Prevalence and response to sexual and gender based violence among people living with HIV/AIDS in Lira District
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Makerere University
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A dissertation submitted to the School of Graduate Studies in partial fulfilment for the award of the Degree of Master of Public Health of Makerere University.
This was a cross sectional study done in Lira district, Uganda to assess the prevalence and response to SGBV among the PHAs and specifically to determine the prevalence of SGBV among the PHAs, to identify the types of SGBV suffered by the PHAs, to assess the victim responses to SGBV and the capacity of the health care providers to manage SGBV cases among the PHAs. Sexual and Gender Based violence (SGBV) is violence directed at a person on the basis of gender and/or sex. It is realised that, SGBV is still global health, economic, development and human right violation problem. SGBV has a very strong interrelationship with HIV infection. A total of 334 PHAs (167 PHAs from Lira Hospital and 56 PHAs from Orum H/C IV, Ogur H/C IV and Amach H/C IV HIV clinics were interviewed. The main out come (dependent) variables were presence of SGBV cases among the PHAs and response to SGBV by the PHAs. The independent variables were age, sex, education, marital status, occupation, religion, discordance, disclosure, capacity of health care providers and availability of MOH SGBV clinical management guidelines. Descriptive analysis of the data collected was done and associations between variables assessed using cross tabulation and p-values of chi squares to test for statistical significance. A prevalence rate of SGBV among people living with HIV/AIDS in Lira is found to be 47.3% compared to 40% national prevalence (MOH 2007) was found. Women were found to be more affected (77.6%) than men (22.4%). The PHAs are shown here to be abused to varying degree- emotionally (62%), physically (55.5%) and sexually (8.7%). The SGBV victims commonly report to clan leaders, relatives and elders with very few cases being reported to the police for legal action. Quite a big number of SGBV cases are not reported at all (57.6%). Few SGBV victims seek medical treatment. The health care providers are offering SGBV related services but they lack specific training in clinical management of SGBV according to the MOH Guidelines and they do not use the SGBV reporting tools designed by the MOH. Conclusion The prevalence of Sexual and Gender Based Violence is high among people living with HIV/AIDS with most victims being females and the majority being emotionally and physically abused with few cases of sexual abuse. Recommendations Need for community sensitization and education on the dangers and consequences of SGBV, Law enforcement and training of health workers on clinical management of SGBV.
This was a cross sectional study done in Lira district, Uganda to assess the prevalence and response to SGBV among the PHAs and specifically to determine the prevalence of SGBV among the PHAs, to identify the types of SGBV suffered by the PHAs, to assess the victim responses to SGBV and the capacity of the health care providers to manage SGBV cases among the PHAs. Sexual and Gender Based violence (SGBV) is violence directed at a person on the basis of gender and/or sex. It is realised that, SGBV is still global health, economic, development and human right violation problem. SGBV has a very strong interrelationship with HIV infection. A total of 334 PHAs (167 PHAs from Lira Hospital and 56 PHAs from Orum H/C IV, Ogur H/C IV and Amach H/C IV HIV clinics were interviewed. The main out come (dependent) variables were presence of SGBV cases among the PHAs and response to SGBV by the PHAs. The independent variables were age, sex, education, marital status, occupation, religion, discordance, disclosure, capacity of health care providers and availability of MOH SGBV clinical management guidelines. Descriptive analysis of the data collected was done and associations between variables assessed using cross tabulation and p-values of chi squares to test for statistical significance. A prevalence rate of SGBV among people living with HIV/AIDS in Lira is found to be 47.3% compared to 40% national prevalence (MOH 2007) was found. Women were found to be more affected (77.6%) than men (22.4%). The PHAs are shown here to be abused to varying degree- emotionally (62%), physically (55.5%) and sexually (8.7%). The SGBV victims commonly report to clan leaders, relatives and elders with very few cases being reported to the police for legal action. Quite a big number of SGBV cases are not reported at all (57.6%). Few SGBV victims seek medical treatment. The health care providers are offering SGBV related services but they lack specific training in clinical management of SGBV according to the MOH Guidelines and they do not use the SGBV reporting tools designed by the MOH. Conclusion The prevalence of Sexual and Gender Based Violence is high among people living with HIV/AIDS with most victims being females and the majority being emotionally and physically abused with few cases of sexual abuse. Recommendations Need for community sensitization and education on the dangers and consequences of SGBV, Law enforcement and training of health workers on clinical management of SGBV.
Keywords
Sex discrimination, HIV-positive persons, HIV/AIDS, Gender-based violence, Gender discrimination, Sexual violence, Gender, Psychological abuse, Emotional abuse