Abstract
Background: Globally, there is evidence supporting the co-occurrence of intimate partner violence (IPV), substance use disorders (SUD) and mental health disorders among women in prisons, however, there is limited research investigating these domains in the Andean region where rates of female incarceration have increased. The study objective was to explore the prevalence of IPV, SUD and depression among incarcerated women in a Peruvian prison and explore associations among these variables and related correlates. Methods: 249 incarcerated women responded to a questionnaire about IPV, substance use, depression, and sexual behavior, and were screened for HIV/sexually transmitted diseases (STDs). Univariate analysis and logistic regression were used to estimate relative risk and the influence of substance use and depression on IPV rates. Results: Twelve months prior to incarceration, of the women with sexual partners pre-incarceration (n = 212), 69.3% experienced threats of violence, 61.4% experienced ≥1 acts of physical violence, and 28.3% reported ≥1 act of sexual aggression. Pre-incarceration, 68.1% of drug-using women had a SUD, and 61.7% of those who consumed alcohol reported hazardous/harmful drinking. There were 20 (8.0%) HIV/STD cases; and 67.5% of the women reported depressive symptoms. Compared to women with no experiences of physical violence, a greater proportion of women who experienced least l violent act had depressive symptoms and engaged in sex work pre-incarceration. Depression was associated with physical violence (adjusted relative risk = 1.35, 95% confidence interval: 1.14–1.58). Recommendations: The findings provide evidence of a syndemic of IPV, substance abuse and depression among incarcerated women in a Peruvian prison. To help guide policy makers, further research is needed to determine if this is indicative of trends for other at-risk women in the region, and viable options to treat these women during incarceration to prevent recidivism and other long-term negative sequalae.
Highlights
Violence against women is a pervasive public health problem affecting women worldwide— those from lower and middle income countries [1]
There is a more extensive body of work focusing on similar research in Brazil and other South American countries [24,25], to our knowledge, the present study is one of the first attempts to understand the association of intimate partner violence, alcohol use, and illicit drug use among incarcerated women in this region. To partially address this scientific gap and provide evidence to inform the development of interventions that can curtail the growth of this syndemic, the purpose of the present study was to firstly examine the prevalence of IPV among female prisoners in Lima, Perú, and, secondly to assess the relationship between IPV, substance use, depression and indicated correlates
This study provides empirical evidence of a public health problem for women living in Perú, other Andean countries, and other global regions
Summary
Violence against women is a pervasive public health problem affecting women worldwide— those from lower and middle income countries [1]. On substance use, mental health and sexual risk among lower income women [4]. The effect is amplified among incarcerated women where there is often a history of violence and trauma which is known to have an impact on mental health [5,6,7]. Reported rates of physical and/or sexual intimate partner violence in the Americas is the second highest regional estimate globally at approximately 30%, indicating an epidemic of violence against women in this region [1,8]. There is evidence supporting the co-occurrence of intimate partner violence (IPV), substance use disorders (SUD) and mental health disorders among women in prisons, there is limited research investigating these domains in the Andean region where rates of female incarceration have increased. Pre-incarceration, 68.1% of drug-using women had a SUD, and
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