Intimate Partner Violence (IPV) Against HIV-Positive Women in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-Analysis

Tenkorang, Eric Y.; Asamoah-Boaheng, Michael; Owusu, Adobea Yaa

doi:10.1177/1524838020906560

Cited by 40 publications

(40 citation statements)

References 37 publications

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“…Psychosocial stressors, specifically higher numbers of reported PTEs and history of emotional IPV were associated with mental health help-seeking. In a study from Nigeria, emotional IPV was also associated with an increased likelihood of help-seeking while sexual IPV was not [65]. In this setting, physical IPV was associated with increased help-seeking as well, contrary to our findings [65].…”

Section: Discussioncontrasting

confidence: 99%

“…This is likely due in part to the severely limited number of specialized mental health providers across Cameroon, and the low-or no-cost nature of seeking informal help as compared to formal helpseeking. These results are similar to findings from other resource-constrained settings, which suggest helpseeking from informal sources is substantially more common than help-or care-seeking from formal sources [29,30,64,65], and that help-seeking from mental health specialists may be particularly uncommon [64,[66][67][68]. In a hospital-based study conducted among 384 individuals with mental illness in Ethiopia, more than half of the participants (n = 193; 50.2%) had ever sought care from an herbalist or religious healer before seeking formal care services from a psychiatric hospital [30].…”

Section: Discussionsupporting

confidence: 87%

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Correlates of self-reported history of mental health help-seeking: a cross-sectional study among individuals with symptoms of a mental or substance use disorder initiating care for HIV in Cameroon

Filiatreau

Ebasone²,

Dzudie³

et al. 2021

BMC Psychiatry

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Background Mental health and substance use disorders (MSDs) increase the risk of poor human immunodeficiency virus (HIV) care outcomes among people living with HIV (PLWH). Receipt of mental health care may improve these adverse outcomes. We aimed to identify correlates of prior mental health help-seeking among PLWH with symptoms of an MSD in Cameroon. Methods We characterize prior mental health help-seeking from formal (mental health specialist/general medical provider) and informal (traditional healer/religious leader) sources among 161 people with symptoms of depression (Patient Health Questionnaire-9 scores> 9), anxiety (General Anxiety Disorder-7 scores> 9), probable post-traumatic stress disorder (PTSD Checklist for DSM-5 scores> 30), or possible alcohol use disorder (Alcohol Use Disorders Identification Test scores≥16) who were newly entering HIV care at three healthcare facilities in Cameroon between June 2019 and March 2020. Help-seeking was defined as ever speaking to a formal or informal source about emotional problems, sadness, or the way they were feeling or behaving. We estimated the association between sociodemographic and psychosocial measures and lifetime mental health help-seeking from each type of source using log-binomial regression. Results Overall, 55.3% of 161 PLWH with MSD symptoms reported prior mental health help-seeking, with 24.2% and 46.0% seeking help from formal and informal sources, respectively. Religious leaders were the most common source of help (40.4%), followed by general medical professionals (22.4%), traditional healers (16.8%), and mental health specialists (7.4%). Individuals with higher depressive, anxiety, and trauma symptom severity scores were more likely to have sought help than those with lower scores. Individuals with possible alcohol use disorder were the least likely to have sought help. Prior help-seeking was more common among those reporting a higher number of lifetime traumatic events (prevalence ratio [PR]: 1.06; 95% confidence interval [CI]: 1.01, 1.11) and those with a history of emotional intimate partner violence (PR: 1.34; 95% CI: 1.01, 1.80). Conclusions Prior mental health help-seeking was associated with psychosocial stressors. Help-seeking from informal networks was more common than formal help-seeking. Training in the provision of evidence-based mental health support for informal networks could improve access to mental health care for PLWH with MSDs in Cameroon.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 87%

Correlates of self-reported history of mental health help-seeking: a cross-sectional study among individuals with symptoms of a mental or substance use disorder initiating care for HIV in Cameroon

Filiatreau

Ebasone²,

Dzudie³

et al. 2021

BMC Psychiatry

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“…In our primary analyses, eight log-binomial regression models were run to estimate the unadjusted and adjusted associations between (1) prior history of physical violence; (2) prior history of sexual violence; (3) prior history of physical or sexual violence and 4) prior history of both physical and sexual violence, and clinically meaningful depressive symptoms. Adjusted analyses controlled for age [57,58], self-reported gender [57,58] and relationship status [59][60][61], which comprised the minimally sufficient adjustment set in the directed acyclic graph.…”

Section: Discussionmentioning

confidence: 99%

Examining the relationship between physical and sexual violence and psychosocial health in young people living with HIV in rural South Africa

Filiatreau

Giovenco

Twine

et al. 2020

J. Intern. AIDS Soc.

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Introduction Experiences of violence during youth contravene young people’s rights and increase the risk of depression and poor human immunodeficiency virus (HIV) care outcomes among youth living with HIV (YLWH). Intervention targets for mitigating the negative psychosocial effects of violence are needed, particularly in areas like rural South Africa where violence remains pervasive and mental healthcare is limited. This study aims to quantify the associations between physical and sexual violence and depressive symptoms in YLWH in rural South Africa and explore the modification of these associations by key measures of psychosocial well‐being. Methods We conducted a cross‐sectional survey among 362 YLWH ages 12 to 24 in rural South Africa to ascertain participants’ history of physical and sexual violence, current depressive symptoms (Center for Epidemiological Studies‐Depression Scale) and levels of social support (Medical Outcomes Social Support Scale), resilience (Conner‐Davidson Resilience Scale) and self‐esteem (Rosenberg Self‐Esteem Scale). Log‐binomial regression was used to estimate the association between history of physical or sexual violence and clinically meaningful depressive symptoms (scores 16). Effect measure modification by high versus low resilience, social support and self‐esteem was assessed using likelihood ratio tests (α = 0.20). Results A total of 334 individuals with a median age of 21 (interquartile range: 16 to 23) were included in this analysis. Most participants were female (71.3%), single (81.4%) and attending school (53.0%). Ninety‐four participants (28.1%) reported a history of physical or sexual violence and 92 individuals (27.5%) had clinically meaningful depressive symptoms. Meaningful depressive symptoms were significantly higher among participants with a history of physical or sexual violence as compared to those with no history of violence (adjusted prevalence ratio: 2.01; 95% CI: 1.43, 2.83). However, this association was significantly modified by social support ( p = 0.04) and self‐esteem ( p = 0.02). Conclusions In this setting, the prevalence of meaningful depressive symptoms was significantly higher among YLWH with a history of physical or sexual violence as compared to those without a history of violence. However, higher levels of self‐esteem or social support appeared to mitigate this association. Programmes to improve self‐esteem and social support for youth have the potential to minimize depressive symptoms in YLWH who have experienced physical or sexual violence.

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“…Notably, IPV [ 36 – 38 ] was only mentioned by a few respondents, and many felt that adverse events may be prevented based on how HIVST is introduced to sexual partners, such as delivering the intervention in a private setting with limited distractions, similar to other studies with HIV-unknown/negative clients [ 39 ]. Risk of IPV may be particularly high for index clients whose partner tests HIV-negative, as disclosure and sero-discordancy are shown to increase violence experienced among HIV-positive women [ 40 ]. However, nearly all respondents in in-depth interviews believed that their partner was HIV-positive, and therefore had little concern regarding potential discordancy.…”

Section: Discussionmentioning

confidence: 99%

Acceptability of index partner HIV self-testing among HIV-positive clients in Malawi: A mixed methods analysis

Offorjebe

Hoffman

Shaba³

et al. 2020

PLoS ONE

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We sought to evaluate whether HIV-positive adults in Malawi were willing to distribute HIV self-testing (HIVST) kits to their sexual partners of unknown HIV status (index HIVST). Design A mixed-methods study was nested within a larger HIVST trial conducted at 15 health facilities in Malawi. Exit surveys were conducted with HIV-positive adults during routine outpatient department visits to assess perceived acceptability of index partner HIVST versus standard partner referral slips that request partner(s) to attend the health facility. Individuals were included in the sub-analysis irrespective of date of HIV diagnosis or ART initiation (or non-initiation). In-depth interviews were conducted with a sub-sample of respondents. Results 404 HIV-positive adults completed a survey (159 male and 245 female); 21 completed indepth interviews. Respondents reported feeling more comfortable distributing HIVST versus partner referral slips to their partners (90% vs. 81%) and expressed confidence that their partners would test using HIVST compared to referral slips (77% vs. 66%). Acceptability of HIVST did not vary by sex. Qualitative data revealed that index HIVST was perceived to be private, convenient, and may strengthen relationships by assisting in serostatus disclosure. There were minimal fears of adverse events. Reported barriers to index HIVST included lack of trust within the relationship and harmful gender norms. Conclusions HIV-positive clients were willing to distribute HIVST kits to their sexual partners of unknown serostatus. Additional studies are needed to evaluate use of HIVST by index partners,

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Intimate Partner Violence (IPV) Against HIV-Positive Women in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-Analysis

Cited by 40 publications

References 37 publications

Correlates of self-reported history of mental health help-seeking: a cross-sectional study among individuals with symptoms of a mental or substance use disorder initiating care for HIV in Cameroon

Correlates of self-reported history of mental health help-seeking: a cross-sectional study among individuals with symptoms of a mental or substance use disorder initiating care for HIV in Cameroon

Examining the relationship between physical and sexual violence and psychosocial health in young people living with HIV in rural South Africa

Acceptability of index partner HIV self-testing among HIV-positive clients in Malawi: A mixed methods analysis

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