Discursos sobre violencia contra la mujer de jóvenes y profesionales en España. Proyecto PositivMasc / Discourses on violence against women by young people and professionals in Spain: PositivMasc project

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

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

Stories of Backlash in Interviews With Survivors of Intimate Partner Violence Against Women in Sweden.

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

Estudo descritivo dos casos notificados de violência sexual e dos serviços de atendimento especializado em Minas Gerais, 2019 / Estudio descriptivo de los casos notificados de violencia sexual y de los servicios de atención especializada en Minas Gerais, Brasil, 2019 / Descriptive study of reported cases of sexual violence and specialized care services in the state of Minas Gerais, Brazil, 2019

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

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

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

La urgencia de dar respuesta sanitaria a la violencia de género / The urgency of providing a health response to gender-based violence

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

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

Time trend and spatial distribution of the cases of lethal violence against women in Brazil. / Tendência temporal e distribuição espacial dos casos de violência letal contra mulheres no Brasil.

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

Sexual harassment in secondary school: Prevalence and ambiguities. A mixed methods study in Scottish schools.

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

Development and validation of a data quality index for forensic documentation of sexual and gender-based violence in Kenya.

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

Impacto de la pandemia por COVID-19 y el confinamiento en los homicidios por violencia de género en España / Impact of COVID-19 pandemic and lockdown on gender-based violence homicides in Spain

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

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

Examining Violence Against Women at a Regional Level 1 Trauma Center During the COVID-19 Pandemic.

INTRODUCTION: There is a growing concern that certain public health restrictions imposed to prevent the spread of coronavirus disease 2019 (COVID-19) could result in more violence against women (VAW). We sought to determine if the rates and types of VAW changed during the COVID-19 pandemic at our level 1 trauma center (L1TC). METHODS: We performed a retrospective review of female patients who presented to our L1TC because of violence from 2019 through 2020. Patients were grouped into a pre-COVID or COVID period. The primary aim of this study was to compare rates of VAW between groups. Secondary aims sought to evaluate for any difference in traumatic mechanism between periods and to determine if a temporal relationship existed between COVID-19 and VAW rates. RESULTS: There was no difference in rates of VAW between the pre-COVID and COVID period (3.1% vs 3.6%, P = .6); however, rates of penetrating trauma were greater during the COVID period (38.2% vs 10.3%, P = .01). After controlling for patient age and race, the odds of penetrating trauma increased during the pandemic (OR 5.8, 95% CI 1.6-28.5, P < .01). From February 2020 through October 2020, there was a direct relationship between rates of COVID-19 and VAW (r2 .78, P < .01). CONCLUSION: Rates of VAW were unchanged between the pre-COVID and COVID periods, yet the odds of penetrating VAW were 5 times greater during the pandemic. Moving forward, trauma surgeons must remain vigilant for signs of violence and ensure that support services are available during future crises.

Tendência temporal e distribuição espacial dos casos de violência letal contra mulheres no Brasil / Time trend and spatial distribution of the cases of lethal violence against women in Brazil / Tendencia temporal y distribución espacial de los casos de violencia letal contra la mujer en Brasil

Resumo Objetivo: analisar a tendência temporal e a distribuição espacial dos casos de violência letal contra mulheres no Brasil, segundo faixa etária e raça/cor. Método: estudo ecológico, de séries temporais, com distribuição espacial dos óbitos de mulheres vítimas de agressão, cadastrados no Sistema de Informação sobre Mortalidade, residentes no Brasil, regiões geográficas e estados brasileiros. Devido ao sub-registro de óbitos em alguns estados, empregaram-se fatores de correção das taxas de mortalidade. Para a análise de tendência, adotamos o modelo de regressão polinomial. Além disso, as taxas médias e as tendências de aumento/reduções anuais foram distribuídas considerando como unidade de análise as unidades federativas do Brasil. Resultados: a taxa média foi de 6,24 casos de violência letal por 100 mil mulheres, com variação importante entre as regiões e os estados brasileiros. As principais vítimas de morte violenta no Brasil são mulheres jovens, pretas/pardas e indígenas, com tendência de crescimento nessas populações. As Regiões Norte e Nordeste se destacaram com os aumentos anuais médios mais expressivos (0,33; r2 = 0,96 e 0,26; r2 = 0,92, respectivamente). Conclusão: evidenciou-se tendência de estabilidade da violência letal contra a mulher, com diferenças regionais significativas. Mulheres jovens, pretas/pardas e indígenas são mais vulneráveis à morte violenta no Brasil.

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

Resumen Objetivo: analizar la tendencia temporal y la distribución espacial de los casos de violencia letal contra la mujer en Brasil, según la franja etaria y la raza/color. Método: estudio ecológico, de las series temporales, con distribución espacial de las muertes de mujeres víctimas de agresión, registradas en el Sistema de Información de Mortalidad, residentes en Brasil, regiones geográficas y estados brasileños. Debido a que hay subregistro de las muertes en algunos estados, se utilizaron factores de corrección para las tasas de mortalidad. Para el análisis de tendencias, adoptamos el modelo de regresión polinomial. Además, las tasas medias y las tendencias anuales de aumento/disminución fueron distribuidas considerando como unidad de análisis las unidades federativas de Brasil. Resultados: la tasa promedio fue de 6,24 casos de violencia letal por cada 100.000 mujeres, con variación significativa entre regiones y estados brasileños. Las principales víctimas de muerte violenta en Brasil son mujeres jóvenes, negras/morenas e indígenas y la tendencia es creciente en estas poblaciones. Las regiones Norte y Noreste presentaron los aumentos medios anuales más significativos (0,33; r2 = 0,96 y 0,26; r2 = 0,92, respectivamente). Conclusión: hubo una tendencia a la estabilidad de la violencia letal contra la mujer, con diferencias regionales significativas. Las mujeres jóvenes, negras/morenas e indígenas son más vulnerables a la muerte violenta en Brasil.

Percepción y detección de violencia de género e identificación como víctimas: Un estudio bibliométrico / Perception and detection of gender violence, and identification as victims: A bibliometric study

El presente estudio bibliométrico tuvo como objetivo conocer y analizar la actividad científica disponible sobre percepción y detección de violencia de género (VG) e identificación como víctimas. Se realizó una búsqueda sin límite temporal en la base de datos Scopus hallando 2.152 documentos. Para reducir el ruido documental de la búsqueda, se cribaron los resultados y se analizaron 974 documentos finales procedentes de 465 fuentes documentales, 160 revistas, 2.758 autores/as, 159 instituciones y 79 países. Los resultados muestran un aumento en la producción en los últimos años, destacando la publicación de artículos originales. Asimismo, predomina la autoría única por país, siendo Estados Unidos el país puntero. Entre los objetivos de los documentos más citados se encuentra la detección de VG por el personal sanitario, la valoración del riesgo de reincidencia mediante la percepción de las víctimas, así como el estudio de percepciones y actitudes de diferentes actores hacia la VG

This bibliometric study seeks to know and analyse the available scientific activity on the perception and detection of gender violence as well as in the identification as victims. An unlimited search was conducted in the Scopus database, finding 2,152 documents. Subsequently, the results were screened by reducing the documentary noise. The results were obtained from 1984-2020 and the final 974 documents were analysed from 465 documentary sources, 160 journals, 2,758 authors, 159 institutions, and 79 countries. The results show an increase in production in recent years, highlighting the publication of original articles. Likewise, the single author-ship per country predominates, being the United States the leading country. The main objectives of the most cited documents are detection of gender violence by healthcare personnel, assessment of the risk of recidivism through the perception of the victims, as well as the study of perceptions and attitudes of different actors towards gender-violence

A retrospective study on femicides assessed at the Institute of Legal Medicine of Milan. Are older women at risk?

The purpose of the present research is to analyze temporal tend, victim's and perpetrator's specific features and the role of risk factors of femicides assessed at the Institute of Legal Medicine of Milan (in the North of Italy) from 2006 to 2020. The classical definition of femicide (the killing of a woman because of her gender) was used, in order to exclude murders of a woman because of economic issues, neighborhood quarrels, vengeance for previous discussions and other motives. Data were obtained from autopsies findings, local papers and victim relatives' interviews. The analysis of 86 femicides occurred in the judicial district of the Cities of Milan and Monza from 2006 to 2020 were performed. The results show the temporal distribution of the phenomenon, the methods of murders, the mean age of the victims, victims and perpetrators' relationship and nationality, risk factors. Although a reduction in the total number of femicides was observed, the percentage of femicides when compared to the total number of homicides was the same. Also, an increasing mean age of the victims over the period emerged. Moreover, the analysis of nationality of the victims and the perpetrators did not reflect foreign citizens distribution in Italy.

What Role Should Resistance Play in Training Health Professionals?

The role that resistance plays in medicine and medical education is ill-defined. Although physicians and students have been involved in protests related to the COVID-19 pandemic, structural racism, police brutality, and gender inequity, resistance has not been prominent in medical education's discourses, and medical education has not supported students' role and responsibility in developing professional approaches to resistance. While learners should not pick and choose what aspects of medical education they engage with, neither should their moral agency and integrity be compromised. To that end, the authors argue for professional resistance to become a part of medical education. This article sets out a rationale for a more explicit and critical recognition of the role of resistance in medical education by exploring its conceptual basis, its place both in training and practice, and the ways in which medical education might more actively embrace and situate resistance as a core aspect of professional practice. The authors suggest different strategies that medical educators can employ to embrace resistance in medical education and propose a set of principles for resistance in medicine and medical education. Embracing resistance as part of medical education requires a shift in attention away from training physicians solely to replicate and sustain existing systems and practices and toward developing their ability and responsibility to resist situations, structures, and acts that are oppressive, harmful, or unjust.

Mobility for sex work and recent experiences of gender-based violence among female sex workers in Iringa, Tanzania: A longitudinal analysis.

Female sex workers are highly mobile, which may influence their risk of experiencing physical and sexual violence. However, there remains a paucity of research, particularly longitudinal, from Sub-Saharan Africa exploring mobility and gender-based violence among female sex workers. To address this gap, this study examined the longitudinal relationship between work-related mobility and recent experience of physical or sexual gender-based violence from a client or partner among female sex workers in Iringa, Tanzania. A secondary data analysis was conducted using baseline and 18-month follow-up data from Project Shikamana, a community empowerment-based combination HIV prevention intervention. Responses from 387 female sex workers aged 18 years and older participating in both baseline and follow-up were analyzed. Unadjusted and adjusted Poisson regression models with robust variance estimations, accounting for clustering of female sex workers' responses over time, were fit. Final models adjusted for socio-demographic characteristics and aspects of participants' living situations and work environments. Recent physical or sexual violence from a client or partner was common (baseline: 40%; follow-up: 29%). Twenty-six percent of female sex workers at baseline, and 11% at follow-up, had recently traveled outside of Iringa for sex work. In the final adjusted longitudinal model, female sex workers recently mobile for sex work had a 25% increased risk of any recent experience of physical or sexual gender-based violence when compared with their non-mobile counterparts (adjusted incidence rate ratio: 1.25; 95% CI: 1.03-1.53; p<0.05). Interventions must identify ways-such as mobile support services, linkages and referrals to health and other social services while traveling, or the use of mobile or digital technology-to address mobile female sex workers' unique needs while traveling. Future quantitative and qualitative research is needed to understand the context of female sex workers' mobility and how and why mobility influences risk environments and experiences of gender-based violence.

Intimate partner violence against adolescents and young women in sub-Saharan Africa: who is most vulnerable?

BACKGROUND: Intimate partner violence (IPV) is a global public health and human rights issue that affects millions of women and girls. While disaggregated national statistics are crucial to assess inequalities, little evidence exists on inequalities in exposure to violence against adolescents and young women (AYW). The aim of this study was to determine inequalities in physical or sexual IPV against AYW and beliefs about gender based violence (GBV) in sub-Saharan Africa (SSA). METHODS: We used data from the most recent Demographic and Health Surveys (DHS) conducted in 27 countries in SSA. Only data from surveys conducted after 2010 were included. Our analysis focused on married or cohabiting AYW aged 15-24 years and compared inequalities in physical or sexual IPV by place of residence, education and wealth. We also examined IPV variations by AYW's beliefs about GBV and the association of country characteristics such as gender inequality with IPV prevalence. RESULTS: The proportion of AYW reporting IPV in the year before the survey ranged from 6.5% in Comoros to 43.3% in Gabon, with a median of 25.2%. Overall, reported IPV levels were higher in countries in the Central Africa region than other sub-regions. Although the prevalence of IPV varied by place of residence, education and wealth, there was no clear pattern of inequalities. In many countries with high prevalence of IPV, a higher proportion of AYW from rural areas, with lower education and from the poorest wealth quintile reported IPV. In almost all countries, a greater proportion of AYW who approved wife beating for any reason reported IPV compared to their counterparts who disapproved wife beating. Reporting of IPV was weakly correlated with the Gender Inequality Index and other societal level variables but was moderately positively correlated with adult alcohol consumption (r = 0.48) and negative attitudes towards GBV (r = 0.38). CONCLUSION: IPV is pervasive among AYW, with substantial variation across and within countries reflecting the role of contextual and structural factors in shaping the vulnerability to IPV. The lack of consistent patterns of inequalities by the stratifiers within countries shows that IPV against women and girls cuts across socio-economic boundaries suggesting the need for comprehensive and multi-sectoral approaches to preventing and responding to IPV.

Effectiveness of the Sista2Sista programme in improving HIV and other sexual and reproductive health outcomes among vulnerable adolescent girls and young women in Zimbabwe.

Background: In Zimbabwe, adolescent girls and young women (AGYW) experience high rates of HIV and other sexual and reproductive health challenges. In 2013, the Zimbabwe Ministry of Health and Child Care partnered with the United Nations Population Fund to implement the Sista2Sista programme, a structured peer group intervention aimed at improving health outcomes among vulnerable in- and out-of-school AGYW.Methods: Programme data was analysed for 91 612 AGYW aged 10-24 years old who participated in Sista2Sista from 2013 to 2019. Logistic regression was used to determine odds ratios (OR) and evaluate programme exposure as a factor in a set of defined variables.Results: 58 471 AGYW (63.82%) graduated from the Sista2Sista programme by completing at least 30 of 40 exercises. Graduates were more likely to take an HIV test (2.78 OR 95% CI 2.52-3.10), less likely to get married (0.63 OR 95% CI 0.55-0.73) and less likely to drop out of school (0.60 OR 95% CI 0.53-0.69). At higher thresholds of programme completion, additional positive outcomes were observed. Participants who completed all 40 exercises were more likely to return to school (1.41 OR 95% CI 1.18-1.69), more likely to use contraception (1.38 OR 95% CI 1.21-1.56), more likely to report sexual abuse (1.76 OR 95% CI 1.17-2.66), and less likely to become pregnant as adolescents (0.41 OR 95% CI 0.24-0.72). Individual counselling improved the likelihood of programme graduation.Conclusions: The Sista2Sista programme had a positive effect on HIV and other sexual health outcomes among vulnerable AGYW in Zimbabwe. Strategies to improve graduation rates should be explored.

The pitfalls of modelling the effects of COVID-19 on gender-based violence: lessons learnt and ways forward.

Since early 2020, global stakeholders have highlighted the significant gendered consequences of the COVID-19 pandemic, including increases in the risk of gender-based violence (GBV). Researchers have sought to inform the pandemic response through a diverse set of methodologies, including early efforts modelling anticipated increases in GBV. For example, in April 2020, a highly cited modelling effort by the United Nations Population Fund (UNFPA) and partners projected headline global figures of 31 million additional cases of intimate partner violence due to 6 months of lockdown, and an additional 13 million child marriages by 2030. In this paper, we discuss the rationale for using modelling to make projections about GBV, and use the projections released by UNFPA to draw attention to the assumptions and biases underlying model-based projections. We raise five key critiques: (1) reducing complex issues to simplified, linear cause-effect relationships, (2) reliance on a small number of studies to generate global estimates, (3) assuming that the pandemic results in the complete service disruption for existing interventions, (4) lack of clarity in indicators used and sources of estimates, and (5) failure to account for margins of uncertainty. We argue that there is a need to consider the motivations and consequences of using modelling data as a planning tool for complex issues like GBV, and conclude by suggesting key considerations for policymakers and practitioners in using and commissioning such projections.

Characteristics of violence against women in Kairouan, Tunisia, in 2017.

Violence against women represents a serious concern worldwide. In Tunisia, despite an advanced legislative framework, we still receive women victims of violence. This survey aimed to characterize the demographic and clinical profile of women victims of violence in Kairouan, central Tunisia. This survey was designed as a cross-sectional study. It concerned women victims of violence over 18 years old, consulting the emergency department of the University Hospital of Kairouan during 3 months in 2017. We defined violence against women according to the Tunisian protection of gender discrimination law. This survey included 100 Tunisian victims of violence; their median age was 35 (ranging from 18 to 59 years old). This study showed that 58% of victims, CI95% [48.3%, 67.6%], were illiterate or had only a primary level education and that 90%, CI95% [84.1%, 95.8%], had a low or middle socioeconomic level. The Intimate Partner Violence was about 70% among all cases, CI 95% [61.0%, 78.9%]. Most aggressive partners were young (aged between 39 and 51 years old). The most affected part of the body was the face (76%, CI 95% [67.6%, 84.3%]). Alcohol consumption was the primary risk factor of violence in 29.6% of cases, CI95% [20.0%, 37.9%]. Other risk factors were the occupational instability, conflicts with the family in-laws and infidelity. Violence against women remains widespread. Even strict legislations in Tunisia didn't protect women sufficiently from different types of violence. It mostly happens within intimate relationships. Therefore, surveillance and early intervention controlling risk factors are extremely important.

Creencias sexistas y actitudes de violencia de género. Situación de estudiantes universitarios del área de la salud. Cartagena - Colombia / Sexist beliefs and attitudes of gender violence situation of university students in the health area. Cartagena Colombia

INTRODUCCIÓN: La violencia contra la mujer es un problema que atenta contra la igualdad, el desarrollo y la paz social. Situación que se reconoce como factor asociado al deterioro en la calidad de vida de los individuos en la medida que se constituye en violación de los Derechos Humanos. OBJETIVO: Describir el grado de acuerdo o desacuerdo entre las creencias sexistas y las que conducen a la violencia en estudiantes del área de la salud de una Institución de Educación Superior de Cartagena. MATERIALES Y MÉTODOS: Estudio descriptivo, transversal, la muestra calculada fue de 509 estudiantes, seleccionados mediante muestreo por conveniencia, se utilizó el cuestionario de Actitudes hacia el Género y la Violencia (C.A.G.V), el cuestionario se dividió en dos secciones, la primera, aborda datos sociodemográficos, la segunda, las creencias sexistas y violencia. RESULTADOS: El factor con mayor desacuerdo y/o rechazo a las creencias sexistas es el factor 1 con un 79% de participantes en desacuerdo, los factores 2, 3 y 4 tiene presentan un alto porcentaje de desacuerdo y actitud indiferente en hombres y mujeres ante las creencias evaluadas. CONCLUSIÓN: Se concluye que existen comportamientos que promueven la violencia, en este estudio se evidenció dominación, aislamiento y conductas que suelen pasar inadvertidas, es así como la violencia contra las mujeres ejercidas por sus parejas o ex parejas abre campos a importantes problemas de salud, problemas que han demostrado un desequilibrio del bienestar psicosocial a corto y/o a largo plazo

INTRODUCTION: Violence towards women is a problem that attempts towards equalness, the development of social peace. Situation that is acknowledged as a factor associated with the deterioration in the quality of life of the individuals as it is constituted a violation of human rights. TARGET: To describe the degree of agreement and disagreement between the sexist beliefs and those that lead students in the health area of superior education institution of Cartagena. MATERIALS AND METHODS: Descriptive study, cross-sectional the calculated sample was of 509 students, selected through convenience sampling, the questionnaire of attitudes towards gender and violence was used. (C.A.G.V), the questionnaire was divided in two sections, the first one, deals with social demographics the second, sexist beliefs and violance. RESULTS: The factor with the most disagreement and rejected to sexist beliefs it is factor 1 with 79% of participants in disagreement, the factors 2,3,4 a high percentage is shown of disagreement and indifference in men and women to the evaluated beliefs. CONCLUSION: It is concluded that exists behaviors that promote violence, and this study was evidenced domination, isolation and conducts that pass unnotified, this is how violence against women done by the partner or ex-partner opens fields to important health issues; problems that have shown an unbalanced and well-being psychosocial in long and short term

El VIH como vía de materialización de la Violencia de Género e Intragénero / HIV as a means of materializing Gender Violence and violence in same-sex couples

OBJETIVO: El objetivo general de esta investigación consiste en identificar la prevalencia y características de la violencia en pareja (perpetrador/a y receptor/a) en pacientes seropositivos adscritos al Instituto Mexicano del Seguro Social (IMSS) de Nuevo León (México). MÉTODO: Se ha planteado una investigación cuantitativa, a través de un diseño descriptivo y transversal, utilizando como instrumento principal la escala Likert de violencia en la relación de pareja de Cienfuegos y la escala Likert sobre el uso del VIH como vía de materialización de la violencia. Se aplicaron 265 cuestionarios autoadministrados y se obtuvo una muestra de 198 pacientes. RESULTADOS: Existe una prevalencia de la violencia en pareja como receptor/a del 40.40% y como perpetrador/a del 40.90%, siendo en ambas formas la violencia psicológica la más frecuente. La prevalencia del uso del VIH como vía de materialización de la violencia en pareja como receptor/a es del 4.54% y como perpetrador/a del 2.52%. Existe una mayor proporción de víctimas y agresores mujeres, no heterosexuales y de parejas en la que ambos miembros son seropositivos; así como en pacientes con mayor nivel de apego seguro y satisfacción con la vida. CONCLUSIONES: Al igual que en la VG, se constata la existencia de violencia en relaciones formas por personas del mismo sexo en la que alguno de sus miembros es seropositivo/a. Asimismo, se corrobora que el VIH se utiliza como medio para ejercer la violencia en pareja

OBJECTIVE: The general objective of this research is to identify the prevalence and characteristics of partner violence (perpetrator and recipient) in HIV positive patients enrolled in the Mexican Institute of Social Security (IMSS, in Spanish) in the state of Nuevo Leon, Mexico. METHODOLOGY: A quantitative research was proposed, through a descriptive and transversal design, using as main instrument the Likert scale of violence in partner relationships of Cienfuegos and the Likert scale on the use of HIV as a means to materialize violence. We applied 265 self-administered questionnaires and obtained a statistic sample of 198 patients. RESULTS: There is a prevalence of partner violence of 40.40% as a receiver and of 40.90% as a perpetrator, psychological violence is the most frequent form in both cases. The prevalence of the use of HIV as a means of materializing partner violence as a recipient is of 4.54% and of 2.52% as a perpetrator. There is a higher proportion of non-heterosexual female victims and aggressors, and of couples in which both members are HIV positive; as well as in patients with a higher level of secure attachment and satisfaction with life. CONCLUSIONS: As in GBV (gender-based violence), there is evidence of the existence of violence in same-sex relationships in which one of the members is HIV positive. Likewise, it is possible to corroborate that HIV is used as a means to exercise partner violence