Spatial Analysis of the Alcohol, Intimate Partner Violence, and HIV Syndemic Among Women in South Africa

Intimate partner controlling behaviour and intimate partner violence among married women in rural areas in South Africa

BACKGROUND

Violence against women is a critical public health issue, and Intimate Partner Violence (IPV) is prevalent globally as its predominant form. Despite extensive research on its prevalence, the connection between IPV and controlling behaviour has not been sufficiently researched, especially within the context of rural living. This study contributes to this gap by assessing the relationship between intimate partner controlling behaviour and IPV among rural dwellers in South Africa.

METHODS

The study used the domestic violence module data from the 2016 South Africa Demographic and Health Survey (SADHS). The data were analysed using both descriptive statistics- percentages, mean, and standard deviation- and inferential statistics-logistic regression.

RESULT

The study found intimate partner controlling behaviour as a predictor of IPV among married women residing in rural communities in South Africa. Accusations of infidelity, restrictions on seeing family members, general movement control, and jealousy were the forms of intimate partner controlling behaviour that predicted the occurrence of IPV.

CONCLUSION

Intimate partner controlling behaviour is associated with intimate partner violence. Based on this finding, we argue that preventative, and responsive approaches that combine education, awareness raising, pathways to help seeking, women's personal development and empowerment will have greater benefits in helping to tackle the problem of controlling behaviour and intimate partner violence against rural women in South Africa.

Prevalence, locations and predictors of attitudes accepting both intimate partner violence and additional forms of violence against women and girls in South Sudan: a geospatial analysis

Most research on violence against women and girls (VAWG) in South Sudan has focused on intimate partner violence (IPV) neglecting other forms of VAWG. This research aims to determine the prevalence of attitudes accepting IPV and whether it overlaps with attitudes accepting additional forms of VAWG (child marriage, raiding villages for women during cattle rustling or other raids or female genital mutilation) in South Sudanese men and women, or are different attitudinal phenomena. We used data from the National Household Survey South Sudan 2020 (n = 1,732 women, n = 1,730 men aged 15-49 years). We estimated attitudinal prevalences and applied spatial analysis (Global Moran's I, Getis and Ord's local Gi*, and Kuldorff's SatScan) and multilevel regression to assess overlapping attitudes accepting IPV and at least one other form of VAWG studied in the 10 states and three administrative areas comprising the country. The prevalence of attitudes accepting IPV overlapping with the prevalence of attitudes accepting at least one other form of VAWG was 34.72% (95% CI = 33.14%-36.34%). Sub-national results were non-randomly correlated (Global Moran's I= 0.23). Higher clusters displaying overlaps were located in the counties Kapoeta East, Kapoeta South, Kapoeta North, Budi, Pibor, and Ikotos. People married, cohabiting or living together (aOR = 1.40, 95% CI = 1.04-1.90) as well as people widowed, divorced or separated (aOR = 1.75, 95% CI = 1.05-2.93) were associated with attitudinal overlaps. Conversely, communities with any formal education were associated with a lower odds of overlapping (aOR = 0.26. 95% CI = 0.09-0.70). In South Sudan overlapping acceptance of IPV and at least one other form of VAWG are spatially clustered. Therefore, strategies to understand and tackle them should be strengthened especially in those locations. Essential elements include increasing schooling for children and promoting women's empowerment, especially among male-female partnerships. These conclusions have national and international policy implications.

Intimate partner violence among Nepalese women and associated factors in 2021-2022

Intimate partner violence (IPV) remains a significant public health challenge globally, impacting millions and contributing to preventable suffering and pain, both emotionally and physically. In Nepal, like many other nations, tackling IPV is a key priority on the path to achieving sustainable development goals. IPV prevalence and its correlates were studied using the deidentified data for secondary analysis from the 2022 Nepal Demographic and Health Survey (DHS), and changes in IPV at the urban, rural, and national levels from the 2016 Nepal DHS. These cross-sectional surveys employed a two-stage cluster sampling technique. In the Nepal DHS 2022, a total of 4,523 ever-partnered women were included and administered IPV-related questions. Various socio-demographic, attitudinal, and experiential attributes of 15-49 year old women were identified and used in the simple and multiple logistic regression models for computing the bivariate and multivariable associations with IPV. Over their lifetime, 27.27% women experienced IPV perpetrated by their current or most recent husband/intimate partner, with physical IPV being the most common type reported. The six statistically significant factors associated with IPV in the multivariable model included educational level of women and their partner, number of living children, use of alcohol by partner, knowing about father having ever beaten mother, and controlling behavior displayed by partner. While changes in IPV from 2016 to 2022 were not statistically significant. One in four women having experienced IPV in their lifetime in Nepal with no discernable change over the course of 6-years is a major public health challenge requiring investing in programs that encourage and ensure economic and social autonomy for women and change in the harmful gender norms.

Gender-based violence syndemics in global health: A systematic review

Global guidance indicates that protections for gender and equity issues, such as gender-based violence (GBV), should be mainstreamed across sectors. One novel strategy that can be leveraged to illustrate the cross-cutting impacts of GBV is to investigate GBV syndemically. This systematic review identified, evaluated, and synthesized quantitative studies conducted in LMICs that tested syndemic theories involving GBV. A systematic search of the peer-reviewed literature was conducted in Medline, Global Health, Scopus, Anthro Source, Anthropology Plus, Web of Science, PsychInfo, and Gender Watch. Peer-reviewed empirical research published in English that used quantitative methods to test syndemic theories involving GBV in LMICs were included. 4068 references were retrieved, 2160 studies were screened against their titles/abstracts, and 227 studies were assessed for full text eligibility. Overall, 45 studies met the inclusion criteria. Most articles conceptualized GBV as an exposure that clustered with other epidemics. More than half of the evidence base investigated combinations of GBV, mental health, substance use, and HIV/AIDS. Research articles investigating the SAVA syndemic among men who have sex with men (MSM) and transgender women provided the strongest evidence, particularly in India. Notable analytical gaps pertained to GBV measurement challenges and statistical approaches to test contextual factors in LMICs. The current evidence base is predominantly focused on GBV syndemic models that inform response/harm mitigation efforts rather than prevention. Future research should concentrate on how the political environment perpetuates clustering and interactions, expanding the contexts studied beyond upper middle-income countries, and improving methodological rigor in terms of GBV measurement.

Prevalence, Correlates, and Trends of Intimate Partner Violence Against Women in Cambodia: Findings From 2014 and 2021-22 Cross-Sectional Demographic and Health Surveys

Intimate partner violence (IPV) is globally endemic and a gross violation of human rights, in addition to abuse of intimacy by some men against their female intimate partners. Based on literature review, attitudinal, socio-demographic, and experiential attributes of 15 to 49 year old ever partnered women in the heterosexual relationships were identified. This study used the anonymized 2020-21Cambodia Demographic and Health Survey (CDHS) data to compute the IPV prevalence and its correlates, in addition to computing the changes in IPV prevalence at the urban, rural, and at the national levels using data from the 2014 CDHS. Identified attitudinal, socio-demographic, and experiential attributes were used in the bivariate and multivariable analysis. Simple and multiple logistic regression models were used for computing the bivariate and multivariate associations with IPV; additionally, trend analysis was done to compute changes in IPV prevalence between the 2 surveys. Lifetime prevalence of IPV was 20.70%, while the most common subtype was emotional IPV at 18.70%. Ten out of 12 correlates studied were found to be statistically significantly associated with IPV in the bivariate analysis. These were added in the multivariable model and 7 were found to be statistically significantly associated with IPV. Which included educational attainment of women and their intimate partners, number of living children, women's IPV acceptance, male partner's alcohol use, knowledge of physical beating of mother by one's father, and controlling behavior exercised by partner. During the intervening period between the 2 CDHSs, IPV and its subtypes were decreased in both urban and rural areas, as well as nationally. IPV decrease between the 2 DHSs and lower IPV rates in 2021-22 augur well for the health and human rights of Cambodian women. However, the ultimate target of eliminating IPV against women, will require measures that ensure economic and gender empowerment, and gender equality.

Prevalence, correlates, and trends of intimate partner violence against women in Sierra Leone: findings from 2013 and 2019 demographic and health surveys

Background

Intimate partner violence (IPV) is a globally pervasive public health and medical problem in addition to being a serious violation of women's rights. The two-fold objectives of this study were to compute the lifetime prevalence and correlates of IPV perpetrated by current/former husbands/partners of ever-married women aged 15-49 years using the nationally representative Sierra Leone Demographic and Health Survey (DHS) conducted in 2019; ethnicity-based levels and trends of IPV were also computed using the data from the DHS conducted in 2013 along with the 2019 DHS.

Methods

Twelve IPV correlates pertaining to socio-demographic, attitudinal, and experiential attributes were analyzed using logistic regression models for bivariate and multivariable analysis. IPV was computed as a composite variable comprising of physical, emotional, and/or sexual IPV.

Results

Lifetime prevalence of experiencing any kind of IPV was a staggering 60.81%, whereas emotional, physical, and sexual IPV prevalence were reported by 45.90%, 49.81%, and 8.14% of the respondents, respectively. No ethnicity reported a statistically significant decrease in any type of IPV during the intervening period between the two surveys. Five out of nine ethnicities reported a statistically significant increase in emotional IPV, while few ethnicities reported a statistically significant increase in one or more types of IPV.

Conclusion

The high lifetime prevalence of IPV is alarming and points to the need for targeted health promotion campaigns to reverse the tide of IPV in Sierra Leone, including focusing on changes in cultural and ethnicity-based norms and mores to ensure women's human rights are respected and upheld.