Browsing by Subject "Gender-based violence"

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    Adapting an evidence-based HIV behavioral intervention for South African couples
    (Biomed Central Ltd, 2015) Wechsberg, Wendee; El-Bassel, Nabila; Carney, Tara; Browne, Felicia; Myers, Bronwyn; Zule, William
    BACKGROUND: In South Africa, heterosexual couples are at risk for HIV infection and transmission through substance use, gender-based violence and traditional gender roles, and sex risk behaviors such as having multiple partners and unsafe sex. METHODS: To address these interconnected HIV risks among heterosexual couples, we used the ADAPT framework to modify an existing, efficacious women's HIV prevention intervention (the Western Cape Women's Health CoOp) to include components of an evidence-based couple's intervention from the United States (Project Connect) and components from the Men as Partners program that has been used successfully in South Africa. We conducted focus groups with men, women and couples, and obtained feedback from a long-standing Community Collaborative Board (CCB) to guide the synthesis of elements of these three interventions into a new intervention. We then piloted the adapted intervention for feasibility and acceptability. RESULTS: The new intervention is called the Couples' Health CoOp. This intervention targets men who use alcohol and other drugs and engage in unprotected sex, and their main female sex partners. The intervention addresses substance use, sex risk, HIV and other sexually transmitted infections, gender roles, gender-based violence, communication skills, and goal-setting activities to increase sexy (eroticize) safe-sex behaviors. The Couples' Health CoOp also includes "voices" from the focus group members to ground the intervention in the experiences of these at-risk couples. In addition, it utilizes a participant handbook that reiterates workshop content and includes homework assignments for couples to complete together to increase problem-solving skills within their relationship, and to improve their sexual relationship and help sustain HIV risk-reduction strategies. All of these adaptations were based on participants' suggestions made during formative work and pilot testing. CONCLUSIONS: The Couples' Health CoOp is a couple-based HIV prevention intervention that targets alcohol and other drug use to reduce sexual risk, reduce gender-based violence and offer alternatives for conflict resolution, promote healthy relationships, and modify traditional gender roles in South Africa.TRIAL REGISTRATION NUMBER:NCT01121692.
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    Protection Orders in South Africa: The Effectiveness of Implementation and Enforcement for Victims of Gender-based Violence
    (2021) Ncube, Mongiwa Pamela; Barratt, Amanda
    This study's focus is aimed at determining the effectiveness of a protection order (PO) in South Africa obtained against gender-based violence (GBV). This legal instrument's function is to protect victims against further violation from the perpetrator. The Domestic Violence Act 116 of 1998 (DVA), grants victims the right to a PO. However, the enormous number of GBV cases in South Africa continues to increase. This alludes to South Africa's lack of adequate implementation and enforcement, in contradiction of its constitutional obligation to protect. The continued prevalence of GBV requires an investigation of whether preventative legal instruments, such as the PO, are fulfilling their purpose and the judicial implications of failure to provide protection. This study examined the international human rights law obligation South Africa has to promote and fulfil the right to protection against GBV. Extensive existing research confirms that victims of GBV, statistically, are likely to be female. It was vital to examine obligations that South Africa has assumed through regional legal mechanisms, as they similarly guide implementing protective measures against GBV. The national legal framework was revisited and the provisions in the DVA were reassessed to give a clear indication of the PO processes. The outcome of the study revealed that South Africa's PO process provisions in the DVA, have enabled South Africa to comply with its international, regional and domestic obligation to safeguard victims against GBV. However, there are glaring shortcomings in the implementation of the PO machinery. Law enforcement and prosecuting authority were found to be major contributors to these shortcomings. The research found that several of these essential service providers are challenged with full adherence to the provisions regarding the granting of the PO. These shortcomings have the effect that, in practice, South Africa has failed to comply with its obligations to international and regional human rights treaties and the South African Constitution. This study recommends ways in which POs can be applied more successfully in South Africa. The study suggests revised and strengthened legal processes, and more effectively informed intervention strategies.
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    Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women
    (BioMed Central, 2023-06-22) Nguyen, Kim A.; Myers, Bronwyn; Abrahams, Naeemah; Jewkes, Rachel; Mhlongo, Shibe; Seedat, Soraya; Lombard, Carl; Garcia-Moreno, Claudia; Chirwa, Esnat; Kengne, Andre P.; Peer, Nasheeta
    Abstract Background The association of traumatic experiences with problematic alcohol use has been described, but data on possible mediation effects of mental distress are sparse. We examined whether mental ill-health mediated the association between trauma exposure across the lifespan and alcohol use. Method We analysed cross-sectional data from a sample of rape-exposed and non-rape-exposed women, living in KwaZulu-Natal, with self-reported data on alcohol misuse (AUDIT-C cut-off ≥ 3) and exposure to childhood maltreatment (CM), intimate partner violence (IPV), non-partner sexual violence (NPSV), other traumatic events, and mental ill-health. Logistic regression and multiple mediation models were used to test the mediation effects of symptoms of depression and PTSS on the association between abuse/trauma and alcohol misuse. Results Of 1615 women, 31% (n = 498) reported alcohol misuse. Exposure to any CM (adjusted odds ratio (aOR): 1.59, 95% confidence interval (CI): 1.27–1.99), as well as to sexual, physical and emotional CM, were independently associated with alcohol misuse. Lifetime exposure to any IPV (aOR:2.01, 95%CI:1.59–2.54), as well as to physical, emotional and economic IPV, NPSV (aOR: 1.75, 95%CI: 1.32–2.33), and other trauma (aOR:2.08, 95%CI:1.62–2.66), was associated with alcohol misuse. Exposure to an increasing number of abuse types, and other traumatic events, was independently associated with alcohol misuse. PTSS partially mediated the associations of CM, IPV, NPSV and other trauma exposures with alcohol misuse (ps ≤ 0.04 for indirect effects), but depression symptoms did not. Conclusions These findings highlight the need for trauma-informed interventions to address alcohol misuse that are tailored to the needs of women who have experienced violence.
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    The Young Women’s Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV
    (BioMed Central, 2018-07-11) Wechsberg, Wendee M; Browne, Felicia A; Carney, Tara; Myers, Bronwyn; Minnis, Alexandra; MacDonald, Robert; Ndirangu, Jacqueline W; Turner, Leslie B; Howard, Brittni N; Rodman, Nathaniel
    Background South Africa remains the global epicentre of HIV infection, and adolescent women have the highest incidence of HIV in the country. South Africa also has high rates of alcohol and other drug (AOD) use, violence, and gender inequality. Violence converges with AOD use, gender inequities and other disparities, such as poverty, to increase sexual risk and poor educational attainment for adolescent women. This study seeks to test the efficacy of peer recruitment and cofacilitation of the Young Women’s Health CoOp (YWHC), a comprehensive gender-focused intervention to reduce HIV risk behaviours and increase the uptake of HIV counselling and testing (HCT) among out-of-school, adolescent women who use AODs. The YWHC is facilitated by local research staff and supported by peers. Methods This cluster-randomised trial is enrolling participants into two arms: a control arm that receives standard HCT, and an intervention arm that receives the YWHC. Participants are enrolled from 24 economically disadvantaged communities in Cape Town, South Africa. These geographically distinct communities serve as clusters that are the units of randomisation. This study uses adolescent peer role models and research field staff to recruit marginalised adolescent women. At baseline, participants complete a questionnaire and biological testing for HIV, recent AOD use, and pregnancy. The core intervention is delivered in the month following enrollment, with linkages to health services and educational programmes available to participants throughout the follow-up period. Follow-up interviews and biological testing are conducted at 6 and 12 months post enrollment. Discussion The study findings will increase knowledge of the efficacy of a comprehensive HCT, gender-focused programme in reducing AOD use, victimisation, and sexual risk behaviour and increase uptake services for out-of-school, adolescent women who use AODs. The trial results could lead to wider implementation of the YWHC for vulnerable adolescent women, a key population often neglected in health services. Trial registration Trial registration no: NCT02974998 , November 29, 2016.