Feasibility and preliminary effects of a screening, brief intervention and referral to treatment model to address gender‐based violence among women who use drugs in Kyrgyzstan: Project WINGS (Women Initiating New Goals of Safety)

Abstract

Introduction and aims Intimate partner violence (IPV) and other forms of gender-based violence (GBV) are serious public health threats among women who use drugs or engage in binge drinking in Kyrgyzstan. This study aimed to evaluate the feasibility and preliminary effects of a two-session IPV and GBV screening, brief intervention and referral to treatment model (WINGS) with HIV counselling and testing for women who use drugs or engage in binge drinking in Kyrgyzstan, using a pre/post-design. Design and methods We screened 109 women from harm reduction nongovernment organisations in Kyrgyzstan, of whom 78 were eligible, 73 participated in the intervention study, and 66 completed a 3-month post-intervention follow-up. To assess the effects of the intervention, we used random-effect Poisson and Logistic regression analyses for continuous and dichotomous outcomes respectively. Results At baseline, 73% reported any physical or sexual IPV victimisation, and 60% reported any physical or sexual GBV victimisation in the past year. At the 3-month follow-up, participants reported experiencing 59% fewer physical IPV incidents in the prior 90 days than at baseline (P <0.001) and 27% fewer physical GBV incidents than at baseline (P <0.01). From baseline to the 3-month follow-up, participants also reported a 65% reduction in the odds of using any illicit drugs (P < 0.05) and were more likely to report receiving GBV-related services (P< 0.001). Discussion and conclusion The high rates of participation, attendance and retention and significant reductions in IPV and GBV victimisation and drug use from baseline to the 3-month follow-up suggest the feasibility and promising effects of this brief intervention.

Gender-based vulnerability in women who inject drugs in a harm reduction setting

“…Rates of gender-based and intimate partner violence are two to five times higher among WWID than women who do not use drugs [23]. Remarkably and similar to the findings of our study, over half of all interviewed women reported having experienced sexual violence in their lifetime [24,25] and strikingly, three-quarters of women had ever experienced some degree of physical or emotional violence by their partners. Unfortunately, this behavior is permanent because of the financial dependence on the partner for housing, drug supply, and fear [26]…”

Training medical students: victim’s perceptions of selectively screening women for intimate partner violence in health care settings

“…A systematic review of 12 trials found that interventions such as advocacy and cognitive behavioural therapy, played a major role in reducing both physical and psychological violence associated with IPV [41]. A significant reduction in IPV victimization was reported following a counseling intervention [42]. These forms of interventions were regarded as beneficial to victims, their partners and members of the public.…”

Tailored integrated interventions for intimate partner violence and substance use are urgently needed

“…In their novel trial presented in this issue, Gilbert et al . report significant reductions in IPV victimisation and drug use for female substance users in Kyrgyzstan who received a brief intervention and referral to treatment (screening, brief intervention and referral to treatment) model (women initiating new goals of safety) with HIV counselling and testing. Placing such integrated interventions in a broader context such as Graham et al .…”

“…There remains a need for interventions to improve safety for survivors. In their novel trial presented in this issue, Gilbert et al [36] report significant reductions in IPV victimisation and drug use for female substance users in Kyrgyzstan who received a brief intervention and referral to treatment (screening, brief intervention and referral to treatment) model (women initiating new goals of safety) with HIV counselling and testing. Placing such integrated interventions in a broader context such as Graham et al [37] describe in their prevention model for alcoholrelated IPV in the context of societal, community, relationship and individual risk factors and solutions is critical.…”