The global prevalence of sexual violence against pregnant women: a systematic review and meta-analysis

Experiences of intimate partner violence and antepartum depression among women seeking antenatal care in Addis Ababa, Ethiopia: findings from the MISPOD study

Despite the high prevalence of intimate partner violence (IPV) and antepartum depression, there is limited evidence on the association between the two in Ethiopia. We aimed to investigate the association between experience of IPV during and before pregnancy and depression in the third trimester of pregnancy. We surveyed women attending antenatal care clinics in 22 selected health facilities in Addis Ababa in the third trimester of pregnancy. We used a 12-item tool to measure IPV and the Edinburgh Postnatal Depression Scale (EDPS) to measure antepartum depression. We performed multivariable logistic regression analysis to determine the association between IPV and antepartum depression. Of the 399 women included, 14.5% (95% CI: 11.3-18.5%) had symptoms suggestive of antepartum depression (EDPS score ≥ 11) and 31.6% (95% CI: 27.1-36.4%) had recently experienced some form of IPV. The adjusted odds of antepartum depression was 2.24 higher among women who had experienced IPV compared to those who had not (95% CI: 1.11-4.54). Antepartum depression was higher among women aged 15-24 compared to those aged 25-34 (AOR = 2.76, 95% CI: 1.05, 7.23), women with low maternal social support compared to those with adequate support (AOR = 7.04, 95% CI: 2.07, 23.97), and women who worried very often about feeding their family compared to those who did not worry at all (AOR = 8.95, 95% CI: 3.09, 25.94). The findings highlight the need for integrated and tailored interventions to mitigate IPV and antepartum depression to address the needs of adolescent and young women, and those living in poverty or lacking social support.

Violence Against Women and Girls in Zimbabwe: A Review of a Decade of the Empirical Literature

Violence against women and girls (VAWG) is a complex social problem affecting many women globally. In Zimbabwe, intimate partner violence (IPV) and child marriages remain persistent public health problems with detrimental effects on the health and well-being of women and girls. Statistics show that Zimbabwe has one of the highest rates of IPV and child marriage in sub-Saharan Africa. Given this background, this paper systematically reviewed published research on VAWG in Zimbabwe from 2012 to 2022 to identify research gaps. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we systematically searched for literature across five electronic databases: Web of Science, Medline, Psych-Info via EBSCO-Host, and Google Scholar. Our initial search yielded 261 articles, of which only 45 met our inclusion criteria. We summarized these studies using thematic analysis and performed a quality assessment using the Mixed Methods Appraisal Tool. The findings revealed several gaps, including a limited focus on relational and perpetrator perspectives, insufficient attention to other forms of VAWG such as non-partner sexual violence, rape, and trafficking, and a lack of studies on marginalized groups such as people with disabilities, sex workers, and same-sex couples. In addition, there were no longitudinal studies examining trends and dynamics of VAWG over extended periods or comparing different geographical regions. Few studies also focused on the evaluation of interventions. Although significant progress has been made in addressing VAWG, this review underscores the need for more research to fill these gaps for effective and evidence-based policymaking and response strategies.

Kelly P. Reducing Violence Against Women and Girls in the Arab League: A Systematic Review of Preventive Interventions

The UN's Sustainable Development Goal #5 (Gender Equity) includes violence against women and girls (VAWG), considering it as a violation of the rights of women and girls. The variety of risk factors for VAWG in Arab countries suggests the need to identify effective interventions to guide practitioners and policy makers. A systematic review of preventive interventions across the Arab League examined the outcomes of VAWG. Authors registered the study on the prospective register of systematic reviews database. Authors conducted the search for evidence up to 2023. Database searching identified 1,502 studies and after application of the eligibility criteria, 17 studies remained for inclusion. Quality appraisal used the Mixed Methods Appraisal Tool. Evidence emerged from eight Arab countries. Interventions occurred at the primary, secondary, and tertiary levels of prevention. However, only two studies employed interventions using more than one level of prevention, which considered systems strengthening and the development of community solidarity networks. The evidence revealed a lack of clear evaluation and evidence for the effectiveness of interventions and prevention alongside reactive approaches, with no evidence as to how systems may reduce or prevent VAWG. One main issue is patriarchal dominance in Arab countries creating the lack of a collective female voice in any of the evidence. However, Arab countries can change with support. Achieving the UN's Sustainable Development Goal #5 by 2030 means interventions and programs need to include more than one prevention level, consider systems and include the collective female voice.

Low uptake of gynecological consultation following domestic or sexual violence: A case-control study during pregnancy follow-up

OBJECTIVE

The aim of this study was to examine the association between exposure to domestic and sexual violence and low uptake of gynecological consultation.

STUDY DESIGN

Between October 2021 and October 2022, a case-control studywas conducted in mother andchild centers and sexual health centers in the Paris, France area. The case group included pregnant women who did not have a scheduled gynecological consultation in the past two years. The control group included pregnant women who had a scheduled gynecological consultation in the past two years. Pregnant women were interviewed using a standardized questionnaire about a history of domestic and sexual violence, the date of their last gynecological consultation and the gynecological health.

RESULTS

A total of 405 pregnant women were included in the case group (n = 129) or in the control group (n = 276). After adjustment for age, couple, social security, supplementary health insurance, dyspareunia, abnormal vaginal discharge, dysmenorrhea, regular pelvic pain, mastodynia, vulvodynia and history of difficult delivery, a history of intimate partner violence was associated with the absence of a gynecological consultation in the past two years (OR 2.13; CI95% 1.21-3.73, p = 0.008). A history of sexual violence, regardless of age, was associated with the absence a gynecological consultation in the past two years (OR 1.92; CI95% 1.05-3.49, p = 0.03). The absence of a gynecological consultation was associated with dyspareunia and domestic or sexual violence (p < 0.0001 and p < 0.0001, respectively).

CONCLUSIONS

This study highlighted the association between domestic and sexual violence and the absence of gynecological consultations in the past two years. It underlines the importance of screening for domestic and sexual violence during gynecological consultations and its impacts on mental health, in particular psychotraumatic symptoms, and on gynecological health, in particular dyspareunia.

Prevalence and determinants of intimate partner sexual violence among pregnant women in sub-Saharan Africa: Evidence from the most recent DHS data 2015-2022

INTRODUCTION

Intimate partner sexual violence (IPSV) is sexual violence against women by a current or former sexual partner. Sexual violence among pregnant women is higher in low-income countries, particularly in sub-Saharan Africa (SSA), which has numerous negative impacts for both the mother and the growing fetus. There is no recent and distinct information on the magnitude and factors associated with IPSV among pregnant women in SSA.

OBJECTIVE

This study aimed to assess the prevalence of IPSV and its determinants among pregnant women in SSA.

DESIGN

A cross-sectional study design using demographic health survey data from 2015 to 2022 in 20 sub-Saharan African countries was used.

METHODS

The analysis was conducted using a weighted sample of 10,775 women who were pregnant during the survey period (2015-2022). A multilevel logistic regression model was used to identify the determinants of IPSV among pregnant women. The adjusted odds ratio at 95% confidence interval (95% CI) was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of <0.05 are declared statistically significant.

RESULT

In this study, the pooled prevalence of IPSV among pregnant women in SSA was 11.06% (95% CI: 10.48-11.67). Respondents currently working, male-headed households, presence of justified beating, respondent mother's history of abuse, respondent having no media access, respondent having self-reported sexually transmitted diseases (STIs), partner alcohol use, and residing in East Africa had increased odds of IPSV during pregnancy. On the other hand, nulliparous respondents, respondents involved in healthcare decision-making, households with a high wealth index, and residents of West Africa had decreased odds of IPSV among pregnant women.

CONCLUSION

This study revealed that a significant proportion (11%) of pregnant women experienced intimate partner sexual violence during pregnancy in SSA. Hence, the government, policymakers, and other relevant authorities should give special attention to women's at-risk of sexual violence, including women who live in households with justified beatings, women with STIs, working women's, women with drunken partners, and non-autonomous women's. Prioritization of the east African region, increasing media access, and promoting a healthy lifestyle in the community shall be done to reduce the burden of the problem.

Intention of Staff and Students to Use Internal Whistleblowing to Report Sexual Violence: A Case Study of a Nigerian University

Sexual violence with its enormous negative consequences has become an epidemic most especially among the young populations. An effective danger-proof reporting system is necessary for curbing this menace including use of the internal whistleblowing mechanism. The study employed a concurrent (parallel) mixed method descriptive design for explaining the sexual violence experiences of university students, the intention of staff and students to blow the whistle, and their preferred whistleblowing strategies. A total of 167 students and 42 members of staff (69% males and 31% females, respectively) were randomly selected from four academic departments (50%) of a university of technology in Southwest Nigeria. An adapted questionnaire containing three vignettes on sexual violence and a focus group discussion guide were used for data collection. We discovered that 16.1% of the students reported to have experienced sexual harassment, 12.3% had attempted rape, and 2.6% had experienced rape. Tribe (Likelihood-Ratio, LR = 11.16; p = .004) and sex (χ² = 12.65; p = .001) were strongly associated with sexual violence experiences. Also, 50% staff and 47% students had high intention. Regression analysis showed that industrial and production engineering students will be 2.8 times more likely to have intention to internally blow the whistle more than other students (p = .03; 95% CI [1.1, 6.97]). Female staff had 5.73 odds of intention more than male staff (p = .05; [1.02, 32.1]). Also, we observed that senior staff will 31% less likely blow the whistle than the junior staff (Adjusted Odd Ratio, AOR = 0.04; [0.00, 0.98]; p = .05). In our qualitative findings, courage was mentioned as a factor necessary for blowing the whistle while anonymous reporting was emphasized for successful whistleblowing. However, the students preferred external whistleblowing. The study has implication for the establishment of sexual violence internal whistleblowing reporting system in higher education institutions.

Longitudinal Association Between Intimate Partner Violence and Alcohol Use in a Population Cohort of South African Women

Intimate partner violence (IPV) is a common traumatic stressor for women worldwide, especially for women living in low-and-middle-income countries. One of the most common correlates of IPV victimization is alcohol use, but the dynamics of IPV and drinking among women are not well understood. Although some research suggests that women drink in the aftermath of IPV to cope with distress related to the violence they experienced, other studies imply that higher levels of alcohol use among one or both partners in a relationship make violence more likely. In this study, we examine this question in a secondary analysis of a longitudinal study of a population cohort of pregnant women in South Africa (N = 1238) using a Bayesian approach to latent growth curve structural equation modeling. Results indicate that on average, IPV decreases and alcohol use increases over time and that these trajectories are associated with each other. Further, results suggest that although IPV drives drinking (rather than the other way around), higher average levels of alcohol use are associated with a slower decrease in IPV. Findings have implications for future research on the association between IPV and alcohol use, as well as for clinical intervention for women who experienced IPV.