Sexual violence and HIV transmission: summary proceedings of a scientific research planning meeting.

[Extract] Globally, more than 1 in 3 women have experienced physical or sexual violence (SV) from intimate partners or SV from non-partners [1]. Furthermore, over 10% of all girls are estimated to have experienced a forced sexual act, with the highest rates of SV against girls found in sub-Saharan Africa [2]. Although public recognition of SV is growing in Zambia, reliable data on the nature and extent of such violence is limited. Approximately 20% of Zambian women aged 15 to 49 have experienced some form of sexual violence; however, this is likely underestimated due to underreporting [3]. Previous research in Zambia suggests that exposure to SV is equally pervasive among adolescent girls [4,5]. The risks associated with SV, especially among young women, are numerous. Immediate health consequences include unwanted pregnancy, physical trauma, mental distress and acquisition of HIV and other sexually-transmitted infections. The linkage between sexual and gender-based violence (SGBV) and risk of HIV has been well documented in Africa and is especially pronounced in countries with high HIV prevalence, such as Zambia [3,6-8]. Growing awareness of these negative consequences of SGBV led the Government of Zambia to develop a set of national guidelines for the management of SGBV, highlighting the need for a response system linking the health, police, and social services sectors. A critical component of this response is the prevention of HIV infection in SV survivors through the provision of preventive anti-retroviral therapy, or HIV post-exposure prophylaxis (PEP). The initial dose of PEP must be taken within 72 hours of exposure to HIV [9]. Given the time sensitivity of PEP and the fact that police and health services are often the first points of contact for SV survivors, strong coordination between these two sectors is central to the effective medical management of SV cases in Zambia [10]. Building on the results of previous research in Zambia, which demonstrated that trained Victim Support Unit (VSU) police officers could effectively administer the emergency contraception pill to SV survivors, the Population Council, Zambia Police Service, and Ministry of Health aimed to assess the feasibility of having trained VSU police officers safely and effectively provide a PEP starter dose to SV survivors with immediate referral to comprehensive medical services [10].

The Interplay between Sexually Transmitted Infections and HIV: An Evolving Story.

Conflict settings are often the context of some of the highest rates of sexual and gender-based violence (SGBV). Although women are disproportionately the victims of SGBV, they are not the only victims. Indirect impacts of SGBV also impact men, families, and communities. Examining SGBV as only a woman's concern reinforces the hegemonic gender-binary view that SGBV somehow does not include men, who can be direct victims of SGBV, family members of female victims of SGBV, and/or perpetrators of SGBV. This qualitative study seeks to fill a gap by exploring the impact of SGBV on individuals, families, and communities, and potential options to ameliorate those issues. Data were collected in 2019 from community-based discussions in South Kivu, Democratic Republic of Congo. Women described being direct victims of SGBV, as well as the burden of being at constant alert to the possible threat of violence. Men talked more about SGBV being perpetrated against women, and the indirect effect on men's perception of their social husband and/or father role to protect and provide for their family. Taken together, women and men describe three types of violence: sexual violence by an unknown assailant who is often associated the rebel groups or the military; sexual violence from a known assailant within one's community; and sexual or physical violence within intimate partnerships (i.e., intimate partner violence). Women focused more on community-based solutions to reduce their exposure to violence, while men discussed the government's responsibility to end the long-standing conflict that has severely disrupted lives. Practically, these findings support the need to specify different types of SGBV, and the opportunity to tailor interventions by type.

We review the effects of war on HIV and STI transmission and critically appraise short- and medium-term approaches to prevention. Our intent is to stimulate thinking about the potential for increased HIV/STI transmission in current and future armed conflicts with particular reference to Afghanistan and to encourage timely interventions to prevent a worsening HIV epidemic in Central and South Asia. (excerpt)

Responding to sexual violence in armed conflict

The aim of the study described in this article is to examine the dimensions and correlates of attitudes toward survivors of sexual violence (SV) in Eastern Democratic Republic of the Congo (DRC). Four dimensions of attitudes were identified: victim responsibility, victim denigration, victim credibility, and deservingness. Gender roles attitudes represented the most significant correlate of attitudes toward survivors in this population. Other significant correlates of overall attitudes toward survivors included current employment, province of residence, knowledge about the SV law, awareness about where to go for information on sexual and gender-based violence (SGBV), and the perceived prevalence of SV in own community. There are differences and communalities in the variables associated with the various dimensions of attitudes. For example, sex of the respondent and discussion of SGBV with others were only significantly associated with the tendency to ascribe responsibility to the victim. The findings indicate that changing negative gender norms should be central to efforts aimed at promoting accepting attitudes toward survivors. Furthermore, addressing the various dimensions of attitudes toward survivors may require different strategies.

BackgroundGender-based violence, and gender inequality more broadly, has been found to be associated with increased risk of sexually transmitted infections (STI) including HIV among women and girls as well as...

Despite many years of rigorous evaluation of a variety of interventions, HIV incidence rates in parts of Africa remain unacceptably high. A recent review identified 37 randomized controlled trials testing interventions to reduce HIV incidence.1 Except for 3 randomized controlled trials of male circumcision2‐4 and 1 trial of syndromic treatment of sexually transmitted diseases,5 and, recently, 1 trial of a vaginal microbicide,6 no significant reductions in HIV incidence were observed. In some trials of vaginal microbicides, trial participants in the active treatment arm actually had increased HIV incidence rates.7 Trials with candidate vaccines have been equally disappointing.8 A recently completed trial of a prime-boost strategy conducted in Thailand showed statistically significant, but limited, protection against HIV.9 Nevertheless, even vaccine optimists think that a preventive HIV vaccine is many years away. Sexually transmitted infections (STIs) were identified as important cofactors for HIV transmission early in the epidemic.10,11 Many prospective observational studies showed that the presence of ulcerative and nonulcerative STIs increased the likelihood of HIV transmission.10,11 Several interventions were based on this observation including mass treatment with antibiotics,12 improved syndromic management of STIs,5,13 and herpes simplex virus (HSV)-2 suppressive treatment.14 Null findings of these interventions should be interpreted with caution. Failure to show an effect does not necessarily mean that the STI is not causally associated with HIV. As Barnabas and Wasserheit highlight,15 the stage of the HIV epidemic in which an intervention trial is conducted may significantly influence observed efficacy. Another possible reason for the failure of these trials to demonstrate efficacy is that the intervention may not have adequately controlled the STI or its biologic effects.

Preface: On the Duty to Face Sexual Violence and Conflict The Honourable Michaelle Jean. Acknowledgments. Sexual Violence in Conflict and Post-Conflict Societies: Situating International Agendas and their African Contexts 1. Seeing Sexual Violence in Conflict and Post-Conflict Societies: The Limits of Visibility Doris Buss 2. The Political Economy of War: What Women Need to Know Meredeth Turshen Sexual Violence and Conflict: Civil Society Perspectives on Patterns, Causes and Solutions 3. Sexual Violence Patterns, Causes, and Possible Solutions: An Interview with Kudakwshe Chitsike, Research and Advocacy Unit, Zimbabwe and Jessica Nkuuhe, Independent Consultant, Uganda Doris Buss 4. Sexual Violence Patterns, Causes, and Possible Solutions: An Interview with Julienne Lusenge, Solidarite Feminine pour la Paix Integrale (SOFEPADI), Democratic Republic of Congo Sexual Violence and Harm: From Conflict to Post-Conflict Societies 5. Gendered Insecurity and the Enduring Impacts of Sexual and Gender-Based Violence (SGBV) in Northern Uganda Rebecca Tiessen and Lahoma Thomas 6. Through War to Peace: Sexual Violence and Adolescent Girls Donna Sharkey 7. Ritual and Reintegration of Young Women Formerly Abducted as Child Soldiers in Northern Uganda Christine Mbabazi Mpyangu 8. Considering Gender Relations and Culture in the Psychosocial Adaptation of Individuals and Communities Affected by Sexualised Violence in African Conflicts Sophie C. Yohani Representing Harms and the Trouble with (Victim) Categories 9. Sexual Violence, Female Agencies, and Sexual Consent: Complexities of Sexual Violence in the 1994 Rwandan Genocide Jennie E. Burnet 10. The Representation of Rape by the Special Court for Sierra Leone Valerie Oosterveld 11. Justice and Reparations for Rwanda's Enfants Mauvais Souvenirs Sandra Le Courtois 12. On Transitional Justice Entrepreneurs and the Production of Victims Tshepo Madlingozi The Gender of Security 13. A Gendered Reading of Security and Security Reform in Post Conflict Societies Fionnuala Ni Aolain, Naomi Cahn and Dina Haynes 14. Security Sector Reform in Africa: A Lost Opportunity to Deconstruct Militarised Masculinities? Yaliwe Clarke 15. Women Peacekeepers and UNPOL Officers in the Fight Against Sexual and Gender-Based Violence in Post-Conflict Zones Sophie Toupin Post-Conflict Development and International Agendas 16. Development and Its Discontents: Ending Violence Against Women in Post-Conflict Liberia Pamela Scully 17. International Assistance to Combat Sexual Violence in the Congo: Placing Congolese Women at the Heart of the Process! Denis Tougas

Gender-based violence in refugee settings

ABSTRACTThe eastern Democratic Republic of Congo (DRC) is impacted by a prolonged conflict and humanitarian crisis. Sexual and gender-based violence (SGBV) affects an estimated 39.7% of women and 23.6% of men in the region, and is associated with serious medical, psychological, and socio-economic outcomes for survivors and communities. IMA World Health, a faith-based non-profit organisation, implements a USAID-funded project, Ushindi, which is a collaborative effort with three national NGOs and one technical partner in response to SGBV in eastern DRC. The consortium provides a comprehensive package of services to SGBV survivors, focusing on medical, emotional, psychological, legal, and socio-economic needs.

The relationship between drug abuse and sexual performance among women on methadone: Heightening the risk of sexual intimate violence and HIV

More than a decade of fighting in the Democratic Republic of the Congo (DRC) has resulted in extensive human rights abuses, of which sexual and gender-based violence (SGBV) is one of the most salient and disturbing features. This paper uses qualitative data, based on 10 focus groups with 86 women and men to better understand gendered community perspectives on SGBV and its consequences in South Kivu. We conclude that for many survivors, rape has consequences far beyond the physiological and psychological trauma associated with the attack. Respondents say sexual violence has become a societal phenomenon, in which the community isolation and shame experienced as a result of the attack become as important as concerns about the attack itself. Male focus group participants explain their own feelings of shame and anger associated with knowing their female relatives were raped. These findings highlight the complexity of community reintegration for survivors and identify a number of programmatic and policy implications, such as the need for counselling for survivors of sexual violence with their families as well as individually; the importance of income-generating training; and the need for improved justice mechanisms to bring perpetrators to justice.

Sexual and gender-based violence (SGBV) against minority populations is a global public health problem with consequential effects on human health and development. It has been reported among men who have sex with men (MSM) and transwomen in forms of verbal abuse and physical and sexual violence. This study was carried out to determine the prevalence of SGBV among MSM and transwomen in Nigeria. It was cross-sectional in design utilizing a snowballing method to recruit participants. A total of 382 responses were received through an online questionnaire. Descriptive statistics and logistic regression were used to analyze the data at the significance level of 5%. The mean (SD) age of respondents was 27(0.3) years. About 35 % (95%CI: 30.2-39.8) of all respondents had ever experienced sexual violence, and 42.1 % (95%CI: 37.3-47.2) had ever experienced physical violence. The prevalence of sexual violence within one year preceding the study was 13.8% (95%CI: 10.8-17.5), while physical violence was 16.3% (95%CI: 13.0-20.2). Transwomen were about thrice (odds ratio: 2.92, p<0.01) and 5.6 times (p<0.001) more likely to experience sexual and physical violence respectively than MSM self-identified as males. Transwomen were also about 3 times more likely to experience IPV than MSM self-identified as males (odds ratio: 2.92, p<0.01). One-fifth (18.1%) of all respondents had ever experienced IPV, and for transwomen, it was 1 in 3. This study showed a high prevalence of both sexual and physical violence among MSM and transwomen in Nigeria, and this necessitate the creation of a legal framework that will protect their rights. Keywords: Gaymen, Gender-based violence, Men who have sex with men, Prevalence, Sexual violence, Transwomen.

Hormone regulation of the mucosal environment in the reproductive tract and the prevention of HIV infection.