Browsing by Subject "Intimate Partner Violence"

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    Intimate partner violence among HIV-infected pregnant women initiating antiretroviral therapy in South Africa
    (2015) Bernstein, Molly; Myer, Landon; Gevers, Anik
    Background: Intimate Partner Violence (IPV) is recognized globally as a major public health concern linked to numerous adverse physical, mental, sexual and reproductive health outcomes. IPV is associated with both pregnancy and HIV-infection independently, but there are few data on IPV in populations of HIV-infected pregnant women. We examined the prevalence and predicators of IPV among pregnant women initiating lifelong antiretroviral therapy (ART) in a large primary care clinic in Cape Town, South Africa. Methods: Consecutive pregnant women seeking antenatal care in Gugulethu, Cape Town were recruited into the MCH-ART study examining service models for postpartum ART care. IPV, depression, alcohol and drug use, and emotional distress were assessed using the 13-item WHO Violence Against Women questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), alcohol and drug use disorders identification test (AUDIT/DUDIT) and the Kessler-10 (K-10) scale, respectively. Questionnaires were administered privately by trained interviewers. Women identified with specific IPV or mental health concerns were referred to appropriate services. Logistic regression was used to examine factors independently associated with experiences of IPV after adjusting for age and socioeconomic status. Results: From April 2013-May 2014, 623 women were enrolled (median age, 28 years):97% reported being in a relationship, 38% were married and/or cohabiting and 70% reported not having discussed or agreed on pregnancy intentions prior to conception . Overall, 21%(n=132) reported experiencing ≥ 1 act of IPV in the past 12 months, including emotional violence(15%), physical violence(15%) and sexual violence(2%). Of those reporting any IPV, 48% reported experiencing multiple types. Emotional and physical violence were most prevalent among women 18-24 years old, while sexual violence was most commonly reported among women 25-29 years old. Women who reported not discussing or disagreeing on pregnancy intentions with their partners prior to conception were significantly more likely to experience violence(p=0.030), and women who experienced IPV reported higher levels of substance abuse, depression and emotional distress(p<0.001 for all associations). Discussion: These data demonstrate high levels of IPV in this population. While the potential impact of HIV-infection, pregnancy and pregnancy intention on the risk of IPV and related factors require further research, IPV-related screening and support services should be considered as part of the package of care for ART in pregnancy.
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    Respectability, morality and reputation: social representations of intimate partner violence against women in Cape Town
    (2015) Van Niekerk, Taryn Jill; Boonzaier, Floretta
    This study examined the social representations of intimate partner violence (IPV) that emerged amongst violent men, their social networks and within the media, and framed within social representations theory and feminist poststructuralism. In-depth individual interviews were conducted with 11 men, recruited from two men's programmes at an NGO, and seven focus group discussions were conducted with the men's social networks. A total of 11 3 reports on violence against women were collected from two newspapers that draw the largest readership in the Cape Town area. A thematic decomposition analysis - emphasising language, power and subjectivity - revealed how participants' representations of respectability, morality, and reputation served to maintain patriarchy, and make violence permissible. The findings also shed light on the polarity of human thought, demonstrating how 'non-valid' victims of IPV are blamed and 'othered' for the violence perpetrated against them; yet in contrast, men who perpetrate violence are protected and defended. Understanding violence as an intersectional experience - defined by race, class, gender and sexuality in the context of post-apartheid South Africa - is central to the analysis. This study employed an integrated and unique methodology to sample men, their networks and printed media reports, which involved an analysis of violence as a social act. To my knowledge, it is the first study to have asked questions about what social representations of intimate partner violence emerge in men and their social networks' narratives and how these resonate in South African media's discourses. Suggestions for prevention and community-based programmes, interventions for perpetrators and victims of intimate partner violence, and practical recommendations for improved journalistic practice are provided. The community, relationships and individuals are shown to be inseparable spheres, and the contextualised analyses of power and oppression are shown to open possibilities for social change.
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    The effects of sexual trauma, intimate partner violence (IPV) and mental health on early versus late antiretroviral therapy (ART) initiation amongst women in South Africa
    (2024) Crookes, Charles; Joska, John
    OBJECTIVES This study had two objectives. Firstly, to determine the prevalence of physical and sexual IPV, sexual trauma and mental health symptoms in a sample of women initiating ART at two primary healthcare facilities in Khayelitsha, Cape Town. Secondly, to investigate associations between socio-demographics, sexual trauma and mental health variables on ART initiation times. METHODS This study used data from participants screening into a larger RCT of an intervention for 16 sexual trauma in women living with HIV (WLWH). This study incorporated a cross-sectional data analytic design. Electronically administered surveys collected data on demographics (age and pregnancy status), sexual trauma, physical and sexual IPV, mental health symptoms (depression, PTSD and suicidality). The outcome of interest included firstly the intention to determine the prevalence of trauma experiences and mental health symptoms in this sample of women initiating ART at two primary health care facilities in Khayelitsha. Secondly, to investigate for associations of significance between the demographic, trauma and mental health variables on ART initiation times. Early initiation was defined as ART commencement within 21 days from HIV diagnosis and late was after 21 days from diagnosis. RESULTS In total, 170 participants were included in this study. The mean age of participants was 30.65 (SD = 8.7). Most of the participants (80%) were initiated on ART early. Lifetime sexual trauma was reported by 38,2 % (n = 65). More than half the participants reported physical and or sexual IPV (57%; n = 97), more than a third reported depressive symptoms (39,4%; n = 67), half reported PTSD symptoms (50%; n = 85) and acute, high risk, suicidality was noted in (4,7%; n = 9) of the participants. In both univariate and multivariate analysis, no associations between demographic, mental health variables and most notably sexual trauma with ART initiation time were found. Logistic regression also found no association with the variables when compared with early versus late ART initiation. CONCLUSION Despite the high prevalence of sexual trauma and lifetime physical and sexual IPV, no 17 association with delays to ART initiation were found. This study could have been limited by its small sample size and we recommend future studies explore the effects of the variables in broader samples and in other areas of South Africa