“Violence. Enough already”: findings from a global participatory survey among women living with HIV

Orza, Luisa; Bewley, Susan; Chung, Cecilia; Crone, E Tyler; Nagadya, Hajjarah; Vazquez, Marijo; Welbourn, Alice

doi:10.7448/ias.18.6.20285

Cited by 52 publications

(52 citation statements)

References 21 publications

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“…Gender‐based violence (GBV) disproportionately impacts and compromises the wellbeing of women and girls across the world . A global participatory survey among women living with HIV (WLHIV) found that 89% of those who responded to the GBV section reported having experienced or feared GBV . GBV has deleterious impacts on physical and mental health .…”

Section: Introductionmentioning

confidence: 99%

A longitudinal study of associations between HIV‐related stigma, recent violence and depression among women living with HIV in a Canadian cohort study

et al. 2019

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Introduction Women living with HIV (WLHIV) experience stigma and elevated exposure to violence in comparison with HIV‐negative women. We examined the mediating role of experiencing recent violence in the relationship between stigma and depression among WLHIV in Canada. Methods We conducted a cohort study with WLHIV in three Canadian provinces. Recent violence was assessed through self‐reported experiences of control, physical, sexual or verbal abuse in the past three months. At Time 1 (2013‐2015) three forms of stigma were assessed (HIV‐related, racial, gender) and at Time 2 (2015‐2017) only HIV‐related stigma was assessed. We conducted structural equation modelling (SEM) using the maximum likelihood estimation method with Time 1 data to identify direct and indirect effects of gender discrimination, racial discrimination and HIV‐related stigma on depression via recent violence. We then conducted mixed effects regression and SEM using Time 1 and Time 2 data to examine associations between HIV‐related stigma, recent violence and depression. Results At Time 1 (n = 1296), the direct path from HIV‐related stigma (direct effect: β = 0.200, p < 0.001; indirect effect: β = 0.014, p < 0.05) to depression was significant; recent violence accounted for 6.5% of the total effect. Gender discrimination had a significant direct and indirect effect on depression (direct effect: β = 0.167, p < 0.001; indirect effect: β = 0.050, p < 0.001); recent violence explained 23.15% of the total effect. Including Time 1 and Time 2 data (n = 1161), mixed‐effects regression results indicate a positive relationship over time between HIV‐related stigma and depression (Acoef: 0.04, 95% CI: 0.03, 0.06, p < 0.001), and recent violence and depression (Acoef: 1.95, 95% CI: 0.29, 4.42, p < 0.05), controlling for socio‐demographics. There was a significant interaction between HIV‐related stigma and recent violence with depression (Acoef: 0.04, 95% CI: 0.01, 0.07, p < 0.05). SEM analyses reveal that HIV‐related stigma had a significant direct and indirect effect on depression over time (direct effect: β = 0.178, p < 0.001; indirect effect: β = 0.040, p < 0.001); recent violence experiences accounted for 51% of the total effect. Conclusions Our findings suggest that HIV‐related stigma is associated with increased experiences of recent violence, and both stigma and violence are associated with increased depression among WLHIV in Canada. There is an urgent need for trauma‐informed stigma interventions to address stigma, discrimination and violence.

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Section: Introductionmentioning

confidence: 99%

A longitudinal study of associations between HIV‐related stigma, recent violence and depression among women living with HIV in a Canadian cohort study

et al. 2019

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“…However, many people living with HIV, particularly women, may be hesitant to disclose their HIV status due to fear of stigma, discrimination and particularly violence [36,37]. To reduce the risk of violence resulting from HIV status disclosure to a partner, HIV and SRHR policymakers, programme managers and healthcare providers could work towards developing and implementing novel approaches for safer disclosure, including assessing for partner violence and engaging peer-counsellors and communities of people living with HIV [38][39][40]. There is also a need to explore programmatic and clinical approaches that could be used in cases of nondisclosure of HIV status when disclosure could increase harm [41].…”

Section: Facilitated Disclosure Of Hiv Statusmentioning

confidence: 99%

Achieving pregnancy safely for HIV‐serodiscordant couples: a social ecological approach

Saleem

Narasimhan

Denison

et al. 2017

Journal of the International AIDS Society

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The recognition and fulfilment of the sexual and reproductive health and rights (SRHR) of all individuals and couples affected by HIV, including HIV-serodiscordant couples, requires intervention strategies aimed at achieving safe and healthy pregnancies and preventing undesired pregnancies. Reducing risk of horizontal and vertical transmission and addressing HIV-related infertility are key components of such interventions. In this commentary, we present challenges and opportunities for achieving safe pregnancies for serodiscordant couples through a social ecological lens. At the individual level, knowledge (e.g. of HIV status, assisted reproductive technologies) and skills (e.g. adhering to antiretroviral therapy or pre-exposure prophylaxis) are important. At the couple level, communication between partners around HIV status disclosure, fertility desires and safer pregnancy is required. Within the structural domain, social norms, stigma and discrimination from families, community and social networks influence individual and couple experiences. The availability and quality of safer conception and fertility support services within the healthcare system remains essential, including training for healthcare providers and strengthening integration of SRHR and HIV services. Policies, legislation and funding can improve access to SRHR services. A social ecological framework allows us to examine interactions between levels and how interventions at multiple levels can better support HIV-serodiscordant couples to achieve safe pregnancies. Strategies to achieve safer pregnancies should consider interrelated challenges at different levels of a social ecological framework. Interventions across multiple levels, implemented concurrently, have the potential to maximize impact and ensure the full SRHR of HIV-serodiscordant couples.

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“…The right to sexual and reproductive health services (SRHS) is understood as the possibility of having easy access to and receiving timely and efficient care that meets the needs of women throughout their life course as well as the freedom to make reproductive decisions. However, studies regarding women living with HIV (WLHIV) and their conditions for accessing SRHS show that their SRH needs are largely unmet , leading to high rates of unsafe abortions and three times the number of unplanned pregnancies than women not living with HIV (WNLHIV) . In 2017, the World Health Organization (WHO) launched the Consolidated Guideline on Sexual and Reproductive Health and Rights of Women Living with HIV to support countries to implement evidence‐based interventions to improve access to SRHS and contribute to the realization of this basic right .…”

Section: Introductionmentioning

confidence: 99%

Access to sexual and reproductive health services for women living with HIV in Latin America and the Caribbean: systematic review of the literature

et al. 2019

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Introduction Systematic reviews show that women living with HIV ( WLHIV ) have high unmet sexual and reproductive health ( SRH ) needs due to barriers to access sexual and reproductive health services ( SRHS ). In Latin America and the Caribbean ( LAC ), as of 2016, there were nearly one million WLHIV , but the existing evidence of their SRH needs comes from a few individual studies. This systematic review provides an overview of these women's needs to help define new and/or adapt existing public health strategies to the local context. This review synthesizes the evidence from the literature on the use of and access to SRHS related to family planning, antenatal care, abortion services and violence against WLHIV in LAC . Methods Using a systematic review of mixed studies, a search was performed in MEDLINE , EMBASE , LILACS , INASP , POPLINE , SCOPUS , for studies conducted in LAC , from 2004 to 2017, as well as contact with authors and hand search as needed. Two independent reviewers evaluated the quality of the studies using the Mixed Methods Appraisal Tool; inclusion was conducted according to the PRISMA flow diagram. An exploratory narrative synthesis followed by quantitative synthesis data was undertaken. Group analysis or meta‐analysis was not considered appropriate given the level of heterogeneity of the studies. Results A total of 18 studies in 13 LAC countries for a population of 5672 WLHIV were included. Data from individual studies reported unmet family planning needs; higher, but inconsistent use of condom as the sole contraceptive method OR =1.46 [1.26 to 1.69]; lesser use of other non‐permanent contraceptive methods OR =0.26 [0.22 to 0.31]; more unplanned pregnancies OR =1.30 [1.02 to 1.66]; more induced abortions OR =1.96 [1.60 to 2.39]; higher risk of immediate postpartum sterilization; and higher exposure to sexual and institutional violence by WLHIV when compared with women without HIV . Conclusions This review presents evidence from LAC about the SRH unmet needs of WLHIV that must be addressed by decreasing institutional and structural barriers, facilitating services and reducing stigma, and discrimination...

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“Violence. Enough already”: findings from a global participatory survey among women living with HIV

Cited by 52 publications

References 21 publications

A longitudinal study of associations between HIV‐related stigma, recent violence and depression among women living with HIV in a Canadian cohort study

A longitudinal study of associations between HIV‐related stigma, recent violence and depression among women living with HIV in a Canadian cohort study

Achieving pregnancy safely for HIV‐serodiscordant couples: a social ecological approach

Access to sexual and reproductive health services for women living with HIV in Latin America and the Caribbean: systematic review of the literature

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