BACKGROUND: Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia.
METHODS: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis.
RESULTS: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services.
CONCLUSIONS: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population.

Violence against women and girls (VAWG) continues to be a pervasive issue globally, and in Ethiopia, that harms women and challenges progress towards a more gender-equal society. Many interrelated social, economic, and cultural factors impact VAWG. Religion is a complex factor that can contribute to and act as a preventative measure against VAWG. Thus, faith-leaders have been identified as key actors in VAWG prevention. This study examines Ethiopian Evangelical faith-leaders transformative knowledge change following a Channels of Hope for Gender training intervention. Focus group discussions were conducted with faith-leaders from five different Evangelical Church groups. The results show that the faith-leaders\' experience of the Channels of Hope training challenged their gender norms and allowed them to enact relationship and community-level changes. Additionally, they demonstrated efforts and interest in generating change at the level of the Church. However, barriers remained to fully addressing VAWG and implement gender transformative learning more widely. Thus, we conclude that the Channels for Hope training is useful in generating mindset changes and improving relationship-level interactions, but that it requires a longer implementation timeframe and further support from other structures and interventions to achieve sustainable change to prevent VAWG.

BACKGROUND: Men\'s violence against women is a global health problem causing physical, mental, sexual and reproductive ill-health. The World Health Organisation has estimated that every third woman in the world has been exposed to physical and/or sexual violence. Swedish primary care is central for victims of violence, as it is normally the first port of call for seeking healthcare. This requires professional competence on violence, and its causes. It also requires resources for working with violence prevention, disclosure and supportive actions. The aim of this study is to deepen the understanding of how primary care professionals in Sweden deal with violence against women. We analyse their viewpoints, experiences and practices of working with violence as a health problem, and especially if, and if so how, they ask patients about violence.
METHODS: A qualitative, explorative research design was adopted. Research interviews were conducted with 18 health professionals at eight primary care clinics. These clinics were located in four different regions, from the south to the north, in large urban areas, middle-size cities and rural areas. The interviews were voice recorded and transcribed verbatim. Thematic analysis was used to analyse the interviews.
RESULTS: Three themes, with a total of ten related sub-themes, were developed. These themes are: (a) Varying understandings and explanations of violence against women; (b) The tricky question of asking about violence; and (c) Multiple suggestions for improving primary care\'s work with violence against women. The awareness of violence varied considerably, with some practitioners being highly knowledgeable and having integrated violence into their everyday practice, whereas others were less knowledgeable and had not paid much attention to violence. The very naming of violence seemed to be problematic. Several suggestions for improvements at professional, managerial and organisational levels were articulated.
CONCLUSIONS: The results shed important light on the professionals\' problems and struggles when dealing with violence against women in primary care. Better support and resources from the healthcare organisation, clearer leadership and more detailed policy would improve and facilitate everyday practice. All of these factors are indispensable for primary care\'s work with victims of men\'s violence against women.

UNASSIGNED: Healthcare workers (HCW) play an important role in managing women living with HIV (WLHIV) with gender-based violence (GBV) experience, but little is known about their experience in screening and managing GBV among WLHIV. This study explored the perceptions and experience of the HCWs on screening and managing GBV cases among WLHIV.
UNASSIGNED: We performed a descriptive phenomenological qualitative study to elicit the views and experience of HCW on GBV screening and management for WLHIV. The study was conducted in the semi-urban setting in Morogoro Region, Tanzania. Ten in-depth interviews (IDIs) were administered to HCW selected purposefully based on their roles at an HIV care and treatment center. Data were transcribed using patterns matching study aim and then merged into relevant themes for analysis and interpretation. NVIVO software version 12 was used for data coding and analysis.
UNASSIGNED: We found that HCW experienced multiple challenges in GBV screening and management, including limited capacity for GBV screening and management; inadequate training on assessment and handling GBV cases, limited resources (time, GBV guidelines and screening tools), inadequate GBV referral and monitoring systems; referral forms for GBV survivors to social support centers and follow-up mechanisms to trace survivors, mental aspects; HCWs\' fear of being stressed by listening to women\'s\' GBV traumatic experiences, HCWs\' fear of causing problems to the women\'s families and HCW biased notions on women disclosure of GBV; the believes that women will not report their GBV experiences.
UNASSIGNED: We identified context-specific challenges preventing HCW to deliver optimal services of GBV to WLHIV, stressing the necessity to strengthen HCW capacity and resources for GBV services and to integrate psychosocial services into HIV care. Policy and programs should be developed to support GBV screening and management for WLHIV.

UNASSIGNED: Sexual and gender-based violence (SGBV), including rape and child sexual abuse, remains a significant challenge in post-conflict northern Uganda. Many victims have never sought help. Consequently, the scale of the problem is not known, and SGBV victims\' injuries, both psychological and physical, remain hidden and unresolved.
UNASSIGNED: We aimed to explore whether health workers in rural Reproductive Health Services (RHS), following specific training, could provide a valuable resource for SGBV screening and subsequent referral to targeted services.
UNASSIGNED: Our project had three elements. First, RHS workers were trained to use a questionnaire to screen subjects for past SGBV Second, the screening questionnaire was used by RHS workers over a 3-month period, and the data collected were analysed to explore whether the screening approach was an effective one in this setting, and to record the scale and nature of the problem. Third, victims detected were offered referral as appropriate to hospital services or to a dedicated SGBV ActionAid shelter.
UNASSIGNED: Of 1656 women screened, 778 (47%) had suffered SGBV: 123 rape, and 505 non-sexual violence. 1,254 (76%) had been directly or indirectly affected by conflict experiences; 1066 had lived in internally displaced persons camps. 145 (9%) requested referral to Gulu SGBV Shelter; 25 attended the shelter and received assistance, and 20 others received telephone counselling.
UNASSIGNED: Undetected SGBV remains a significant problem in post-conflict northern Uganda. RHS workers, following specific training, can effectively screen for and identify otherwise unrecognised survivors of SGBV. This matters because without ongoing detection, survivors have no opportunity for resolution, healing or help.

UNASSIGNED:
UNASSIGNED: Intimate partner violence is defined as any behavior by a current or past male intimate partner during marriage, cohabitation, or any other formal or informal union that causes physical, sexual, or psychological harm. Men are the most common perpetrators of this against women. It affects almost one-third of all women worldwide.
UNASSIGNED: This study aimed to assess the prevalence, consequences, and factors associated with intimate partner violence among partnered women in Gambella town.
UNASSIGNED: A community-based, cross-sectional study design was employed. A systematic random sampling technique was used to select the study participants. Data was collected using a pretested, structured questionnaire. The data were entered and analyzed using SPSS software version 25. The bivariate and multivariate logistic regression method was used to identify factors associated with intimate partner violence. Variables with a p-value <0.05 were considered significantly associated with intimate partner violence.
UNASSIGNED: The overall prevalence of intimate partner violence in the lifetime and the last 12 months was 58.8, 95% CI (54.0, 63.6), and 51.8, 95% CI (46.7, 56.8), respectively. More than half (53.3%) of the violence resulted in physical injury, while 32.9% were separated from their partners whereas, mother\'s history of exposure to IPV [AOR: 1.8, 95% CI (1.03-3.27), p < 0.05], respondent\'s age [AOR: 3.4, 95% CI (1.8, 6.5), p < 0.001], substance use [AOR:2.5, 95% CI (1.5-4.1), p < 0.001], disagreement on sexual intercourse [AOR:3.2, 95% CI (1.8-5.7), p < 0.01], monthly family income [AOR:0.32, 95% CI: (0.16-0.63), p < 0.01] and family size [AOR:2.8, 95% CI: (1.6-4.8), p < 0.01] were significantly associated with IPV.
UNASSIGNED: The study indicated that the prevalence of intimate partner violence was very high. Age of the woman, family size, substance use, economic status, were among factors significantly associated with intimate partner violence. Therefore, responsible stakeholders should respond to the deep-rooted and highly complicated gender inequality by implementing preventive measures.

Intimate partner violence (IPV) against women is a global public health problem. Conceptual frameworks suggest misperceived norms around IPV might drive perpetration of violence against women in southern and eastern Africa. We conducted a cross-sectional, population-based survey of all men residing in a rural parish in southwest Uganda, eliciting their endorsement of IPV in five hypothetical scenarios and their reported frequency of perpetration of violence against their wife/main partner. They also reported their perceptions about the extent to which most other men in their villages endorsed and/or perpetrated IPV, which we compared against the population data to measure the primary explanatory variable of interest: whether individuals misperceived norms around IPV. We fitted multivariable Poisson regression models specifying personal IPV endorsement and IPV perpetration as the outcomes. Overall, 765 men participated in the study (90% response rate): 182 (24%) personally endorsed IPV, and 78 of 456 partnered men (17%) reported perpetrating one or more acts of IPV at least once per month. Although most men neither endorsed nor reported perpetrating IPV, 342 (45%) men mistakenly thought that most other men in their villages endorsed IPV and 365 (48%) men mistakenly thought that most other men perpetrate IPV at least monthly. In multivariable regression models, men who misperceived most men to endorse IPV were more likely to endorse IPV themselves (adjusted relative risk [aRR] = 2.44; 95% CI [1.66, 3.59]; p < .001). Among partnered men, those who misperceived IPV perpetration to be normative were more likely to perpetrate IPV themselves (aRR = 4.38; [2.53, 7.59]; p < .001). Interventions to correct misperceived norms about IPV may be a promising method for reducing violence against women in rural Uganda.

Survivors of sexual assault and intimate partner violence often face many challenges in seeking/receiving healthcare and are often lost to follow up.
Our study objectives are to evaluate the feasibility, acceptability, and satisfaction of using telemedicine technology among sexual assault and intimate partner violence patients who present to a Canadian Emergency Department.
Qualitative research was conducted using a thematic approach.
Patients were identified from a case registry of all sexual assault and intimate partner violence cases seen between 1 April 2020 and 31 March 2022 from an emergency department of a large Canadian hospital. Qualitative trauma-informed interviews were conducted with consenting participants. Thematic qualitative analyses were performed to investigate barriers and drivers of telemedicine for follow-up care.
Of the 1007 sexual assault and intimate partner violence patients seen during the study timeframe, 180 (8%) consented to be contacted for future research, and 10 completed an interview regarding telemedicine for follow-up care. All participants were cisgendered women, 5 (50%) experienced sexual assault, 6 (60%) physical assault, and 3 (30%) verbal assault. All knew their assailant, and 6 (60%) were assaulted by a current or former intimate partner. Three themes emerged as drivers of telemedicine use: increased comfort, increased convenience, and less time required for the appointment. Three thematic barriers to telemedicine use included lack of privacy from others, lack of safety from their assailant, and pressure to balance competing tasks during the appointment.
This study illustrated that telemedicine for sexual assault and intimate partner violence follow-up care is feasible, acceptable, and can improve patient satisfaction with follow-up care. Ensuring safety and privacy are key considerations when offering telemedicine as an appropriate option for survivors.
A qualitative analysis of telemedicine and virtual healthcare for survivors of sexual assault and intimate partner violenceWhy was the study done? Sexual assault and intimate partner violence are prevalent issues in our society. More than 3/10 Canadian women have been sexually assaulted at least once since the age of 15 years and more than 4/10 Canadian women have experienced IPV in their lifetime. Survivors face many obstacles to receiving care after sexual assault and intimate partner violence and are often lost to follow up.What did the researchers do?The researchers studied the acceptability, feasibility, and satisfaction of using telemedicine technology among sexual assault and intimate partner violence survivors who presented to a Canadian Emergency Department. Sexual assault and intimate partner violence survivors were interviewed individually about their experience receiving follow-up care via telemedicine. The interviews were done using a trauma-informed approach, and data analyses were done to explore the barriers and drivers of telemedicine for follow-up care.What did the researchers find?The total number of interviews was 10, and all participants were cisgendered women. All knew their assailant and six were assaulted by a current or former intimate partner. Survivors found that telemedicine was an accessible way to have a follow-up appointment and were mostly satisfied with their experience. Three major drivers to using telemedicine included increased comfort being at home in their own space, increased convenience as they did not have to leave their house to have the appointment, and less time required for the appointment. Three major barriers to using telemedicine included lack of privacy from others during the appointment, pressure to balance competing tasks during the appointment, and lack of safety from their assailant.What do the findings mean?This study has shown that follow-up care for sexual assault and intimate partner violence survivors using telemedicine can be feasible, acceptable, and can improve patient satisfaction. However, it is important to consider factors such as safety and privacy on an individual basis when offering telemedicine as an option for follow-up care for survivors.

BACKGROUND: We assessed the impact of a personal agency-based training for refugee women and their male partners on their economic and social empowerment, rates of intimate partner violence (IPV), and non-partner violence (NPV).
METHODS: We conducted an individually randomized controlled trial with 1061 partnered women (aged 18-45) living in a refugee camp in Rwanda. Women received two days of training, and their partners received one day of training. The follow-up survey where all relevant outcomes were assessed was carried out at 6-9 months post-intervention.
RESULTS: At follow up, women in the intervention arm were more likely to report partaking in income generating activities (aIRR 1.27 (1.04-1.54), p < 0.05) and skill learning (aIRR 1.59 (1.39-1.82), p < 0.001) and reported a reduction in experience of physical or sexual NPV in the past six months (aIRR 0.65 (0.39-1.07), p < 0.09). While improved, no statistically significant impacts were seen on physical or sexual IPV (aIRR 0.80 (0.58-1.09), p = 0.16), food insecurity (β 0.98 (0.93 to 1.03), p = 0.396), or clean cookstove uptake (aIRR 0.95 (0.88 to 1.01), p = 0.113) in the past six months. We found statistically significant reduction in physical and sexual IPV amongst those experiencing IPV at baseline (aIRR 0.72 (0.50 to 1.02), p < 0.07). Small improvements in self-efficacy scores and our indicator of adapting to stress were seen in the intervention arm. Some challenges were also seen, such as higher prevalence of probable depression and/or anxiety (aIRR 1.79 (1.00-3.22), p = 0.05) and PTSD (aIRR 2.07 (1.10-3.91), p < 0.05) in the intervention arm compared to the control arm.
CONCLUSIONS: Our findings echo previous research showing personal agency training can support economic well-being of women. We also find potentially promising impacts on gender-based violence. However, there is some evidence that integration of evidence-based mental health support is important when enhancing agency amongst conflict-affected populations.
BACKGROUND: The trial was registered with ClinicalTrials.gov, Identifier: NCT04081441 on 09/09/2019.

The COVID-19 pandemic brought on a marked increase in intimate partner violence (IPV) worldwide, Mexico being no exception. Factors that exacerbated gender-based violence (GBV) in the household during the pandemic include gendered loss of income, regression in access to social and legal justice resources, reversal to more traditional gender norms and roles, and increased alcoholism. While there are studies about the prevalence and determinants of IPV in rural and urban Mexico, there appears to be a lack of information regarding how these realities differed as they interacted with the compounding pressures of the COVID-19 pandemic. Stemming from 10 ethnographic interviews with women across rural and urban localities of Oaxaca, Mexico City, and Mexico State, who were recruited from NGOs providing psychological and legal services against GBV, we analyze some factors associated with the prevalence of IPV during confinement. We conclude that all women in our study experienced IPV both before and during the pandemic, with variations in IPV patterns influenced by their rural or urban residence, socio-economic status, ethnic-racial identity, and proximity to the abuser\'s network. We also found that not all impacts were negative, rather COVID-19 measures had a paradoxical effect for some women where restrictions on geographical mobility and decrease in access to alcohol became pivotal protective factors. We recommend that public policymakers and civil society organizations alike pay attention to these differential challenges and benefits in their crisis responses.