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Silima M, Christofides N, Franchino-Olsen H, Woollett N, Meinck F. "I've accepted it because at the end of the day there is nothing, I can do about it": A qualitative study exploring the experiences of women living with the HIV, intimate partner violence and mental health syndemic in Mpumalanga, South Africa. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002588. [PMID: 38709813 PMCID: PMC11073682 DOI: 10.1371/journal.pgph.0002588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/08/2024] [Indexed: 05/08/2024]
Abstract
In South Africa, Mental Health (MH), HIV, and Intimate Partner Violence (IPV) form a syndemic, that disproportionately affects women. These challenges are often co-occurring and create complex adversities for women. Recognising these intersections and the broader socio-cultural dynamics at play is crucial to understanding the layered experiences of these women and developing effective interventions. This research explores the experiences of the women living with at least two of the epidemics (HIV, IPV and or MH) and how they cope. A qualitative study design was used and 20 women (22-60 years) were recruited from Mpumalanga, South Africa. To be eligible for the study the women had to have experienced at least two of the epidemics. Data were collected through home-based interviews, arts-based activities, and analysed thematically using MAXQDA (2022) software. MH challenges were prevalent among all the participants and were linked to both IPV and HIV, resulting in symptoms such as anxiety, depression, and suicidal thoughts. In relation to the HIV-MH link, MH challenges in this combination included feelings of denial, sadness and anxiety related to participant's HIV diagnosis. A bidirectional relationship also existed in the IPV-MH group where pre-existing MH challenges among women increased their vulnerability of having violent partners, whilst IPV also increased MH challenges. In the IPV-MH-HIV group early childhood violence exposure was linked with MH challenges and later victimization and vulnerability to HIV. Participants primarily used religion, acceptance, occasional alcohol, and family support as coping strategies. Particularly in IPV situations, alcohol use/misuse was the most prevalent coping strategies. The study highlights the syndemic relationship between HIV, IPV and MH challenges among South African women living in a peri-urban community, with a central emphasis on MH challenges. Interventions should holistically address these challenges, with particular focus on MH challenges, cultural sensitivity, and promotion of healthy coping strategies.
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Affiliation(s)
- Mpho Silima
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Hannabeth Franchino-Olsen
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
| | - Nataly Woollett
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Visual Arts, University of Johannesburg, Johannesburg, South Africa
| | - Franziska Meinck
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- School of Social and Political Sciences, University of Edinburgh, Edinburgh, United Kingdom
- School of Health Sciences, North-West University, Vanderbijlpark, South Africa
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Chadambuka C. Coping Strategies Adopted by Women Who Experienced Intimate Partner Violence in the Context of Social Norms in Rural Areas in Zimbabwe. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:2776-2800. [PMID: 32697141 DOI: 10.1177/0886260520943734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Intimate partner violence (IPV) has detrimental effects on the welfare of women. Research on the coping strategies employed by rural women in Zimbabwe is notably lacking, despite the fact that the majority of Zimbabwean women reside in rural areas. Therefore, this study sought to explore the strategies that women in rural areas used to manage and cope with IPV. The study adopted a qualitative research approach, and participants were recruited through the purposive sampling method in Chimanimani Rural District, Eastern Highlands, Zimbabwe. Face-to-face interviews using a narrative approach were conducted with 25 women between 19 and 49 years and seven key informants. The 25 women consisted of women who had left abusive relationships and were selected on the basis that they should have experienced IPV in their former relationships. Current IPV victims were excluded from the study. All the interviews were recorded, with participants' consent, to avoid loss of data. Data was analyzed by the author and an additional independent data analyst using thematic analysis. Findings from this study revealed that social norms influenced participants' covert coping behavior, which include acceptance of abuse and prayer. There is need to strengthen the existing coping strategies that are utilized by women as these could be the starting point for intervention efforts. This is important as it enables practitioners to develop context-specific and context-driven intervention strategies that will effectively serve the victims in their distinctive situation(s).
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Tullio V, Lanzarone A, Scalici E, Vella M, Argo A, Zerbo S. Violence against women in heterosexual couples: A review of psychological and medico-legal considerations. MEDICINE, SCIENCE, AND THE LAW 2021; 61:113-124. [PMID: 33591871 DOI: 10.1177/0025802420936081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Intimate partner violence against women (IPVAW) is the most pervasive violation of women's rights worldwide, causing devastating lifelong damage. Victims can suffer physical, emotional or mental health problems, and experience detrimental effects in social, psychological and relational health with their families, especially children. Due to the complexity regarding violence against women in heterosexual couples, it is important to make a clear distinction between psychological and physical mistreatment, which also includes psychological violence. This differentiation is important in determining different emotional and psychological aspects of mistreatment in order to understand the reasons why some women stay in such relationships and to explain the personality profiles of victims and perpetrators. In this short narrative review, we have combined perspectives of depth psychology and attachment theory from studies on trauma, traumatic bonds and the perpetrator/victim complex in gender violence. We have also considered the growing literature on IPVAW as it relates to the medico-legal field. Our search strategy included intimate partner violence, attachment styles, risk factors and the victim/perpetrator relationship. Distinguishing the different types of IPVAW is a necessary step in understanding the complexity, causes, correlations and consequences of this issue. Above all, it enables the implementation of effective prevention and intervention strategies.
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Affiliation(s)
- Valeria Tullio
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties - Medico Legal Section, University of Palermo, Italy
| | - Antonietta Lanzarone
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties - Medico Legal Section, University of Palermo, Italy
| | - Edoardo Scalici
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties - Medico Legal Section, University of Palermo, Italy
| | - Marco Vella
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Italy
| | - Antonina Argo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties - Medico Legal Section, University of Palermo, Italy
| | - Stefania Zerbo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties - Medico Legal Section, University of Palermo, Italy
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Yun JY, Shim G, Jeong B. Verbal Abuse Related to Self-Esteem Damage and Unjust Blame Harms Mental Health and Social Interaction in College Population. Sci Rep 2019; 9:5655. [PMID: 30948757 PMCID: PMC6449380 DOI: 10.1038/s41598-019-42199-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 03/27/2019] [Indexed: 12/14/2022] Open
Abstract
Verbal abuse is an emotional abuse intended to inflict intense humiliation-denigration-fear as perceived by exposed person. Network-based approaches have been applied to explore the integrative-segregated patterns of associations among the psychological features and external stimuli for diverse populations; few studies reported for verbal abuse effects in college population. Self-reporting measurements acquired form 5,616 college students were used for network analyses. Escalating cascades of verbal abuse from differential sources (parents, peers, or supervisors; network 1) and directed associations among verbal abuse severity-psychopathology-social interaction (network 2) were estimated using the directed acyclic graphs. Principal connectors of verbal abuse–psychopathology–social interaction were shown using the graph theory metrics calculated from the intra-individual covariance networks (network 3). Directed propagating patterns of verbal abuse phenomena differed by source (network 1). Severe peer-related verbal abuse affected psychomotor changes and influenced irritability (network 2). Verbal abuse of self-esteem damage and unjust blame served as connectors in the verbal abuse-psychopathology-social interaction; influence of smartphone overuse-related distress was stronger in cases with more severe verbal abuse (network 3). Verbal abuse that damages self-esteem and conveys unjust blame harms mental health and social interaction for college population.
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Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea.,Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Geumsook Shim
- KAIST Clinic Pappalardo Center, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Bumseok Jeong
- KAIST Clinic Pappalardo Center, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea. .,Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea. .,KAIST Institute for Health Science and Technology, KAIST, Daejeon, Korea.
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Shavaki MA, Harandi TF, Pourabbasi A, Rahimzadeh M. Coping strategies in Iranian mothers of children with type 1 diabetes. J Diabetes Metab Disord 2019; 17:137-142. [PMID: 30918847 DOI: 10.1007/s40200-018-0352-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/14/2018] [Indexed: 11/29/2022]
Abstract
Purpose Having a child with type 1 diabetes as a stressor causes the use of coping strategies in mothers. The aim of this study was to investigate the coping strategies in mothers of children with type 1 diabetes and their relationship with stress management. Methods This study was conducted on mothers of children with type 1 diabetes (N = 180) in Tehran and Karaj (Iran). Data were collected by a multi-sectional questionnaire that its validity and reliability were confirmed. Data were analyzed by SPSS software (v 19) and using statistical tests. Results The highest mean score was related to problem-focused coping (22.11) and the lowest was related to emotion-focused coping strategies (12.2). Regression model showed that the variables of mother's age, problem- focused coping, and meaning-based coping had a positive effect, and variables of father's age and emotion-focused coping had a negative effect on stress management in mothers. Conclusion Mothers of children with type 1 diabetes can be more successful in their stress management through using problem-focused and meaning-based coping approaches. Hence, the need for continuous education of effective coping strategies to these mothers is felt.
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Affiliation(s)
| | - Tayebeh Fasihi Harandi
- 2Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Ata Pourabbasi
- 3Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Rahimzadeh
- 2Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Hatcher AM, Stöckl H, Christofides N, Woollett N, Pallitto CC, Garcia-Moreno C, Turan JM. Mechanisms linking intimate partner violence and prevention of mother-to-child transmission of HIV: A qualitative study in South Africa. Soc Sci Med 2016; 168:130-139. [PMID: 27643847 DOI: 10.1016/j.socscimed.2016.09.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/08/2016] [Accepted: 09/09/2016] [Indexed: 01/10/2023]
Abstract
Prevention of mother-to-child transmission (PMTCT) can virtually eliminate HIV infection among infants, yet up to one-third of women miss PMTCT steps. Little is known about how partner dynamics such as intimate partner violence (IPV) influence pregnant and postpartum women's adherence to PMTCT. We conducted 32 qualitative interviews with HIV-positive pregnant and postpartum women in Johannesburg who experienced IPV. Trained researchers conducted in-depth interviews over the period of May 2014-Nov 2015 using narrative and social constructionist approaches. Interviews were transcribed verbatim and analyzed thematically and inductively using Dedoose qualitative software. Twenty-six women experienced recent IPV and one-third had poor adherence to PMTCT. Women's experience of partner violence influenced PMTCT behaviors through four pathways. First, fear of partner disclosure led some women to hide their HIV status to avoid a violent reaction. Despite strategic non-disclosure, several maintained good adherence by hiding medication or moving out from their partner's home. Second, IPV caused feelings of depression and anxiety that led to intentionally or accidentally missing medication. Five women stopped treatment altogether, in a type of passive suicidality, hoping to end the distress of IPV. Third, men's controlling behaviors reduced access to friends and family, limiting social support needed for good adherence. Fourth, in a protective pathway, women reported good adherence partly due to their mothering role. The identity around motherhood was used as a coping technique, reminding women that their infant's wellbeing depended on their own health. PMTCT is essential to prevent vertical HIV transmission, but women living with IPV face multiple pathways to non-adherence. Addressing IPV in antenatal care can support the health of women and infants and may enhance PMTCT coverage.
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Affiliation(s)
- A M Hatcher
- Wits School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Johannesburg, South Africa; Division of HIV/AIDS, University of California San Francisco, San Francisco, United States.
| | - H Stöckl
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, England, United Kingdom
| | - N Christofides
- Wits School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - N Woollett
- Wits Reproductive Health & HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - C C Pallitto
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - C Garcia-Moreno
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - J M Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
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