Dataset Information

Psychological and Physical Intimate Partner Violence and Maternal Depressive Symptoms during the Pre- and Post-Partum Period among Women Living with HIV in rural South Africa.

ABSTRACT:

Purpose

Women in South Africa also have high rates of depression and intimate partner violence, and they often co-occur. Women living with HIV who experience IPV are particularly likely to experience elevated levels of depressive symptoms and such symptoms are more likely to persist. Although the association between IPV and depression has been examined extensively, the role of depression on IPV has not. Therefore, this study examined the bidirectional association between intimate partner violence (IPV) and depression in South Africa (SA).

Method

Participants were N=699 pregnant women with HIV in rural SA who completed measures of depressive symptoms and IPV at baseline (M=17.52±5.77 weeks of pregnancy), 32 weeks antenatally, and 6- and 12-months postnatally.

Results

Depressive symptoms were linked to increased psychological IPV from baseline to 32-weeks, and from 32-weeks to 6-months. However, from 6-months to 12-months, depressive symptoms were associated with decreased psychological IPV. Psychological IPV was linked to depressive symptoms from baseline to 32-weeks. Depressive symptoms were associated with physical IPV from 32-weeks to 6-months, and 6-months to 12-months. Physical IPV was associated with increased depressive symptoms from baseline to 32-weeks, and from 32-weeks to 6-months.

Conclusions

Findings merit replication, as there may be measurement differences of psychological IPV in SA. However, targeting depressive symptoms and IPV concurrently in prevention and intervention programs may help optimize maternal and child outcomes in the context of prevention of mother-to-child transmission of HIV.

SUBMITTER: Rodriguez VJ

PROVIDER: S-EPMC7339971 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Psychological and Physical Intimate Partner Violence and Maternal Depressive Symptoms during the Pre- and Post-Partum Period among Women Living with HIV in rural South Africa.

Rodriguez Violeta J VJ Shaffer Anne A Lee Tae Kyoung TK Peltzer Karl K Weiss Stephen Marshall SM Jones Deborah Lynne DL

Journal of family violence 20181217 1

<h4>Purpose</h4>Women in South Africa also have high rates of depression and intimate partner violence, and they often co-occur. Women living with HIV who experience IPV are particularly likely to experience elevated levels of depressive symptoms and such symptoms are more likely to persist. Although the association between IPV and depression has been examined extensively, the role of depression on IPV has not. Therefore, this study examined the bidirectional association between intimate partner ...[more]

PMID: 32636575

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Project description:Intimate partner violence (IPV) affects individuals and families from all backgrounds, regardless of their ethnicity, socio-economic status, sexual orientation, or religion. Pregnancy and childbirth could be a time of vulnerability to violence because of changes in physical, emotional, social, and economic demands and needs. Prevalence of IPV against women during the perinatal period is increasingly researched and documented. However, evidence on IPV prevalence among intimate partners as well as on the course of IPV over the perinatal period is scarce. The purpose of this review was to provide a narrative synthesis of the existing literature regarding the prevalence estimates of IPV among intimate partners over the perinatal period. Through this review, we also gained better insight into associated factors, as well as the various forms of IPV. Of the 766 studies assessing prevalence estimates identified, 86 were included, where 80 studies focused on unidirectional IPV (i.e., perpetrated by men against women) and six studies investigated bidirectional IPV (i.e., IPV perpetrated by both partners). Most of the included studies reported lower overall prevalence rates for unidirectional IPV postpartum (range: 2-58%) compared to pregnancy (range: 1.5-66.9%). Psychological violence was found to be the most prevalent form of violence during the entire perinatal period. Studies on bidirectional IPV mostly reported women's perpetration to be almost as high as that of their partner or even higher, yet their findings need to be interpreted with caution. In addition, our results also highlighted the associated factors of IPV among partners, in which they were assimilated into a multi-level ecological model and were analyzed through an intersectional framework. Based on our findings, IPV is found to be highly prevalent during the entire perinatal period and in populations suffering from social inequalities. Further research exploring not only the occurrence, but also the motivations and the context of the bidirectionality of IPV during the perinatal period may facilitate better understanding of the detrimental consequences on partners and their families, as well as the development of effective intervention strategies. Public health prevention approaches intervening at optimal times during the perinatal period are also needed.

Project description:Existing data suggest that there are distinct patterns (or classes) of intimate partner violence (IPV) experience that depart from dichotomous categorizations used to monitor progress toward Sustainable Development Goal 5.2. Less is known about the patterning of IPV in non-Western settings. This study estimates distinct classes of IPV experience in Nepal and examines potential community-level variability in these classes and in the association between IPV class and depressive symptoms. This study used data collected in 2016 from a random sample of Nepalese married women of reproductive age (N?=?1440) living in 72 communities in three districts (Nawalparasi, Chitwan, and Kapilvastu). We used fixed effects and random effects latent class models of 2 through 6 classes. We fit a negative binomial regression model adjusted for relevant confounders to examine the relationship of the latent IPV classes with depressive symptoms. A four-class model was the best fitting. It included a "low exposure" class (77.36% of the sample) characterized by a low probability of experiencing any form of IPV, a "sexual violence" class (9.03% of the sample) characterized by a high probability of experiencing a form of sexual violence, a "moderate violence" class (6.60% of the sample) characterized by modest probabilities of experiencing less severe emotional and physical IPV, and a "systematic violence" class (7.01% of the sample) characterized by a high probability of being exposed to all forms of IPV. Adding random effects did not improve model fit, suggesting no community-level variations in classes. Relative to membership in the low exposure class, membership in all other classes was associated with a higher count of depressive symptoms. Those in the systematic class had a mean weighted symptom count 2.29 times that of the low exposure group. Classes of IPV exposure must be identified to ensure that surveillance and programming are attuned to women's experiences of violence.

Project description:IntroductionThe dynamics of intimate partner violence (IPV)-one of the world's leading public health problems-in urban Africa remain poorly understood. Yet, urban areas are key to the future of women's health in Africa.Study objectivesWe explored survivor-, partner-, and household-level correlates of prevalence rates for types of IPV in urban SSA women.MethodThe study uses DHS data from 42,143 urban women aged 15-49 in 27 SSA countries. Associations at the bivariate level were examined using the Pearson Chi-square test. The modified Poisson regression test estimated the relative prevalence of IPV subtypes in the study population at the multivariate level.ResultsApproximately 36% of women in urban SSA experienced at least one form of IPV; 12.8% experienced two types; and 4.6% experienced all three types. SSA urban women who had only primary-level education, had 3 or more living children, were informally employed, were in polygynous unions, or who approved of wife-beating similarly displayed higher adjusted prevalence rates for all three forms of IPV compared respectively to their counterparts without formal education, without a living child, were unemployed, in monogamous unions, or who do not approve of wife-beating. On the other hand, the region's urban women who began cohabiting between ages 25 and 35 years or who lived in higher wealth households showed consistently lower adjusted prevalence rates for all three forms of IPV relative to their counterparts who began cohabiting before 18 years or who lived in lower wealth households. Compared to their counterparts without formal education, without a living child, or whose partners did not have formal education, women with secondary and higher education, with 1-2 living children, or whose partners had only primary level schooling displayed higher adjusted prevalence rates for both IPEV and IPPV, but not for IPSV. However, relative to their counterparts whose partners were aged 25 years or below, living with a partner aged 40 years and above was associated with statistically significant reduced prevalence rates for IPPV and IPSV, but not for IPEV. Only for IPPV did women with partners educated at secondary and above levels display statistically significant higher adjusted prevalence rates relative to their counterparts with uneducated partners. Also, solely for IPPV did women who began cohabiting between ages 18 and 24 years or whose partners were employed (whether formally or informally) show decreased adjusted prevalence rates relative to their counterparts who started cohabiting before 18 years or whose partners were unemployed. In addition, only for IPSV did women aged 40 years and above or living in middle wealth households show statistically significant reduced adjusted prevalence rates relative to their counterparts aged less than 25 years or living in lower wealth households.Discussion and conclusionBy 2030, the majority of SSA women will be urban dwellers. Complexities surround IPV in urban SSA, highlighting the unique dynamics of the problem in this setting. While affirming the link between IPV and marital power inequities and dynamics, findings suggest that the specific correlates of prevalence rates for different IPV sub-types in urban SSA women can, at once, be both similar and unique. The contextual drivers of the differences and similarities in the correlates of the prevalence rates of IPV sub-types among the region's urban women need further interrogation.

Dataset Information

Psychological and Physical Intimate Partner Violence and Maternal Depressive Symptoms during the Pre- and Post-Partum Period among Women Living with HIV in rural South Africa.

Purpose

Method

Results

Conclusions

Publications

Psychological and Physical Intimate Partner Violence and Maternal Depressive Symptoms during the Pre- and Post-Partum Period among Women Living with HIV in rural South Africa.

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