Burden of and risk factors for sexual violence among women with and without disabilities in two sub-Saharan African countries

Abstract

Background Available data suggest that women with disabilities have an increased risk of sexual violence, but little is known about the situation of those women living in resource-limited settings. Objectives To assess the burden and examine the drivers of sexual violence among women with disabilities. Methods This is a pooled analysis of two population-based surveys conducted in Cameroon and Burundi. Adults with and without disabilities were randomly recruited from the general population. Structured interviews were conducted at both sites to collect data on participants’ functional limitations, life-course history of sexual violence, education, employment, and resources. Only women with disabilities whose impairments started before the age of 10 years (n = 359) and women without disabilities (n = 720) are included in this analysis. The age-adjusted prevalence of violence was computed, and risk factors were assessed using a discrete survival regression and mediation analysis. Results At both sites, the participants with disabilities had a lower education level and had an increased risk of food insecurity. The pooled age-adjusted prevalence of lifetime sexual violence was 19.8% (95%CI:15.3–24.3) among women with disabilities and 11.7% (95%CI:9.3–14.1) among those without disabilities (OR ap : 2.0, 95%CI:1.4–2.8). Women with cognitive limitations and those with visual impairments had the highest risk of sexual violence (OR ap : 3.5 (95%CI:2.0–6.3) and 2.7 (95%CI:1.4–5.0), respectively). Over the life course, the risk of sexual violence was especially high among women with disabilities who had lived with an intimate partner before the age of 25 years ( p < 0.001). Education level mediated approximately one-third of the total association between disability and sexual violence ( p = 0.001). There was no evidence of an indirect effect through food insecurity. Conclusion This study provides evidence of the high burden of sexual violence among women with disabilities who live in urban African contexts. The social environment and access to education may be key contributors to this vulnerability.

Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana

“…The study addresses a critical aspect of the 2030 Agenda by emphasising disability-disaggregated data to ensure inclusivity. However, most existing research on violence against PwDs focuses on women and sexual violence [ 87 – 89 ]. Therefore, these findings underscore the need for inclusive violence prevention and response programs since IV is mostly a continuum [ 53 ], regardless of gender.…”

“…Larger households appear to expose PwDs to higher violence risk than smaller households. Both qualitative and quantitative findings indicate that family members, neighbours, and strangers, including intimate partners, are major perpetrators of emotional and physical violence [ 19 , 87 , 90 ]. Despite this, most survivors do not report incidents, echoing prior studies that this is especially true for survivors of sexual violence, particularly women [ 19 , 87 , 90 ].…”

Violencia hacia mujeres con discapacidad: una revisión de la literatura

“…Revista Española de Discapacidad, 12(1), 7-30 de género en la pareja afecta a todos los ámbitos de la vida de estas mujeres (e.g., de Beaudrap et al, 2022;Dunkle et al, 2020), y sus efectos perduran mucho después de haber finalizado la relación de maltrato (Namatovu et al, 2022).…”

“…Además, este tipo de violencia suele ser menos visible, dado que surge en el entorno íntimo de la pareja y ello favorece que estas situaciones permanezcan ocultas (Meseguer-Santamaría et al, 2021). Por tanto, parece existir consenso acerca de que la discapacidad es un factor de riesgo para sufrir violencia de género en la pareja (Dunkle et al, 2020;Fanslow et al, 2021;Martínez, 2022;Valentine et al, 2019), y que constituye una amenaza para la salud de las mujeres puesto que acarrea daños graves y duraderos (de Beaudrap et al, 2022;Dunkle et al, 2020), cuyas consecuencias persisten mucho después de haber finalizado la relación (Namatovu et al, 2022). No obstante, también hay otros factores que hacen que aumente el riesgo de sufrir violencia de género en la pareja, tales como tener bajos ingresos, la falta de vivienda, ser extranjera, el alcoholismo de la pareja, presentar discapacidad antes de los 15 años, tener dependencia física o problemas de salud mental y la percepción de vulnerabilidad por parte de la pareja (Fanslow et al, 2021, Jones et al, 2021Martínez, 2022;Meseguer-Santamaría et al, 2021).…”

Utilization of family planning and associated factors among women with disabilities in ethiopia: A systematic review and meta-analysis

“…Studies indicate that disabled women were at higher risk of experiencing sexual violence than nondisabled women [11][12][13], and experience more challenges than women without disabilities in having their reproductive health needs met. Women with Disabilities (WWDs) face multiple barriers to quality contraceptive care [14], whether through stigma, increased risk of violence or abuse, lack of access to care [15], prejudices, and discrimination from healthcare service providers [14,16]and receive poor quality services [2,17].…”