At Risk: The Relationship between Experiences of Child Sexual Abuse and Women's HIV Status in Papua New Guinea

Lewis, Ione

doi:10.1080/10538712.2012.668265

Cited by 14 publications

(19 citation statements)

References 15 publications

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“…These roles were often the criteria for inclusion in a study. Specific experiences were also examined, such as violence, accusations of witchcraft and sorcery [59] and sexual abuse [22,34,60]. Major themes identified from inductively coding the literature were:…”

Section: Resultsmentioning

confidence: 99%

Women and HIV in a moderate prevalence setting: an integrative review

et al. 2013

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BackgroundAlmost 32,000 people are living with human immunodeficiency virus (HIV) in Papua New Guinea (PNG). The primary route of transmission in this moderate prevalence setting is through heterosexual sex. Thus a gendered understanding of HIV is required to inform HIV prevention, treatment and care options. The aim of this review is to investigate understandings specifically about women and HIV in PNG and to identify gaps in the literature to inform future HIV research.MethodsAn integrative review of literature about women, HIV and PNG was conducted using a systematic search of online databases, including book chapters and grey literature. Prior to inclusion, literature was assessed using inclusion and exclusion criteria, and the Critical Appraisal Skills Programme (CASP) appraisal tool. Selected articles, book chapters and reports were coded and a constant comparative method of analysis used to construct a series of themes.ResultsThe 26 articles, book chapters and reports included in the review were predominantly descriptive, original research (23/26 pieces of literature). Six themes were identified in the literature: economic, social and cultural factors (including mobility); gender issues (including violence against women); knowledge about HIV (including perception of risk of HIV); religious beliefs about HIV; women perceived as responsible for HIV transmission; and prevention of HIV. Literature about women and HIV in PNG is predominantly focussed upon women who sell sex, women as mothers or young women. Women are usually represented as either victims of HIV or responsible for transmitting HIV. Anthropological and social research has described the economic, social and cultural context along with the lived experience of HIV in PNG, but there is limited operations research or implementation research available.ConclusionsThe literature reviewed has highlighted the importance of a gendered analysis of HIV prevention, care and treatment in PNG. There is an opportunity for operations, implementation and health systems research about HIV in PNG to shift research from description to action.

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Section: Resultsmentioning

confidence: 99%

Women and HIV in a moderate prevalence setting: an integrative review

et al. 2013

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“…In PNG, gender refers to the characteristics assigned to women and men by the society in which they live [ 11 ]. Gender influences the type of tasks undertaken by men and women, employment opportunities and can indicate vulnerability to inter-personal violence and HIV [ 12 – 15 ]. Matching the gender of the researcher and research participant therefore reflects social and cultural patterns [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Co-interviewing across gender and culture: expanding qualitative research methods in Melanesia

et al. 2014

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BackgroundThe social and cultural positions of both researchers and research participants influence qualitative methods and study findings. In Papua New Guinea (PNG), as in other contexts, gender is a key organising characteristic and needs to be central to the design and conduct of research. The colonial history between researcher and participant is also critical to understanding potential power differences. This is particularly relevant to public health research, much of which has emerged from a positivist paradigm. This paper describes our critical reflection of flexible researcher responses enacted during qualitative research in PNG.MethodsLed by a senior male HIV researcher from PNG, a male from a PNG university and a female from an Australian university conducted qualitative interviews about faith-based responses to HIV in PNG. The two researchers planned to conduct one-on-one interviews matching gender of participants and interviewer. However, while conducting the study, four participants explicitly requested to be interviewed by both researchers. This experience led us to critically consider socially and culturally situated ways of understanding semi-structured interviewing for public health research in Melanesia.ResultsNew understandings about public health research include: (i) a challenge to the convention that the researcher holds more power than the research participant, (ii) the importance of audience in Melanesia, (iii) cultural safety can be provided when two people co-interview and (iv) the effect an esteemed leader heading the research may have on people’s willingness to participate. Researchers who occupy insider-outsider roles in PNG may provide participants new possibilities to communicate key ideas.ConclusionsOur recent experience has taught us public health research methods that are gender sensitive and culturally situated are pivotal to successful research in Melanesia. Qualitative research requires adaptability and reflexivity. Public health research methods must continue to expand to reflect the diverse worldviews of research participants. Researchers need to remain open to new possibilities for learning.

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“…Many survivors of non-partner sexual violence also presented for care. In a study of women attending antenatal and HIV voluntary testing and counselling services across four provinces of PNG, 9.7% of the sample (n = 114) reported rape prior to the age of 16 [ 4 ]. Our study estimates a presentation rate of 7.0% of females aged 0–14 in the catchment population during the analysis period, almost all of whom presented for rape, suggesting that where services are available for child sexual abuse survivors, a considerable proportion will present, in particular those experiencing severe forms of abuse such as rape.…”

Section: Discussionmentioning

confidence: 99%

“…In conjunction with the burden gender-based violence imposes on the health and wellbeing of women and children [ 4 , 5 ], health services for survivors are limited. PNG’s health system has been described by the World Health Organization as being in a state of ‘slow breakdown and collapse’ [ 6 ], meaning that survivors of gender-based violence are faced with significant challenges in accessing medical care.…”

Section: Introductionmentioning

confidence: 99%

Health Services for Gender-Based Violence: Médecins Sans Frontières Experience Caring for Survivors in Urban Papua New Guinea

et al. 2016

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BackgroundLevels of gender-based violence in Papua New Guinea (PNG) are high; health services for survivors are limited. Evidence from the few existing health services for survivors can inform improvements in care in this and similar settings.MethodsMédecins Sans Frontières supported health services for survivors in Lae, PNG from 2008–2013. Routine monitoring data from August 2010-April 2013 were used to describe patient and service characteristics.Results5,892 individuals received care over 6,860 presentations, the majority self-referred or referred by friends and family. Presentations were attributed to intimate partner violence(62%), non-partner sexual violence(15%), other forms of violence(3%), and past (but not current) violence(21%). 97% were female; an estimated 4.9% (95%CI:4.8–5.0%) of females resident in the catchment area presented to the programme during the 2.8years analysed. Of presentations for non-partner sexual violence, 79% knew their abuser and 50% were children <16 years. 92% of presentations reporting current violence received medical treatment for injuries. The majority of patients who received multiple counselling sessions reported improved functioning and decreased severity of psycho-social complaints.ConclusionsCommunity awareness of the availability of free, best-practice, accessible, confidential medical and counselling services for sexual and gender-based violence in Lae, PNG resulted in many survivors presenting for care. High levels of ongoing intimate partner violence and child sexual abuse by known abusers indicates that alongside comprehensive medical care, access to effective services in non-health sectors such as policing, protection and legal services are needed if survivors are to escape the cycle of violence.

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At Risk: The Relationship between Experiences of Child Sexual Abuse and Women's HIV Status in Papua New Guinea

Cited by 14 publications

References 15 publications

Women and HIV in a moderate prevalence setting: an integrative review

Women and HIV in a moderate prevalence setting: an integrative review

Co-interviewing across gender and culture: expanding qualitative research methods in Melanesia

Health Services for Gender-Based Violence: Médecins Sans Frontières Experience Caring for Survivors in Urban Papua New Guinea

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