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1.
J Interpers Violence ; : 886260519885118, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31702407

RESUMO

Violence against women and girls (VAWG) has important social, economic, and public health impacts. Governments and international donors are increasing their investment in VAWG prevention programs, yet clear guidelines to assess the "value for money" of these interventions are lacking. Improved costing and economic evaluation of VAWG prevention can support programming through supporting priority setting, justifying investment, and planning the financing of VAWG prevention services. This article sets out a standardized methodology for the economic evaluation of complex, that is, multicomponent and/or multiplatform, programs designed to prevent VAWG in low- and middle-income countries (LMICs). It outlines an approach that can be used alongside the most recent guidance for the economic evaluation of public health interventions in LMICs. It defines standardized methods of data collection and analysis, outcomes, and unit costs (i.e., average costs per person reached, output or service delivered), and provides guidance to investigate the uncertainty in cost-effectiveness estimates and report results. The costing approach has been developed and piloted as part of the "What Works to Prevent Violence Against Women and Girls?" (What Works?) program in five countries. This article and its supplementary material can be used by both economists and non-economists to contribute to the generation of new cost-effectiveness data on VAWG prevention, and ultimately improve the allocative efficiency and financing across VAWG programs.

2.
BMC Int Health Hum Rights ; 19(1): 29, 2019 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640716

RESUMO

BACKGROUND: Violence against women has particular importance for women's health and wellbeing in the Arab world, where women face persistent barriers to social, political and economic equality. This review aims to summarize what is known about the prevalence of physical, sexual and emotional/psychological intimate partner violence (IPV) against women in the 22 countries of the Arab League, including geographic coverage, quality and comparability of the evidence. METHODS: A systematic review of IPV prevalence in Arab countries was carried out among peer-reviewed journal articles and national, population-based survey reports published by international research programmes and/or governments. Following PRISMA guidelines, Medline and the Social Sciences Citation Index were searched with Medical Subject Headings terms and key words related to IPV and the names of Arab countries. Eligible sources were published between January 2000 and January 2016, in any language. United Nations databases and similar sources were searched for national surveys. Study characteristics, operational definitions and prevalence data were extracted into a database using Open Data Kit Software. Risk of bias was assessed with a structured checklist. RESULTS: The search identified 74 records with population or facility-based IPV prevalence data from eleven Arab countries, based on 56 individual datasets. These included 46 separate survey datasets from peer-reviewed journals and 11 national surveys published by international research programmes and/or governments. Seven countries had national, population-based IPV estimates. Reported IPV prevalence (ever) ranged from 6% to more than half (59%) (physical); from 3 to 40% (sexual); and from 5 to 91% (emotional/ psychological). Methods and operational definitions of violence varied widely, especially for emotional/psychological IPV, limiting comparability. CONCLUSIONS: IPV against women in Arab countries represents a public health and human rights problem, with substantial levels of physical, sexual and emotional/psychological IPV documented in many settings. The evidence base is fragmented, however, suggesting a need for more comparable, high quality research on IPV in the region and greater adherence to international scientific and ethical guidelines. There is a particular need for national, population-based data to inform prevention and responses to violence against women, and to help Arab countries monitor progress towards the Sustainable Development Goals.

3.
Ciênc. Saúde Colet ; 24(8): 2835-2844, ago. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1011875

RESUMO

Abstract Domestic violence (DV) is a serious public health problem in the world. DV against women is also a global problem without cultural, geographic, religious, social, economic or national boundaries. This descriptive cross-sectional study was carried out to determine the situations of DV in women living in Istanbul and the Aegean Region in Turkey. The study population included outpatient clinics of state hospitals both regions. A stratified sampling by age was performed and 1100 women were included into the sample. Data were collected at face-to-face interviews with Domestic Violence Against Women Determination Scale. The mean age of the women living in Istanbul was 41.81 ± 9.75 years and Aegean Region was 33.72 ± 11.38 years. The prevalence of emotional and financial violence were higher in Istanbul and the Aegean Region. The women living in Istanbul got higher scores for Domestic Violence Against Women Determination Scale. The prevalence of the women reporting to suffer from violence from their spouses was 15.4% in Istanbul and 14% in the Aegean Region. While the prevalence of the women suffering from violence was higher in Istanbul, the women in Aegean Region suffered from more severe violence. The violence prevalence was lower among the wives and the husbands with high education levels, employed women and high-income families.


Resumo A violência doméstica (VD) é um grave problema de saúde pública no mundo. VD contra as mulheres também é um problema global sem fronteiras culturais, geográficas, religiosas, sociais, econômicas ou nacionais. Este estudo descritivo transversal foi realizado para determinar as situações de VD em mulheres que vivem em Istambul e na região do Egeu, na Turquia. Foi realizada uma amostragem estratificada por idade e 1.100 mulheres foram incluídas na amostra. Os dados foram coletados em entrevistas presenciais com a Escala de Determinação de Violência Doméstica Contra a Mulher. A idade média das mulheres que vivem em Istambul foi de 41.81 ± 9.75 anos e a região do Egeu foi de 33.72 ± 11.38 anos. As prevalências de violência emocional e financeira foram maiores em Istambul e na região do Egeu. A pontuação na Escala de Determinação de Violência Doméstica Contra a Mulher foi mais elevada entre as mulheres que vivem em Istambul. A prevalência das mulheres que relatam sofrer violência de seus cônjuges foi de 15.4% em Istambul e 14% na região do Egeu. Embora a prevalência das mulheres que sofrem de violência tenha sido maior em Istambul, as da região do Egeu sofreram de violência mais grave. A prevalência da violência foi menor entre as esposas e os maridos com altos níveis de escolaridade, mulheres empregadas e famílias de alta renda.

4.
PLoS One ; 14(8): e0220919, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31442243

RESUMO

OBJECTIVES: This study aimed to measure the prevalence and associated factors of Intimate Partner Violence (IPV) among women living with and without HIV in Wolaita Zone, Southern Ethiopia. METHODS: A comparative cross-sectional study design was used to interview the 816 women between 18-49 years of age (408 = HIV positive, 408 = HIV negative). Using a multistage sampling technique, participants were recruited from nine health facilities based on probability proportional to the number of clients. After data entry (EpiData version 4.4.2.0) the data were exported to STATA/SE 15 software. Binary and multivariable logistic regression analysis were undertaken and the odds ratio (OR) and 95% confidence interval (CI) are presented. RESULTS: The lifetime prevalence of IPV among all women was 59.7%, [95% CI: 56.31%-63.05%]. IPV was slightly higher among women living with HIV, 250(61.3%), than those who were HIV negative, 238(58.1%). Lifetime prevalence of emotional violence 413(50.6%), physical violence 349(42.8%), sexual violence 219(26.8%), and controlling behaviours by husbands/partners 489(59.9%) were reported. Associations were found between IPV and controlling behaviour of husband/partner [AOR = 8.13; 95% CI: 4.93-13.42],income [AOR = 3.97; 95% CI:1.81-8.72], bride price payment [AOR = 3.46; 95% CI:1.74-6.87], women's decision to refuse sex [AOR = 2.99; 95% CI: 1.39-6.41],age group of women [AOR = 2.86; 95% CI:1.67-4.90], partner's family choosing wife [AOR = 2.83; 95% CI:1.70-4.69], alcohol consumption by partner [AOR = 2.36;95% CI:1.36-4.10], number of sexual partners [AOR = 2.35; 95% CI:1.36-4.09], and if partner ever physically fought with another man [AOR = 1.83; 95% CI:1.05-3.19]. CONCLUSIONS: There is a high prevalence of IPV against women both living with and without HIV. Policy priorities should therefore involve males in programs of gender-based violence prevention in order to change their violent behaviour, and interventions are required to improve the economic status of women. Both sexes should be advised to have a single partner and marriage arrangements should be by mutual consent rather than being made by parents.

5.
Pediatrics ; 144(3)2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31427462

RESUMO

CONTEXT: Compared with cisgender (nontransgender), heterosexual youth, sexual and gender minority youth (SGMY) experience great inequities in substance use, mental health problems, and violence victimization, thereby making them a priority population for interventions. OBJECTIVE: To systematically review interventions and their effectiveness in preventing or reducing substance use, mental health problems, and violence victimization among SGMY. DATA SOURCES: PubMed, PsycINFO, and Education Resources Information Center. STUDY SELECTION: Selected studies were published from January 2000 to 2019, included randomized and nonrandomized designs with pretest and posttest data, and assessed substance use, mental health problems, or violence victimization outcomes among SGMY. DATA EXTRACTION: Data extracted were intervention descriptions, sample details, measurements, results, and methodologic rigor. RESULTS: With this review, we identified 9 interventions for mental health, 2 for substance use, and 1 for violence victimization. One SGMY-inclusive intervention examined coordinated mental health services. Five sexual minority-specific interventions included multiple state-level policy interventions, a therapist-administered family-based intervention, a computer-based intervention, and an online intervention. Three gender minority-specific interventions included transition-related gender-affirming care interventions. All interventions improved mental health outcomes, 2 reduced substance use, and 1 reduced bullying victimization. One study had strong methodologic quality, but the remaining studies' results must be interpreted cautiously because of suboptimal methodologic quality. LIMITATIONS: There exists a small collection of diverse interventions for reducing substance use, mental health problems, and violence victimization among SGMY. CONCLUSIONS: The dearth of interventions identified in this review is likely insufficient to mitigate the substantial inequities in substance use, mental health problems, and violence among SGMY.

6.
Reprod Health ; 16(1): 93, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262331

RESUMO

BACKGROUND: One in three women experience intimate partner violence worldwide, according to many primary studies. However, systematic review and meta-analysis of intimate partner violence is very limited. Therefore, we set to summarize the findings of existing primary studies to generate evidence for informed decisions to tackle domestic violence against women in low and lower-middle income countries. METHODS: Studies were searched from main databases (Medline via PubMed, EMBASE, CINAHL, PopLine and Web of Science), Google scholar and other relevant sources using electronic and manual techniques. Published and unpublished studies written in English and conducted among women aged (15-49 years) from 1994 to 2017 were eligible. Data were extracted independently by two authors, and recorded in Microsoft Excel sheet. Heterogeneity between included studies was assessed using I2, and publication bias was explored using visual inspection of funnel plot. Statistical analysis was carried out to determine the pooled prevalence using Comprehensive Meta-Analysis software. In addition, sub-group analysis was carried out by study-setting and types of intimate partner violence. RESULTS: Fifty two studies were included in the systematic review. Of these, 33 studies were included in the meta-analysis. The pooled prevalence of lifetime intimate partner violence was 55% (95% CI: 52, 59%). Of these, main categories were lifetime physical violence [39% (95% CI: 33, 45%); psychological violence [45% (95% CI: 40, 52%)] and sexual violence [20% (95% CI: 17, 23%)]. Furthermore, the pooled prevalence of current intimate partner violence was 38% (95% CI: 34, 43%). Of these, physical violence [25% (95% CI: 21, 28%)]; psychological violence [30% (95% CI: 24, 36%)] and sexual violence [7.0% (95% CI: 6.6, 7.5%)] were the pooled prevalence for the major types of intimate partner violence. In addition, concurrent intimate partner violence was 13% (95% CI: 12, 15%). Individual, relationship, community and societal level factors were associated with intimate partner violence. Traditional community gender-norm transformation, stakeholders' engagement, women's empowerment, intervention integration and policy/legal framework were highly recommended interventions to prevent intimate partner violence. CONCLUSION: Lifetime and current intimate partner violence is common and unacceptably high. Therefore, concerned bodies will need to design and implement strategies to transform traditional gender norms, engage stakeholders, empower women and integrate service to prevent violence against women. PROTOCOL REGISTRATION: PROSPERO: 2017: CRD42017079977 .

7.
BMC Public Health ; 19(1): 897, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286914

RESUMO

BACKGROUND: While gender-based violence (GBV) has been shown to increase women's risk of HIV acquisition, the role of GBV in the HIV testing to care continuum is less clear. Clarifying how GBV may act as a barrier to accessing HIV services, treatment and care - such as anti-retroviral treatment (ART) or pre-exposure prophylaxis (PrEP) - will not only provide insights into how to best meet individual women's HIV care needs, but also inform public health oriented HIV epidemic control strategies. METHODS: Through a comprehensive scoping review, we synthesized and analyzed existing evidence regarding the influence of GBV on engagement in PrEP and the HIV care continuum among women living with HIV, including members of key populations (female sex workers, transgender women and women who use drugs). We explored PubMed, Scopus and Web of Science for peer-reviewed studies published in 2003-2017. Of the 279 sources identified, a subset of 51 sources met the criteria and were included in the scoping review. RESULTS: Studies were identified from 17 countries. The majority of studies utilized quantitative cross-sectional designs (n = 33), with the rest using longitudinal (n = 4), qualitative (n = 10) or mixed methods (n = 4) designs. Taken together, findings suggest that GBV impedes women's uptake of HIV testing, care, and treatment, yet this can vary across different geographic and epidemic settings. Substantial gaps in the literature do still exist, including studies on the impact of GBV on engagement in PrEP, and research among key populations. CONCLUSIONS: This scoping review contributes to our knowledge regarding the role GBV plays in women's engagement in PrEP and the HIV care continuum. Findings reveal the need for more longitudinal research to provide insights into the causal pathways linking GBV and HIV care and treatment outcomes. Research is also needed to illuminate the impact of GBV on PrEP use and adherence as well as the impact of GBV on engagement along the HIV care continuum among key populations. It is critical that programs and research keep pace with these findings in order to reduce the global burden of GBV and HIV among women.


Assuntos
Antirretrovirais/uso terapêutico , Violência de Gênero/psicologia , Infecções por HIV/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Profilaxia Pré-Exposição/estatística & dados numéricos , Estudos Transversais , Feminino , Identidade de Gênero , HIV , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Humanos , Masculino , Profissionais do Sexo/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/virologia , Pessoas Transgênero/psicologia
8.
Trauma Violence Abuse ; : 1524838019843198, 2019 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-31122182

RESUMO

Gender-based violence (GBV) is a global public health issue which disproportionately affects women. Health-care providers have an important role in recognizing and addressing GBV in practice, yet research suggests that the issue remains underrecognized, with many qualified professionals reporting lack of confidence and a sense of unpreparedness. Prequalifying GBV educational strategies are inconsistent in both quantity and quality worldwide, and to date, there has been no comprehensive review of those programs' effectiveness. This internationally focused literature review aimed to identify best educational practices in GBV for prequalifying health-care students. A systematic search of six databases yielded 17 studies meeting the inclusion criteria, with all studies examining one or more educational intervention. Quality appraisal was undertaken and data were tabulated to capture relevant information. Thematic findings suggest that interactive educational strategies yield better results than didactic approaches. Similarly, interventions with a focus on practical application of learning are generally preferred over strictly theoretical approaches. Courses of longer duration seem to be more effective in instilling attitudinal changes. Lastly, gendered differences were noted in a number of studies, with female students consistently outperforming males. However, more research is needed before conclusions can be drawn about the effectiveness of single- versus mixed-gender audiences. This review makes a useful contribution to the literature of health education, supporting many findings from previous studies and identifying knowledge gaps to be explored in future research. There are implications for both educators and practitioners in creating discernible change for women in their care.

9.
Nurse Educ Today ; 77: 71-76, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30999062

RESUMO

BACKGROUND: Health-care professionals, and nurses especially among them, play an essential role in the health sector's response to gender-based violence. To be able to successfully address this major public health issue they need specific training in the topic. OBJECTIVE: To analyse training on gender-based violence that nursing students receive at universities in Spain. DESIGN: Mixed-methods approach. SETTING: Spain. METHODS: Systematic review of public documents followed by in-depth interviews with university lecturers. RESULTS: Eighty per cent (92/115) of nursing training programmes included content regarding gender-based violence. There was great variability in the topics included in the training. Health consequences due to gender-based violence exposure and the role of the health sector in addressing these health consequences were the most frequently included topics. Ethical issues and legislation were the least frequent ones, as these were only dealt with in one and 18 training programmes, respectively. In the qualitative analysis of the interviews, two categories were identified: 'Supportive legislation and supportive lecturers are essential for integrating gender-based violence training' and 'Approach to gender-based violence shapes the contents and the subject in which it is incorporated'. The first category refers to the main drivers for training integration, while the second category refers to how lecturers' perceptions influenced the way in which training was implemented. CONCLUSIONS: As many as 80% of the nursing education programmes included specific training in gender-based violence, although with great variability in the contents among the universities. For this study's participants, enacted legislation, and lecturers interested in the topic and in decision-making positions were key drivers for this extensive implementation. The variability observed across universities might be explained by lecturers' different approaches to gender-based violence and the nursing profession.


Assuntos
Bacharelado em Enfermagem/normas , Violência de Gênero/tendências , Estudantes de Enfermagem/estatística & dados numéricos , Currículo/normas , Bacharelado em Enfermagem/métodos , Humanos , Entrevistas como Assunto/métodos , Pesquisa Qualitativa , Espanha
10.
Psicol. clín ; 31(1): 145-165, Jan.-Apr. 2019. graf, tab
Artigo em Português | LILACS-Express | ID: biblio-1002873

RESUMO

Este artigo teve como objetivo realizar uma revisão sistemática da literatura sobre protocolos de terapia cognitivo-comportamental (TCC) para tratamento psicológico de mulheres em situações de violência doméstica. MÉTODO: Uma busca foi realizada nas bases Scielo, Pepsic, PubMed, PsycINFO, Scopus e Web of Science com os seguintes descritores: "clinical trial" ou "therapy" ou "psychotherapy" ou "psychological treatment" E "violence" ou "mistreatment" ou "domestic violence" ou "conjugal violence" E "women". Foram identificados 1.329 artigos e, após aplicação de critérios de inclusão e exclusão, restaram 11 artigos. Estes foram analisados a partir de aspectos metodológicos, elementos de intervenção e resultados alcançados. RESULTADOS: Nove artigos relataram estudos clínicos randomizados. As intervenções tiveram como foco sintomas de trauma, ansiedade e depressão. CONCLUSÕES: Os artigos destacaram a avaliação de resultado. Identificou-se a necessidade de estudos que detalhem o processo psicoterapêutico, principalmente no contexto brasileiro, para qualificar as redes de atendimento com práticas baseadas em evidências.


This article aimed to carry out a systematic review of the literature about cognitive behavioral therapy protocols (CBT) for psychological treatment of women in situations of domestic violence. METHOD: A search was conducted on the databases Scielo, Pepsic, PubMed, PsycINFO, Scopus and Web of Science with the following descriptors: "clinical trial" or "therapy" or "psychotherapy" or "psychological treatment" AND "violence" or "mistreatment" or "domestic violence" or "conjugal violence" AND "women". A total of 1.329 articles were identified and, after application of inclusion and exclusion criteria, 11 remained. These were analyzed from methodological aspects, intervention elements and results achieved. RESULTS: Nine articles reported randomized clinical trials. The interventions focused on symptoms of trauma, anxiety and depression. CONCLUSIONS: The articles stressed the assessment of results. The need was manifest for studies to detail the psychotherapeutic process, mainly in the Brazilian context, to qualify the service networks with evidence-based practices.


Este artículo ha tenido como objetivo realizar una revisión sistemática de la literatura sobre los protocolos de terapia cognitivo-conductual (TCC) para el tratamiento psicológico de las mujeres en situaciones de violencia doméstica. MÉTODO: Se realizó una búsqueda en las bases Scielo, Pepsic, PubMed, PsycINFO, Scopus y Web of Science con los siguientes descriptores: "clinical trial" o "therapy" o "psychotherapy" o "psychological treatment" Y "violence" o "mistreatment" o "domestic violence" o "conjugal violence" Y "women". Se identificaron 1.329 artículos y después de la aplicación de criterios de inclusión y exclusión, se mantuvieron 11 artículos. Estos fueron analizados a partir de aspectos metodológicos, elementos de intervención y los resultados obtenidos. RESULTADOS: Nueve artículos eran ensayos clínicos randomizados. Las intervenciones se han centrado en los síntomas de trauma, ansiedad y depresión. CONCLUSIONES: Los artículos fueran centrados en el resultado de la evaluación. Se identifica la necesidad de estudios que detallen el proceso psicoterapéutico, especialmente en el contexto brasileño, para mejorar las redes de servicios a partir de prácticas basadas en evidencias.

11.
Artigo em Português | PAHO-IRIS | ID: phr-50552

RESUMO

[RESUMO]. Objetivo. Conhecer a rota crítica de mulheres em situação de violência doméstica no mundo em sua busca por ajuda. Métodos. Revisão integrativa, com busca realizada nas bases de dados LILACS, MEDLINE via PubMed, EMBASE, Scopus e Web of Science. Não houve restrição quanto ao ano inicial das publicações, porém estabeleceu-se 2017 como ano final. Foram incluídos artigos com disponibilidade do texto integral on-line, publicados em português, inglês ou espanhol, que tratassem do tema da pesquisa e respondessem à pergunta norteadora (“Qual a rota crítica de mulheres em situação de violência doméstica?”). Resultados. Foram incluídos 38 artigos, publicados de 2001 a 2017. Entre os fatores impulsores da busca por ajuda identificaram-se empoderamento econômico e alta escolaridade, severidade da violência e presença de serviços de apoio estruturados e qualificados. Como inibidores identificaram-se o fato de a mulher ser imigrante, a existência de normas culturais de gênero, sentimentos de culpa, medo e vergonha, falta de confiança e pouco conhecimento e/ou disponibilidade limitada de serviços de apoio formal. Filhos, apoio da família e comunidade podem ser fatores inibidores ou impulsores da busca por ajuda. Os tipos de ajuda formal mais procurados são a polícia e os serviços de saúde, enquanto a família, a comunidade e as lideranças religiosas se configuram como apoios informais. Conclusão. A rota crítica das mulheres em situação de violência doméstica no mundo existe de maneira formal e informal. Portanto, é preciso trabalhar questões socioculturais, comunitárias e familiares para incentivar a mulher a romper com a situação de violência, incluindo a busca pela rede de apoio formal qualificada.


[ABSTRACT Objective. To identify the critical pathway taken by women facing domestic violence in the world in their search for help. Method. An integrative review was performed. LILACS, MEDLINE/ PubMed, EMBASE, Scopus, and Web of Science databases were searched until year 2017. The following were inclusion criteria: full text available online, Portuguese, Spanish, or English as language of publication, focus on the theme of interest, and answering the guiding question (Which critical path is taken by women facing domestic violence?). Results. Thirty-eight articles published from 2001 to 2017 were included. Factors driving the search for help included economic empowerment and increased schooling, severity of the violence, and presence of structured and qualified support services. Factors inhibiting the search for help were immigrant status, cultural gender norms, feelings of guilt, fear, and shame, lack of confidence and little knowledge and/or limited availability of formal support services. Children as well as family and community support may function as both inhibitors or drivers of the search for help. The types of formal help most often sought are police and health care services, whereas family, community, and religious leadership provide informal support. Conclusion. The critical pathway of women facing domestic violence in the world includes both formal and informal elements. Therefore, it is necessary to address sociocultural, community, and family issues so as to encourage women to break free from the violent environment and seek qualified formal support networks.


[RESUMEN]. Objetivo. Conocer la ruta crítica que recorren las mujeres en situación de violencia doméstica en el mundo en su búsqueda de ayuda. Métodos. Revisión integradora, con una búsqueda realizada en las bases de datos LILACS, MEDLINE vía PubMed, BASE, Scopus y Web of Science. No hubo restricción en cuanto al año inicial de las publicaciones, pero se estableció el 2017 como el año final. Se incluyeron artículos de texto completo disponible en línea, publicados en español, inglés o portugués, que trataran del tema de investigación y respondieran a la pregunta orientadora (¿Cuál es la ruta crítica que recorren las mujeres en situación de violencia doméstica?). Resultados. Se incluyeron 38 artículos publicados desde el 2001 hasta el 2017. Entre los factores impulsores de la búsqueda de ayuda se encontraron el empoderamiento económico y el alto grado de escolaridad, la gravedad de la violencia y la existencia de servicios de apoyo estructurados y calificados. Como factores inhibidores se encontraron el hecho de que la mujer fuera inmigrante, la existencia de normas culturales de género, los sentimientos de culpa, miedo y vergüenza, la falta de confianza y el escaso conocimiento o la poca disponibilidad de servicios de apoyo formal. Los hijos y el apoyo de la familia y la comunidad pueden ser factores inhibidores o impulsores de la búsqueda de ayuda. Los tipos de ayuda formal más buscados son la policía y los servicios de salud, mientras que la familia, la comunidad y las autoridades religiosas se configuran como formas de apoyo informal. Conclusión. La ruta crítica que recorren las mujeres en situación de violencia doméstica en el mundo comprende la búsqueda de ayuda formal e informal. Por lo tanto, es preciso trabajar en los aspectos socioculturales, comunitarios y familiares para incentivar a las mujeres a desvincularse de la situación de violencia, lo cual incluye la búsqueda de una red de apoyo formal calificada.


Assuntos
Procedimentos Clínicos , Comportamento de Busca de Ajuda , Violência contra a Mulher , Maus-Tratos Conjugais , Violência Doméstica , Procedimentos Clínicos , Comportamento de Busca de Ajuda , Violência contra a Mulher , Maus-Tratos Conjugais , Violência Doméstica , Procedimentos Clínicos , Comportamento de Busca de Ajuda , Violência contra a Mulher , Maus-Tratos Conjugais , Violência Doméstica
12.
BMC Int Health Hum Rights ; 19(1): 9, 2019 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-30832664

RESUMO

BACKGROUND: Female sex workers, MSM, and transgender women-collectively referred to as key populations (KPs)-are disproportionately affected by gender-based violence (GBV) and HIV, yet little is known about the violence they face, its gender-based origins, and responses to GBV. The purpose of this study was to understand the nature and consequences of GBV experienced, to inform HIV policies and programming and to help protect KPs' human rights. METHODS: Using a participatory approach, FSWs, MSM, and transgender women in Barbados, El Salvador, Trinidad and Tobago, and Haiti conducted 278 structured interviews with peers to understand their experiences of and responses to GBV. Responses to open-ended questions were coded in NVivo and analyzed using an applied thematic analysis. RESULTS: Nearly all participants experienced some form of GBV. Emotional and economic GBV were the most commonly reported but approximately three-quarters of participants reported sexual and physical GBV and other human rights violations. The most common settings for GBV were at home, locations where sex work took place such as brothels, bars and on the street; public spaces such as parks, streets and public transport, health care centers, police stations and-for transgender women and MSM-religious settings and schools. The most common perpetrators of violence included: family, friends, peers and neighbors, strangers, intimate partners, sex work clients and other sex workers, health care workers, police, religious leaders and teachers. Consequences included emotional, physical, and sexual trauma; lack of access to legal, health, and other social services; and loss of income, employment, housing, and educational opportunities. Though many participants disclosed experiences of GBV to friends, colleagues and family, they rarely sought services following violence. Furthermore, less than a quarter of participants believed that GBV put them at risk of HIV. CONCLUSIONS: Our study found that across the four study countries, FSWs, MSM, and transgender women experienced GBV from state and non-state actors throughout their lives, and much of this violence was directly connected to rigid and harmful gender norms. Through coordinated interventions that address both HIV and GBV, this region has the opportunity to reduce the national burden of HIV while also promoting key populations' human rights.


Assuntos
Violência de Gênero , Infecções por HIV/epidemiologia , Profissionais do Sexo/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Estigma Social , Adulto , Região do Caribe/epidemiologia , Feminino , Direitos Humanos , Humanos , Entrevistas como Assunto , América Latina/epidemiologia , Masculino , Pesquisa Qualitativa
13.
Syst Rev ; 8(1): 59, 2019 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-30803436

RESUMO

BACKGROUND: Gender-based violence is a public health issue. The prevalence of gender-based violence is high in Sub-Saharan Africa. Therefore, this study aims to produce an overall summary estimate on the prevalence of gender-based violence according to different types and its risk factors among female youths in educational institutions of Sub-Saharan Africa. METHODS: Studies published in English between 2000 and 2017 were identified by searching electronic databases such as MEDLINE, CINAHL, EMBASE, PsychINFO, and other relevant data bases. Three reviewers independently extracted the data and assessed the quality of studies using the Loney guidelines. The pooled prevalence of gender-based violence and type of GBV was computed using STATA software version 14, and between studies heterogeneity was tested using Cochran's Q test and I2 statistics. Meta-regression analyses were done to identify factors associated with GBV estimates. RESULTS: A total of 1377 articles were produced from different databases, and a final 24 articles were included in the review. The overall prevalence of gender-based violence ranged from 42.3% in Nigeria to 67.7% in Ethiopia. The lifetime prevalence of sexual violence ranged from 4.3 to 76.4%, physical violence ranged from 7.4 to 66.1%, and emotional violence prevalence ranged from 26.1 to 50.8%. The overall pooled prevalence of lifetime GBV (n = 7 studies) was 52.83% [95% CI 39.54-65.90%, I2 = 99.1, P < 0.00]. The pooled estimate of sexual violence (n = 23), 26.22% [95% CI 19.48-33.57%, I2 = 99.39, P < 0.00], physical violence (n = 9), 18.86% [95% CI 10.96-28.3%, I2 = 98.98, P < 0.00], and emotional violence (n = 5), 27.06% [95% CI19.57-35.28%], I2 = 97.1, P < 0.00]. The review showed that gender-based violence was significantly associated with place of residence, witnessing parental violence, substance abuse, marital status, and educational status. CONCLUSIONS: The overall prevalence of overall gender-based violence, sexual, physical, and emotional violence was high in Sub-Saharan Africa. The lowest prevalence of GBV was observed in Nigeria, and it was highest in Ethiopia. However, the results should be interpreted with caution because of high between studies heterogeneity. Evidence from the review part revealed GBV was significantly associated with place of residence, witnessing parental violence, substance abuse, marital status, and educational status. The Sub-Saharan African countries should develop a comprehensive educational institution-based prevention strategy and effective interventions to mitigate gender-based violence and to specifically achieve the SDG5. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD4201073260.

14.
Trends Psychol ; 27(1): 127-139, Jan.-Mar. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-991760

RESUMO

Abstract The influence of gender on intimate partner violence (IPV) has been predominantly studied in opposite sex relationships. This article presents the results of a systematic literature review in which the aim was to understand how gender may affect not only the violence in same-sex IPV but also, and mostly, each element of the couple and third-party responses. The search was conducted in four electronic databases: B-on, PubMed, Sage and PsycINFO. From the analysis of seven articles selected, four major domains were identified in which gender affects these relationships: normalizing violence; difficulty in recognizing violence; difficulty in seeking help; and social isolation. It was concluded that gender, or gender role expectations, cannot be ignored while studying this phenomenon. More than influencing violence per se, gender shapes the way each element of the couple perceives their experiences and third-party perceptions (e.g., family, friends, justice system, and victims support services professionals), preventing an adequate social response to this form of violence.


Resumo A importância do gênero na violência na intimidade (VI) tem sido estudada, maioritariamente, nas relações entre pessoas de sexos diferentes. Este artigo é o resultado de uma revisão sistemática da literatura em que se procurou perceber a importância do gênero para a VI entre pessoas do mesmo sexo. Não só na violência em si, mas também e sobretudo nos elementos do casal e na forma como a sociedade responde a este problema. A pesquisa foi feita em quatro bases de dados eletrônicas: B-On, Pub-Med, Sage e PsycInfo. Da análise de sete artigos selecionados, resultaram quatro grandes domínios em que o gênero tem um peso importante nestas relações: normalização da violência; dificuldade em reconhecer a violência; dificuldade em pedir ajuda; e isolamento social. Concluiu-se que o gênero ou as expectativas sociais a si associadas não podem ser ignorados no estudo deste fenômeno. Mais do que influenciar diretamente a violência em si, molda não só a forma como os elementos do casal vivenciam a experiência, mas também as percepções sociais de terceiros (e.g. familiares, amigos/as, profissionais do sistema de justiça e dos serviços de apoio a vítimas), impedindo que haja uma resposta social adequada para este problema.


Resumen La importancia del género en la violencia en la intimidad (VI) ha sido estudiada, sobre todo, en las relaciones entre personas de distintos sexos. Este artículo resulta de una revisión sistemática de la literatura en la que buscamos comprender la importancia del género para la VI entre personas del mismo sexo, no solamente en la propia violencia, sino también, y sobre todo, en los elementos de la pareja y en la forma en cómo la sociedad responde a este problema. La búsqueda se hizo en cuatro bases de datos electrónicas: B-On, Pub-Med, Sage y PsycInfo. Del análisis de siete artículos seleccionados surgieron cuatro grandes dominios en los que el género tiene un peso importante en estas relaciones: normalización de la violencia; dificultad en reconocer la violencia; dificultad en pedir ayuda; y aislamiento social. Se concluyó que el género o las expectativas sociales con él relacionadas no pueden ser ignorados en el estudio de este fenómeno. Más que influir directamente a la propia violencia, él moldea no sólo el modo cómo los elementos de la pareja la viven, sino también las percepciones sociales de terceros (ej. familia, amigos/as, profesionales del sistema de justicia y de los servicios de apoyo a víctimas), impidiendo que se produzca una respuesta social adecuada a este problema.

15.
Psicol. soc. (Online) ; 31: e214338, 2019.
Artigo em Português | LILACS | ID: biblio-1020250

RESUMO

RESUMO Este artigo objetiva apresentar alguns dos efeitos produzidos em vivências, representações, afetos e relações de mulheres em situação de violência doméstica, a partir da participação em um grupo de acompanhamento. Primeiramente, expomos discussões teóricas sobre violência doméstica contra mulheres, trabalhos em grupos e construção de sentidos. O processo de intervenção/participação incluiu pesquisa de campo de natureza qualitativa. As protagonistas foram 19 mulheres que frequentaram, no primeiro semestre de 2017, um grupo de acompanhamento destinado a mulheres em situação de violência doméstica em uma sede do interior da Defensoria Pública do Estado do Paraná. Quanto a pressupostos teórico-metodológicos, pautamo-nos nas contribuições do movimento construcionista social. Por meio dos grupos focais, as mulheres narraram a construção de sentidos novos acerca de variados elementos que compõem suas existências. Nesse processo de mudanças, os trabalhos em grupos figuraram como instrumentais importantes de fortalecimento, resistência e criação de estratégias de enfrentamento à violência doméstica.


RESUMEN Este artículo tiene como objetivo presentar algunos de los efectos producidos en vivencias, representaciones, afectos y relaciones de mujeres en situación de violencia doméstica, a partir de su participación en un grupo de seguimiento. En primer lugar, exponemos discusiones teóricas sobre violencia doméstica contra mujeres, trabajos en grupos y construcción de sentidos. El proceso de intervención/participación incluyó investigación de campo de naturaleza cualitativa. Las protagonistas fueron 19 mujeres que frecuentaban, en el primer semestre de 2017, un grupo de seguimiento destinado a mujeres en situación de violencia doméstica en una sede del interior de la Defensoría Pública del Estado de Paraná. En cuanto a presupuestos teórico-metodológicos, nos basamos en las contribuciones del movimiento construccionista social. Por medio de los grupos focales, las mujeres narraron la construcción de nuevos sentidos sobre variados elementos que componen sus existencias. En ese proceso de cambios, los trabajos en grupos figuraron como instrumentos importantes de fortalecimiento, resistencia y creación de estrategias de enfrentamiento a la violencia doméstica.


ABSTRACT This article aimed to present some of the effects produced in experiences, representations, affections and relationships of women in situations of domestic violence, from their participation in a follow-up group. Firstly, we presented theoretical discussions about domestic violence against women, group work and the construction of meanings. The intervention/participation process included qualitative field research. The protagonists were 19 women who attended, in the first half of 2017, a follow-up group for women in situation of domestic violence in a seat inside the Public Defender's Office of the State of Paraná. As for theoretical-methodological assumptions, we were guided by the contributions of the social constructionist movement. Through the focus groups, they have narrated the construction of new meanings for the varied elements that make up their existences. In this process of change, the group work has been instrumental in strengthening, resiliency and the creation of coping strategies for domestic violence.


Assuntos
Humanos , Feminino , Grupos Focais , Violência Doméstica , Mulheres Maltratadas , Adaptação Psicológica
16.
Cad. Saúde Pública (Online) ; 35(9): e00174818, 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1019636

RESUMO

Intimate partner violence (IPV) is a worldwide public health problem. Many proposals aiming to eliminate its occurrence include the empowerment of women through their socio-economic development. In this context, some studies suggested that microcredit programs (MP) and cash transfer programs (CTP) are initiatives that can also reduce the risk of IPV. Others pointed to an opposite effect. The objective of this study was to investigate the influence of women's economic empowerment in MP and CTP on the risk of physical, psychological and sexual violence through a systematic review. Papers/documents selection was conducted by two researchers according to the following criteria: published in English, Portuguese or Spanish; primary data; assessing the effect of MP or CTP on IPV; in heterosexual couples; on women beneficiaries of the intervention; using a comparator group eligible for an MP or CTP; and focusing on risk IPV as the outcomes. Our results showed that the impact of MP are mixed when it comes to physical and physical/sexual violence. Even so, the review suggests that the effect of MP on sexual violence is trivial or nonexistent. Regarding the impact of CTPs, the present study showed that the effects on physical, physical/sexual, psychological, and sexual violence were also heterogeneous. Women more empowered and with some autonomy could be at risk. Despite that, participation in the empowerment program should be encouraged for poor women and families. However, parallel interventions to lead with IPV should be addressed to the main actions to reduce the risk of increasing IPV prevalence in certain scenarios.


A violência entre parceiros íntimos (VPI) é um problema de saúde pública de alcance global. Muitas propostas para eliminar a VPI incluem o empoderamento das mulheres através do desenvolvimento socioeconômico individual. Nesse contexto, alguns estudos sugerem que programas de microcrédito (PMC) e de transferência de renda (PTR) também podem reduzir o risco de VPI, enquanto outros apontam para um efeito oposto. Através de uma revisão sistemática, este estudo teve como objetivo investigar a influência do empoderamento econômico das mulheres através de PMCs e PTRs sobre o risco de violência física, psicológica e sexual. A seleção de artigos e documentos foi realizada por dois pesquisadores, com base nos seguintes critérios: publicação em inglês, português ou espanhol; dados primários; avaliação do efeito de PMC ou PTR sobre VPI; casais heterossexuais; mulheres beneficiárias da intervenção; uso de um grupo de comparação elegível para um PMC ou PTR e foco sobre o risco de VPI como o desfecho. Nossos resultados mostraram que o impacto dos PMCs é misto no que diz respeito à violência física e física/sexual. Contanto, a revisão sugere que o efeito dos PMCs sobre a violência sexual é trivial ou inexistente. Quanto ao impacto dos PTRs, o estudo mostrou que os efeitos sobre a violência física, física/sexual, psicológica e sexual também foram heterogêneos. As mulheres mais empoderadas e com alguma autonomia poderiam estar em risco maior. Entretanto, a participação no programa de empoderamento deve ser incentivada para as mulheres e famílias pobres. Intervenções paralelas para líder com a VPI devem focar nas principais medidas para reduzir o risco de aumento de prevalência de VPI em determinados cenários.


La violencia doméstica (VPI por sus siglas en portugués) es un problema de salud pública en todo el mundo. Las propuestas para eliminarla incluyen el empoderamiento de las mujeres a través de su desarrollo socioeconómico. Algunos estudios sugieren que los programas de microcrédito (PMCs) y de transferencia de renta (PTRs) son iniciativas capaces de reducir el riesgo de VPI. Otros estudios indican un efecto contrario. Basándonos en una revisión sistemática, el estudio procuró investigar la influencia del empoderamiento económico de las mujeres, a través de PMCs y PTRs, sobre el riesgo de violencia física, psicológica y sexual. Los artículos y documentos fueron seleccionados por dos investigadores, de acuerdo con los siguientes criterios: estudios publicados en inglés, portugués o español; datos primarios; evaluación del efecto del PMC o PTR sobre la VPI; parejas heterosexuales; mujeres beneficiarias de la intervención; un grupo de comparación elegible para un PMC o PTR y centrados en el riesgo de VPI como desenlace. De acuerdo con nuestros resultados, el impacto de los PMCs es mixto en lo que se refiere a la violencia física y física/sexual. No obstante, la revisión sugiere que el efecto de los PMCs sobre la violencia sexual es trivial o inexistente. En relación con el impacto de los PTRs, el estudio mostró que los efectos sobre la violencia física, física/sexual, psicológica y sexual también son heterogéneos. Las mujeres más empoderadas y con alguna autonomía podrían estar en riesgo. Sin embargo, la participación en el programa de empoderamiento debe incentivarse en el caso de las mujeres y familias pobres. Las intervenciones paralelas para combatir VPI deben dar prioridad a medidas para reducir el riesgo de aumento de la prevalencia de esta violencia en determinados contextos.

17.
PLoS One ; 13(12): e0207571, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30521548

RESUMO

BACKGROUND: Intimate Partner Violence (IPV) is a serious, preventable public health problem that affects millions of people worldwide. Research indicates that adults suffering from long term, disabling conditions are more likely to be victims of IPV due to the intersection of disease-associated stigma and discrimination. IPV in turn is known to worsen the overall health and wellbeing of those affected by it. Little research however explores the relationship between neglected tropical diseases such as podoconiosis and IPV. This study explores the relationship between IPV and podoconiosis in northern Ethiopia with the aim of identifying new avenues for limiting disability and promoting the wellbeing of people affected by this neglected tropical disease. METHODS: The study was conducted in East and West Gojjam zones, located in the Amhara Regional State of Ethiopia. Research participants were first screened using the domestic violence screening tool Hurt-Insult-Threaten-Scream (HITS). Data were collected by native speakers of the local language (Amharic) in the form of semi-structured interviews during January and February 2016. Thematic and content data analysis was carried out, using the Open Code 3.4 qualitative data analysis software for coding. RESULTS: A total of 15 women living with podoconiosis and experiencing IPV were interviewed (aged 31 to 75). Women experienced different forms of IPV, including beatings (with or without an object), insults, name calling, undermining, denial of equal rights over common assets, movement monitoring, cheating, abandonment, forced divorce, obstruction of health care access, inhibition of decision-making and sexual coercion. Podoconiosis increases the frequency and severity of IPV and in occasions shapes a change from physical to psychological and financial violence. In turn, frequent episodes of IPV worsen disease outcomes and contribute to disease persistence in the region, in that these impede women's ability to manage the disease and help perpetuate the conditions of poverty that influence disease onset. CONCLUSIONS: Women living with podoconiosis are victims of various, overlapping forms of IPV that negatively impact their health and wellbeing. Poverty, scarce IPV prevention services in the area together with a social acceptance of IPV and these women's decreased ability to work due to the debilitating effects of podoconiosis and childcare responsibilities frequently prompt these women to tolerate IPV and remain in abusive relationships. Tackling disease-associated taboo and stigma, developing accessible IPV interventions, working towards greater gender equality at the household and societal levels and developing sustainable strategies for improving the socio-economic assets of women affected by podoconiosis are all necessary to both prevent IPV and to improve disease outcome.

18.
PLoS One ; 13(11): e0207091, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30496217

RESUMO

INTRODUCTION: Harmful gender norms, views on the acceptability of violence against women, and power inequities in relationships have been explored as key drivers of male perpetration of intimate partner violence (IPV). Yet such antecedents have been inconsistently measured in the empirical literature. This systematic review aimed to identify which measures of gender inequitable norms, views, relations and practices are currently being used in the field, and which are most closely tied with male IPV perpetration. METHODS: We searched five electronic databases to identify studies published between 2000 and 2015 that reported the association between such gender inequities and male perpetration of IPV. Identified scales were categorized by content area and level of generality, as well as other attributes, and we compared the consistency of scale performance across each category. RESULTS: Twenty-three studies were identified, employing 64 measures. Scales were categorized into three main thematic areas: views on gender roles/norms, acceptance of violence against women, and gender-related inequities in relationship power and control. We also classified whether the scale was oriented to respondents' own views, or what they believed others do or think. While overall, measures were positively associated with IPV perpetration in 45% of cases, this finding varied by scale type. Measures inclusive of acceptance of violence against women or beliefs about men's sexual entitlement, followed by scales that measured respondents' views on gender roles/norms, were most consistently associated with IPV perpetration. Measures of relationship power showed less consistent associations. We found few scales that measured peer or community norms. CONCLUSION: Validated scales that encompass views on the acceptance of violence against women, and scales inclusive of beliefs about men's sexual entitlement, may be particularly promising for unpacking pathways to IPV perpetration, targeting interventions, and monitoring progress in IPV prevention efforts. A number of gaps in the literature are identified.

20.
S Afr Med J ; 108(8): 682-686, 2018 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-30182886

RESUMO

BACKGROUND: In South Africa (SA), HIV prevalence is significantly higher in young women than in young men. Intergenerational relationships and women's dependence on men are known HIV risks. OBJECTIVES: To qualitatively explore young women's perceptions and experiences of dating younger and older men and their perceived risks for gender-based violence. METHODS: From July to September 2011, we conducted eight focus group discussions (FGDs) and 20 in-depth interviews (IDIs) with young women aged 15 - 24 years. Women were recruited from two SA communities: one urban location in Gauteng Province and one rural location in Limpopo Province. All interviews were recorded, transcribed and translated from local languages into English. The study team then analysed the transcripts thematically, using an inductive approach, with ATLAS-ti (v6.2) software. RESULTS: In total, 110 young women participated, 20 of them in both the FGDs and the IDIs. Young men were viewed by the participants as immature, unable to provide financially and likely to be HIV-positive, although young women sought out young men for 'love', mutual understanding and intimacy. In contrast, older men were perceived as easy to respect, ready for marriage and able to provide for women's needs. Young women sought older men as providers, but acknowledged that older men were more likely to be violent and that discussing sexual and reproductive health and HIV with them was difficult. Young women expressed the belief that if a man was providing for them financially, he had 'the right' to use violence. CONCLUSIONS: The interviews highlighted young women's mixed views on the 'value' of older v. younger partners, and the perceived and real risks of violence in intergenerational relationships. There is a need for interventions addressing power dynamics in relationships, including healthy communication. However, to address young women's vulnerability to violence, ultimately young women and their families need access to economic opportunities that reduce dependence on transactional relationships.

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