Franziska Meinck1,2,3, Marija Pantelic1,4, Thees F Spreckelsen1, Luisa Orza4, Madison T Little1, Vasileios Nittas5, Vanessa Picker1, Amy A Bustamam6, Rocio Herrero Romero1, Eric P Diaz Mella7, Heidi Stöckl8. 1. Department of Social Policy & Intervention, University of Oxford, Oxford, United Kingdom. 2. Optentia, Faculty of Health Sciences, North-West University, South Africa. 3. School of Social and Political Sciences, University of Edinburgh, Edinburgh. 4. Frontline AIDS, Brighton, United Kingdom. 5. Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland. 6. Department of Health Research Methods, Evidence and Impact, McMaster University, Canada. 7. Escuela de Psicología, Universidad Santo Tomas, Chile. 8. Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Abstract
OBJECTIVE(S): This study explored the effectiveness of gender-based violence (GBV) interventions on young people living with or affected by HIV in low- and middle-income countries (LMICs). DESIGN: Systematic review and meta-analysis. METHODS: We pre-registered a protocol, then searched 13 databases and grey literature. We screened randomized and quasi-experimental studies (n = 2199) of young people (aged 10-24) living with or affected by HIV in LMICs. Outcomes were GBV and/or GBV-related attitudes. We appraised the data for risk of bias and quality of evidence. Narrative syntheses and multilevel random effects meta-analyses were conducted. RESULTS: We included 18 studies evaluating 21 interventions. Intervention arms were categorized as: sexual health and social empowerment (SHSE; n = 7); SHSE combined with economic strengthening (n = 4); self-defence (n = 3); safer schools (n = 2); economic strengthening only (n = 2); GBV sensitization (n = 2) and safer schools and parenting (n = 1). Risk of bias was moderate/high and quality of evidence low. Narrative syntheses indicated promising effects on GBV exposure, but no or mixed effects on GBV perpetration and attitudes for self-defence and GBV sensitization interventions. Safer school interventions showed no effects. For SHSE interventions and SHSE combined with economic strengthening, meta-analyses showed a small reduction in GBV exposure but not perpetration. Economic-only interventions had no overall effect. CONCLUSION: SHSE, SHSE plus and self-defence and gender sensitization interventions may be effective for GBV exposure and GBV-related attitudes but not for GBV perpetration. However, the quality of evidence is poor. Future intervention research must include both boys and girls, adolescents living with HIV and key populations.
OBJECTIVE(S): This study explored the effectiveness of gender-based violence (GBV) interventions on young people living with or affected by HIV in low- and middle-income countries (LMICs). DESIGN: Systematic review and meta-analysis. METHODS: We pre-registered a protocol, then searched 13 databases and grey literature. We screened randomized and quasi-experimental studies (n = 2199) of young people (aged 10-24) living with or affected by HIV in LMICs. Outcomes were GBV and/or GBV-related attitudes. We appraised the data for risk of bias and quality of evidence. Narrative syntheses and multilevel random effects meta-analyses were conducted. RESULTS: We included 18 studies evaluating 21 interventions. Intervention arms were categorized as: sexual health and social empowerment (SHSE; n = 7); SHSE combined with economic strengthening (n = 4); self-defence (n = 3); safer schools (n = 2); economic strengthening only (n = 2); GBV sensitization (n = 2) and safer schools and parenting (n = 1). Risk of bias was moderate/high and quality of evidence low. Narrative syntheses indicated promising effects on GBV exposure, but no or mixed effects on GBV perpetration and attitudes for self-defence and GBV sensitization interventions. Safer school interventions showed no effects. For SHSE interventions and SHSE combined with economic strengthening, meta-analyses showed a small reduction in GBV exposure but not perpetration. Economic-only interventions had no overall effect. CONCLUSION: SHSE, SHSE plus and self-defence and gender sensitization interventions may be effective for GBV exposure and GBV-related attitudes but not for GBV perpetration. However, the quality of evidence is poor. Future intervention research must include both boys and girls, adolescents living with HIV and key populations.
Authors: K Sabapathy; H Stöckl; C Mulubwa; C Mubekapi-Musadaidzwa; G Hoddinott; S Floyd; J Seeley; V Bond; P Bock; S Fidler; H Ayles; R Hayes Journal: AIDS Behav Date: 2022-02-14