创伤性生活事件是否会增加年轻女性遭受亲密伴侣暴力的风险？南非干预研究的横断面分析和结构方程模型数据。

Does experiencing a traumatic life event increase the risk of intimate partner violence for young women? A cross-sectional analysis and structural equation model of data from the intervention in South Africa.

机构信息

Institute for Global Health, UCL, London, UK

Institute for Global Health, UCL, London, UK.

出版信息

BMJ Open. 2022 Apr 29;12(4):e051969. doi: 10.1136/bmjopen-2021-051969.

DOI:10.1136/bmjopen-2021-051969

PMID:35487735

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9058688/

Abstract

OBJECTIVES

To investigate associations and potential pathways between women's lifetime exposure to traumatic events and their recent experiences of intimate partner violence (IPV).

SETTING

South African informal settlements near Durban.

PARTICIPANTS

677 women, living in informal settlements, aged 18-30 years, currently out of school or formal employment.

PRIMARY AND SECONDARY OUTCOME MEASURES

Self-reported experiences of IPV in the past 12 months and exposure to traumatic neighbourhood events (including witnessing murder, being robbed or kidnapped, witnessing and experiencing rape).

RESULTS

Exposure to traumatic events was common among the 677 women surveyed. Over 70% had experienced at least one in their lifetime; one quarter (24%) had experienced 3 or more different events. Women exposed to any traumatic event had a 43% increase in the odds of experiencing IPV in comparison to those with no exposure (aOR 1.43, p≤0.000). Exposure to non-partner rape is more strongly associated with IPV than any other traumatic experience. Pathways from exposure to traumatic events and non-partner rape to recent IPV experience are mediated by a latent variable of poor mental health. Food insecurity is associated with all forms of traumatic experience, and is also indirectly associated with IPV through views by women that are unsupportive of gender equality.

CONCLUSIONS

Women living in South African informal settlements who witness or experience traumatic events were likely to experience IPV, and this increases when women were exposed to multiple types of events. Our model suggests that experiencing traumatic events, and non-partner rape in particular, has negative effects on women's mental health in ways that may increase their vulnerability to IPV. IPV prevention interventions should consider the broader impacts of women's exposure to neighbourhood violence and severe poverty on IPV risk in settings where these are endemic.

TRIAL REGISTRATION NUMBER

NCT03022370; post-results.

摘要

目的

调查女性一生中经历创伤事件与近期亲密伴侣暴力（IPV）经历之间的关联和潜在途径。

地点

德班附近的南非非正规住区。

参与者

677 名年龄在 18-30 岁之间、目前失学或无正式工作的非正规住区女性。

主要和次要结果测量

过去 12 个月内自我报告的 IPV 经历和创伤性邻里事件（包括目睹谋杀、被抢劫或绑架、目睹和经历强奸）的暴露情况。

结果

在接受调查的 677 名女性中，创伤事件的暴露较为常见。超过 70%的人一生中至少经历过一次；四分之一（24%）经历过 3 次或更多不同的事件。与未暴露于创伤事件的女性相比，暴露于任何创伤事件的女性发生 IPV 的可能性增加了 43%（优势比 1.43，p≤0.000）。非伴侣强奸的暴露与 IPV 的关联比任何其他创伤经历都更为密切。从创伤事件和非伴侣强奸暴露到最近 IPV 经历的途径是通过女性心理健康状况不佳的潜在变量来介导的。粮食不安全与所有形式的创伤经历都有关联，并且通过女性对性别平等不支持的观点，间接地与 IPV 有关联。

结论

生活在南非非正规住区的女性，如果目睹或经历创伤事件，很可能会经历 IPV，而且当女性暴露于多种类型的事件时，这种情况会增加。我们的模型表明，经历创伤事件，特别是非伴侣强奸，会对女性的心理健康产生负面影响，使她们更容易受到 IPV 的影响。在这些地区普遍存在 IPV 的情况下，IPV 预防干预措施应考虑到女性暴露于邻里暴力和严重贫困对 IPV 风险的更广泛影响。