Decker Michele R, Lyons Carrie, Guan Kathleen, Mosenge Vanessa, Fouda Ghislane, Levitt Daniel, Abelson Anna, Nunez Gnilane Turpin, Njindam Iliassou Mfochive, Kurani Shaheen, Baral Stefan
Department of Population, Family and Reproductive Health, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Trauma Violence Abuse. 2022 Apr;23(2):676-694. doi: 10.1177/15248380211029405. Epub 2022 Feb 11.
Gender-based violence (GBV) is that perpetrated based on sex, gender identity, or perceived adherence to socially defined gender norms. This human rights violation is disproportionately experienced by HIV key populations including female sex workers (FSW), people who inject drugs (PWID), and men who have sex with men (MSM). Consequently, addressing GBV is a global priority in HIV response. There is limited consensus about optimal interventions and little known about effectiveness. Our systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in International Prospective Register of Systematic Reviews. Peer-reviewed and non-peer-reviewed literature were searched for articles that described a GBV prevention or response intervention specifically for key populations including FSW, PWID, and MSM. Results were organized by level(s) of implementation and pillars of a comprehensive GBV response: prevention, survivor support, and accountability/justice. Of 4,287 articles following removal of duplicates, 32 unique interventions (21 FSW, seven PWID, and nine MSM, not mutually exclusive) met inclusion criteria, representing 13 countries. Multisectoral interventions blended empowerment, advocacy, and crisis response with reductions in violence. Individual-level interventions included violence screening and response services. Violence-related safety promotion and risk reduction counseling within HIV risk reduction programming reduced violence. Quantitative evaluations were limited. Violence prevention and response interventions for FSW, PWID, and MSM span individual, community, and multisectoral levels with evidence of promising practices at each level. The strongest evidence supported addressing violence in the context of sexually transmitted infection/HIV risk reduction. As interventions continue to emerge, the rigor of accompanying evaluations must simultaneously advance to enable clarity on the health and safety impact of GBV prevention and response programming.
基于性别的暴力(GBV)是指基于性别、性别认同或对社会定义的性别规范的认知而实施的暴力。包括女性性工作者(FSW)、注射吸毒者(PWID)和男男性行为者(MSM)在内的艾滋病关键人群遭受这种侵犯人权行为的比例过高。因此,应对基于性别的暴力是全球艾滋病应对工作的一个优先事项。关于最佳干预措施的共识有限,其有效性也鲜为人知。我们的系统评价遵循系统评价和Meta分析的首选报告项目指南,并在国际前瞻性系统评价注册库中进行了注册。我们检索了同行评审和非同行评审的文献,以查找专门针对包括女性性工作者、注射吸毒者和男男性行为者在内的关键人群的基于性别的暴力预防或应对干预措施的文章。结果按实施层面和全面应对基于性别的暴力的支柱进行整理:预防、幸存者支持以及问责/司法。在去除重复文章后,4287篇文章中有32项独特的干预措施(21项针对女性性工作者,7项针对注射吸毒者,9项针对男男性行为者,并非相互排斥)符合纳入标准,涉及13个国家。多部门干预措施将赋权、宣传和危机应对与减少暴力相结合。个体层面的干预措施包括暴力筛查和应对服务。在减少艾滋病毒风险的项目中开展与暴力相关的安全促进和风险降低咨询减少了暴力。定量评估有限。针对女性性工作者、注射吸毒者和男男性行为者的暴力预防和应对干预措施涵盖个体、社区和多部门层面,且各层面均有一些有前景的实践证据。最有力的证据支持在减少性传播感染/艾滋病毒风险的背景下应对暴力。随着干预措施不断涌现,配套评估的严谨性也必须同步提高,以便明确基于性别的暴力预防和应对项目对健康和安全的影响。