Associations between psychosocial wellbeing and experience of gender-based violence at community, household, and intimate-partner levels among a cross-sectional cohort of young people living with and without HIV during COVID-19 in Cape Town, South Africa

BMC Public Health

Research

Audrey Pettifor¹  Anna E. Kågesten²  Anna Nielsen²  Anna Mia Ekström³  Zangin Zeebari⁴  Miriam Hartmann⁵  Gina Itzikowitz⁶  Danielle Giovenco⁶  Linda-Gail Bekker⁶ 

[1] Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, USA;Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden;Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden;Department of Infectious Diseases, South General Hospital, Stockholm, Sweden;Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden;Jönköping International Business School, Jönköping University, Jönköping, Sweden;Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden;Women’s Global Health Imperative, RTI International, Berkely, CA, USA;Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa;

关键词: Violence;    Gender-based Violence;    HIV, young people;    COVID-19;    COVID-19-related stress;    Mental health;    South Africa;   

DOI  :  10.1186/s12889-023-16945-5

 received in 2022-12-30, accepted in 2023-10-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundGrowing evidence indicates that gender-based violence (GBV) increased during COVID-19. We investigated self-reported impact of the pandemic on GBV at community, household and intimate partner (IPV) levels among young people and its associations with psychosocial wellbeing, i.e., COVID-related stressors and mental health.MethodsCross-sectional data were drawn from a survey with young people ages 13–24 (N = 536) living with HIV (YPLWH) and without HIV (YPLWoH), in peri-urban Cape Town, South Africa. The survey, conducted February-October 2021, examined the impact of the initial lockdown on experience and perceived changes in GBV at each level, and pandemic-related psychosocial wellbeing. Descriptive statistics and binomial and multinomial regression analyses were conducted to illustrate exposure and perceived changes in GBV since lockdown, and their association with COVID-related stress factors (e.g., social isolation, anxiety about COVID), mental health (e.g., depression, anxiety), and other risk factors (e.g., age, gender, socioeconomic status) by HIV status.ResultsParticipants were 70% women with mean age 19 years; 40% were living with HIV. Since lockdown, YPLWoH were significantly more likely than YPLWH to perceive community violence as increasing (45% vs. 28%, p < 0.001), and to report household violence (37% vs. 23%, p = 0.006) and perceive it as increasing (56% vs. 27%, p = 0.002) (ref: decreasing violence). YPLWoH were also more likely to report IPV experience (19% vs. 15%, p = 0.41) and perception of IPV increasing (15% vs. 8%, p = 0.92). In adjusted models, COVID-related stressors and common mental health disorders were only associated with household violence. However, indicators of economic status such as living in informal housing (RRR = 2.07; 95% CI = 1.12–3.83) and food insecurity (Community violence: RRR = 1.79; 95% CI = 1.00-3.20; Household violence: RRR = 1.72; 95% CI = 1.15–2.60) emerged as significant risk factors for exposure to increased GBV particularly among YPLWoH.ConclusionsFindings suggest that for young people in this setting, GBV at community and household levels was more prevalent during COVID-19 compared to IPV, especially for YPLWoH. While we found limited associations between COVID-related stressors and GBV, the perceived increases in GBV since lockdown in a setting where GBV is endemic, and the association of household violence with mental health, is a concern for future pandemic responses and should be longitudinally assessed.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 7