GBV among victims presenting in a tertiary health facility in South-East Nigeria during the first phase of the COVID-19 pandemic. Methods: this was a retrospective cross-sectional study, among 710 victims of GBV, who reported and received care at the GBV unit in a tertiary hospital in Enugu, South-east Nigeria. A pro forma designed by the researchers was used to collect secondary data from GBV facility screening forms and folders of all patients that reported any form of GBV over a 3-year period (2018 - 2020). Results: majority (89.9%) of victims of GBV were females and over a half (51.4%) of the cases were in the age group 20-39 years. In total, 56.8% of the GBV cases had been sexually abused. The pattern of GBV over the three years period under study revealed an increase in proportion for both sexual and physical/emotional violence, with a peak in 2019 and a reduction of cases in 2020. Persons below 19 years of age were 23 times more likely to experience sexual violence, than those between 40-59 years of age (AOR: 23.332; 95% CI: 11.037 -49.325) p<0.001. Males were 11 times more likely to experience physical/emotional violence than females (AOR: 11.136; 95% CI: 4.685-26.471) p<0.001. Age, gender, urban dwelling and year of occurrence were significant predictors of GBV. Conclusion: GBV is a cause for concern in Enugu Nigeria; affecting mainly young female victims in their prime. There is an increase in reported cases of GBV in Enugu Nigeria with sexual abuse being more prevalent.

Grisi Siknis: A cultural idiom of gender-based violence and structural inequalities in eastern Nicaragua.

For the Miskitu of Nicaragua, Grisi Siknis is a contagious illness that predominantly affects women. It is characterized by numerous psychosomatic symptoms, including headache, fear, aggressive behavior, loss of consciousness, and periods of rapid frenzy. Although Grisi Siknis has gained academic and public attention due to its unique cultural elements and perceived sexual aspects, little is known how the contextual and gender dimensions of Grisi Siknis are played out in relation to the socio-political context in the region. Based on 16 months of ethnographic work in the Nicaraguan Miskitu Coast, including semi-structured interviews (n = 20) and participant observation, this article documents a semantic shift in the embodied and symbolic language of a cultural idiom of distress. I show how duhindu (Miskitu spirit associated with illness and misfortune) and witchcraft are symbols that share cultural resonance in the Miskitu community, while gender violence discourse is a new language incorporated into the logic of this cultural idiom of distress. I argue that this semantic shift allows the individuals in this study to communicate local experiences of complex forms of structural inequalities (migration status, unemployment, ethnic identity) and gender-based violence that tend to be normalized as a ubiquitous cultural problem while preserving the broader socio-cultural meaning the Grisi Siknis represents. The ethnographic accounts of Grisi Siknis provide empirical data to unpack the unexplored contextual processes and local discourses that transform the meaning and logic of cultural idioms of distress at the individual level of experience.

La intolerancia a la incertidumbre, la tendencia a experimentar preocupaciones y el pesimismo como factores intervinientes en la relación entre la dependencia emocional y la violencia / Intolerance to uncertainty, the tendency to experience worry and pessimism as factors in the relationship between emotional dependence and violence

Las personas con dependencia emocional presentan preocupaciones constantes sobre el posible abandono o traición por parte de la pareja. De esta forma, ponen en marcha un gran abanico de estrategias retentivas dirigidas a cubrir la gran necesidad de controlar la relación. Además, sienten insatisfacción y frustración en la relación ya que sienten que nunca conseguirán lo que quieren o esperan de ella. Por esto, los objetivos del estudio se dirigen a analizar la posible relación entre la dependencia emocional, la intolerancia a la incertidumbre, la tendencia a las preocupaciones y el pesimismo. Asimismo, se comprueba el papel mediador de estos factores en la relación entre la dependencia emocional y la permanencia en relaciones de pareja violentas debido a la elevada prevalencia de darse conjuntamente en una misma relación. Participaron 258 personas, 77.1% mujeres y 22.9% hombres con edades que oscilaron entre los 18 y 67 años (M = 32.63; DT = 11.66). Los resultados reflejaron relaciones positivas entre la dependencia emocional, la intolerancia a la incertidumbre, la tendencia a las preocupaciones y el pesimismo. Igualmente, se comprueba que la dependencia emocional conduce a la permanencia en relaciones violentas a través de los factores mencionados.(AU)

People with emotional dependence present constant concerns about possible abandonment or betrayal by their partner. In this way, they implement a wide range of retention strategies aimed at covering the great need for control in the relationship. In addition, they feel dissatisfaction and frustration in the relationship since they feel they will never get what they want or expect from it. Therefore, the objectives of the study are aimed at analyzing the possible relationship between emotional dependence, intolerance to uncertainty, tendency to worry and pessimism. Also, the mediating role of these factors in the relationship between emotional dependence and permanence in violent relationships is verified due to the high prevalence of occurring jointly in the same relationship. A total of 258 people participated, 77.1% women and 22.9% men with ages ranging from 18 to 67 (M= 32.63; SD= 11.66). The results reflected positive relationships between emotional dependence, intolerance to uncertainty, tendency to worry andpessimism. Likewise, it is proven that emotional dependence leads to permanence in violent relationships through the factors mentioned.(AU)

Dependencia emocional y maltrato en mujeres víctimas de violencia contra la pareja / [Emotional dependence and abuse in women victims of intimate partner violence]

Los objetivos principales de este trabajo han sido estudiar la dependencia emocional (DE) existente en mujeres maltratadas y no maltratadas en relaciones de pareja duraderas con la “Escala de dependencia emocional de la pareja” (SED; Camarillo et al., 2020). Se examinó la relación existente entre la DE con variables clínicas y de personalidad y se establecieron unos puntos de corte para detectar el riesgo de violencia de pareja (VP) en mujeres en función de la DE. La muestra estuvo formada por 257 personas, 144 mujeres maltratadas en tratamiento y 113 mujeres no maltratadas. Las mujeres maltratadas puntuaron significativamente más y con una magnitud mucho mayor que las mujeres no maltratadas en todas las dimensiones de la DE. A su vez, la DE en las mujeres maltratadas estaba positivamente relacionada con la depresión, la ansiedad y la impulsividad y negativamente con la autoestima. Se han establecido unos puntos de corte para detectar el riesgo de VP en función de la DE. Por último, se señalan algunas limitaciones de este estudio y se plantean líneas de investigación futuras.

The main objectives of this paper have been to analyze the emotional dependency in battered and non-battered women when they are involved in lasting relationships with the Partner’s Emotional Dependency Scale (SED; Camarillo et al., 2020). The relationship was examined between emotional dependency and clinical and personality variables (anxiety, depression, self- esteem, and impulsivity), and cut-off points were established to detect the risk of intimate partner violence according to emotional dependency. The sample consisted of 257 people, 144 battered women in treatment and 113 non- battered women with the same demographics. Battered women scored much higher than non-battered women on all dimensions of emotional dependency. In turn, emotional dependency in battered women was significant and positively associated to depression, anxiety, and impulsivity and negatively to self-esteem. Some cut-off points have been suggested to detect the risk of intimate partner violence according to emotional dependency. Lastly, implications of this study for future research in this field are commented upon.