Anguzu Ronald, Kabagenyi Allen, Cassidy Laura D, Kasasa Simon, Shour Abdul R, Musoke Bernadette N, Mutyoba Joan N
Division of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
Department of Population Studies, School of Statistics and Planning, College of Business and Management Studies, Makerere University, Kampala, Uganda.
PLOS Glob Public Health. 2022 Apr 6;2(4):e0000177. doi: 10.1371/journal.pgph.0000177. eCollection 2022.
Cases of coronavirus disease 2019 (COVID-19) detected, and COVID-19 associated mortality increased since the first case was confirmed in Uganda. While adherence to WHO-recommended measures to disrupt COVID-19 transmission has since been implemented, it has been reported to be sub-optimal. An increase in intimate partner violence (IPV) cases was linked to enforcement of COVID-19 lockdowns and other preventive measures especially in informal settings of Kampala. We determined the association between adherence to COVID-19 preventive measures and intimate partner violence among women dwelling in informal settings in Kampala, Uganda. Between July and October 2020, we conducted a three-month prospective cohort study of 148 women living in informal settlements of Kampala during the COVID-19 lockdown and easing of restrictive measures. Participants were surveyed at baseline, at 3-weeks and 6-weeks (endline). The dependent variable was adherence to COVID-19 preventive measures (remained adherent vs poorly adherent) between baseline and endline surveys. This composite outcome variable was computed from implementing all four variables: social distancing, wearing face masks, frequent hand washing and use of hand sanitizers at baseline and endline surveys. The key independent variable was IPV measured as experiencing at least one form of physical, emotional, or sexual IPV. Covariates were age, education, marital status, household size, occupation, and having problems getting food. Adjusted logistic regression analyses tested the independent association between adherence to COVID-19 preventive measures and intimate partner violence. Among 148 respondents, the mean age (SD) was 32.9 (9.3) years, 58.1% were exposed to at least one form of IPV, and 78.2% had problems getting food. Overall, 10.1% were poorly adherent to COVID-19 preventive measures during the first COVID-19 wave. After controlling for potential confounders, remaining adherent to COVID-19 preventive measures were more likely to experience intimate partner violence when compared to women who were poorly adherent to COVID-19 preventive measures during the first COVID-19 wave in Uganda [OR 3.87 95%CI (1.09, 13.79)]. Proportions of women in informal settlements of Kampala experiencing at least one form of IPV during the first COVID-19 wave is substantial. Remaining adherent to preventive measures for COVID-19 transmission may increase IPV exposure risk among women living in informal settlements in Kampala. Contextualizing COVID-19 interventions to the needs of marginalized and vulnerable women and girls in informal settings of Kampala is warranted. Processes to integrated violence prevention and response strategies into the Uganda COVID-19 prevention strategy are underscored.
自乌干达确诊首例2019冠状病毒病（COVID-19）病例以来，检测到的COVID-19病例以及与COVID-19相关的死亡率均有所上升。尽管此后已实施了世界卫生组织推荐的旨在阻断COVID-19传播的措施，但据报道这些措施的实施效果并不理想。亲密伴侣暴力（IPV）案件的增加与COVID-19封锁措施及其他预防措施的实施有关，尤其是在坎帕拉的非正式住区。我们确定了乌干达坎帕拉非正式住区女性遵守COVID-19预防措施与亲密伴侣暴力之间的关联。在2020年7月至10月期间，我们对148名在COVID-19封锁及限制措施放宽期间居住在坎帕拉非正式住区的女性进行了为期三个月的前瞻性队列研究。在基线、3周和6周（终线）时对参与者进行了调查。因变量是基线调查和终线调查之间对COVID-19预防措施的遵守情况（持续遵守与遵守不佳）。这个综合结果变量是根据在基线调查和终线调查时实施的所有四个变量计算得出的：保持社交距离、佩戴口罩、经常洗手和使用洗手液。关键自变量是亲密伴侣暴力，定义为经历至少一种形式的身体、情感或性方面的亲密伴侣暴力。协变量包括年龄、教育程度、婚姻状况、家庭规模、职业以及获取食物存在困难。调整后的逻辑回归分析检验了遵守COVID-19预防措施与亲密伴侣暴力之间的独立关联。在148名受访者中，平均年龄（标准差）为32.9（9.3）岁，58.1%的人经历过至少一种形式的亲密伴侣暴力，78.2%的人获取食物存在困难。总体而言，在第一波COVID-19疫情期间，10.1%的人对COVID-19预防措施遵守不佳。在控制了潜在混杂因素后，与乌干达第一波COVID-19疫情期间对COVID-19预防措施遵守不佳的女性相比，持续遵守COVID-19预防措施的女性更有可能经历亲密伴侣暴力[比值比3.87，95%置信区间（1.09，13.79）]。在第一波COVID-19疫情期间，坎帕拉非正式住区经历至少一种形式亲密伴侣暴力的女性比例相当高。持续遵守COVID-19传播预防措施可能会增加坎帕拉非正式住区女性遭受亲密伴侣暴力的风险。有必要根据坎帕拉非正式住区边缘化和弱势妇女及女孩的需求来调整COVID-19干预措施。强调了将暴力预防和应对策略纳入乌干达COVID-19预防战略的过程。
