Between pandemics: sex worker, sexual minority, and transgender activism from HIV to COVID-19.

Public health crises alter political landscapes. This article investigates social movement strategies during and between the HIV and COVID-19 pandemics. We conducted a set of eighteen in-depth interviews with eleven leaders of organisations working with sex workers, sexual minorities, and transgender people around India, all of whom had been actively involved in HIV prevention programs, before and after the arrival of COVID-19 in India. First HIV, and then COVID-19, altered the political landscape for these groups in relation to three types of institutions: (1) donors (by creating dramatic increases and decreases in the amount, type, and conditions of global funding and deepening inequalities among organisations) (2) the state (by shifting the balance of advocacy and human rights work toward immediate relief); and (3) other social movements (by expanding solidarities across groups but also placing them in competition for limited resources). We argue that, to weather these dramatic shifts, organisations relied on internal alliances and resources built in and after periods of crisis. In this way, despite the differences between the two pandemics, the legacies of HIV shaped the response to COVID-19. Though responses to COVID-19 seem improvised and temporary, they build on a longer-term social movement infrastructure.

Leaving and Beyond: Voices of Survivors of Domestic Violence From Kyrgyzstan.

Despite the global nature of domestic violence against women, few studies have examined the phenomenon in Kyrgyzstan. This grounded theory study gives voice to survivors of domestic violence by examining women's experiences of various forms of violence and the complexities surrounding Kyrgyz women's decision making about leaving violent relationships. Findings revealed that survivors move through a three-stage process of leaving: (a) reaching a turning point, (b) implementing the leaving process, and (c) reclaiming self. Participants described "turning points" as critical events or sudden realizations that the violence had become uncontrollable or intolerable, and that the problem was not going to be solved without external support. The turning points fell into four major categories, including epiphanies and moments of truth, losing hope for a change in the abuser's behavior, reaching the point of saturation and giving up, and experiencing fear for the safety of children and protecting self. The main factor that led women to leave was being confronted with the pervasive fear that the abuse would lead to permanent disability or death. In the second stage, the process of leaving was characterized by an iterative cycle of leaving and returning until women were able to weigh the costs and benefits of staying and leaving in the face of cultural, institutional, and systemic constraints. The final stage of leaving involved "reclaiming self," which was the result of cognitive shifts, finding new meanings in their experiences of abuse and attempts to leave, and support received from advocates at the shelter. Results have implications for interventions with survivors and policies addressing the problem of domestic violence in Kyrgyzstan.

How discrimination and stress affects self-esteem among Dominican immigrant women: an exploratory study.

Understanding the factors that contribute to the health disparities among racial and ethnic minorities in the United States is very important given the growing Latina population. Although researchers have investigated the health and mental health status among Latinas, the relationship between mental health and self-esteem has not been given a lot of attention. Given that self-esteem is a proxy for mental health status, investigations exploring the factors that can negatively affect self-esteem are needed. Therefore, the current study examined the influence of discrimination and stress on self-esteem among Dominican immigrant women. A cross-sectional study was undertaken among 235 immigrant Dominican women in New York City. Women (age 18-49 years) and in the United States for fewer than 20 years were more likely to report experiencing discrimination compared to women older than age 50 years and in the United States for more than 20 years. After controlling for age, time in the United States, educational level, and income, high levels of discrimination (-0.09, p < 0.01) and stress (-0.69, p < 0.001) were significantly associated with reduced self-esteem. Interventions with Latino/a populations, especially women, need to acknowledge their individual evaluations of the discriminatory and stressful experiences that negatively influence their self-esteem and subsequently their mental health status.

A descriptive profile of abused female sex workers in India.

This descriptive study presents the profiles of abused female sex workers (FSWs) in Chennai, India. Of 100 abused FSWs surveyed using a structured questionnaire, severe forms of violence by intimate partners were reported by most (98%) respondents. Of the total sample, 76% experienced violence by clients. Sexual coercion experiences of the FSWs included verbal threats (77%) and physical force (87%) by intimate partners and forced unwanted sexual acts (73%) by clients. While 39% of the women consumed alcohol before meeting a client, 26% reported that their drunkenness was a trigger for violence by clients. The findings suggest that there is an urgent need to integrate services, along with public-health interventions among FSWs to protect them from violence. Recognition of multiple identities of women in the contexts of intimate relationships versus sex work is vital in helping women to stay safe from adverse effects on health.

Intimate partner violence and consistent condom use among drug-using heterosexual women in New York City.

The present study examined the associations of relationship factors, partner violence, relationship power, and condom-use related factors with condom use with a main male partner among drug-using women. Over two visits, 244 heterosexual drug-using women completed a cross-sectional survey. Multivariate logistic regression models indicated that women who expected positive outcomes and perceived lower condom-use barriers were more likely to report condom use with their intimate partners. The findings suggest that future interventions aiming at reducing HIV risk among drug-using women should focus on women's subjective appraisals of risks based on key relationship factors in addition to the occurrence of partner violence.

Profiling abusive men based on women's self-reports: findings from a sample of urban low-income minority women.

Understanding abusive behaviors among nonclinical samples of men is important to help women in the community understand the risks they may face. The purpose of the current study is to identify abusive profiles and subgroups of non-treatment-seeking men using women's self reports. Of the sample of 611 women, 43% reported current abuse; chronicity of psychological aggression was the highest. Cluster analysis results revealed three different types of abusers. Findings provided support for recognizing batterer heterogeneity, especially based on women's reports. Recommendations for future research and the limitations of using batterer typologies are discussed.

An examination of the perceived social support levels of women in methadone maintenance treatment programs who experience various forms of intimate partner violence.

BACKGROUND: Intimate partner violence (IPV) has emerged as a serious problem among women in drug treatment programs. Research has underscored the importance of social support for abused women as well as women who use substances. OBJECTIVES: The main objectives of this study were to describe the perceived social support levels and examine the associations between various forms of IPV and perceived levels of available social support perceived levels among a sample of women in drug treatment programs. METHODS: Face-to-face, structured interviews were conducted with randomly selected 416 women on methadone. RESULTS: The prevalence of physical, sexual, and injurious IPV in the sample was 39%, 31%, and 16% respectively, and the combined IPV prevalence was 44.5%. Findings from multiple linear regression models revealed that lower levels of perceived social support were significantly associated with physical aggression (beta = -4.71; p = .0001), sexual assaults (beta = -4.10; p = .003), and injurious attacks (beta = -4.03; p = .022). Respondents perceived highest levels of social support from their "significant others" (mean = 5.64; standard deviation [SD] = 1.27) and lowest levels of social support from friends (mean = 4.20; SD = 1.48). The average network size was 2.7 individuals. IMPLICATIONS: Findings from this study highlighted significantly lower levels of perceived social support levels for drug-using women in the context of IPV experiences. Interventions with these women should focus on strengthening social support networks that enable help seeking for both IPV and substance abuse issues.

Intimate partner violence is as important as client violence in increasing street-based female sex workers' vulnerability to HIV in India.

OBJECTIVES: There are no studies that examine street-based female sex workers' vulnerability to HIV from both clients and intimate partners. This study documents street-based female sex workers' experiences of client and intimate partners, examines the intersections of violence, alcohol use in condom use, and highlights survival strategies used to avert harm. METHODS: Ethnographic data were collected from 49 female sex workers through focus group discussions and in-depth interviews. RESULTS: Female sex workers experienced multifarious forms of severe client and intimate partner violence. Sexual coercion and forced group sex in the context of alcohol use posed formidable barriers for condom use negotiation. Further, traditional gender norms dictated women's inabilities to negotiate condom-use with intimate partners. However, there was evidence of adoption of successful survival strategies in the face of danger and women's positive evaluations of the benefits of sex work and their contributions to family well-being. CONCLUSIONS: Harm reduction efforts with female sex workers need to account for their vulnerability to HIV from intimate partners in addition to clients. HIV prevention programmes need to include male clients in order to reduce harm among street-based female sex workers. There is an urgent need to build on sex workers' strengths and involve them in designing individual level, community, and structural interventions that could help in reducing women's vulnerability to intimate partner violence and HIV in India.

Predicting the timing of women's departure from abusive relationships.

The aim of this study was to investigate forces that affect the timing of women's exit from violent relationships with men. Abused women were recruited from posters in the community and battered women's shelters, interviewed, and followed up for 10 years. Data for this study are based on 100 women and were analyzed using event history analysis. Age, ethnicity, and alcohol consumption levels of both partners predicted the timing of women's termination of abusive relationships. An interaction effect showed that women who scored above the mean on an index of physical aggression and who never used shelter services had the longest trajectories of violence exposure; severely abused women without shelter use were more likely to stay. Our findings indicate that women who receive shelter services endure shorter periods of violence than women who do not access such services. Further outreach, especially to women experiencing high rates of physical aggression, is recommended.

The voices of battered women in India.

This study endeavors to give voice to marginalized, understudied women who were abused in India. The study included 90 women who were abused who were seeking help to address violence perpetrated against them by their husbands. A semistructured interview was used to collect data on abuse characteristics, consequences of abuse, and help-seeking behavior. Findings reveal that the vast majority of participants experienced daily abuse that was extremely severe, with 70% reporting they lived under the threat of murder. More than 85% reported needing medical care for their injuries. Respondents in this study sought help from a range of sources; the most effective help was provided by counseling centers and women's shelters. These findings have important implications for clinical practice and social policy.