Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Women's Global Health Imperative, RTI International, Berkely, CA, USA.
BMC Public Health. 2023 Oct 27;23(1):2115. doi: 10.1186/s12889-023-16945-5.
Growing evidence indicates that gender-based violence (GBV) increased during COVID-19. We investigated self-reported impact of the pandemic on GBV at community, household and intimate partner (IPV) levels among young people and its associations with psychosocial wellbeing, i.e., COVID-related stressors and mental health.
Cross-sectional data were drawn from a survey with young people ages 13-24 (N = 536) living with HIV (YPLWH) and without HIV (YPLWoH), in peri-urban Cape Town, South Africa. The survey, conducted February-October 2021, examined the impact of the initial lockdown on experience and perceived changes in GBV at each level, and pandemic-related psychosocial wellbeing. Descriptive statistics and binomial and multinomial regression analyses were conducted to illustrate exposure and perceived changes in GBV since lockdown, and their association with COVID-related stress factors (e.g., social isolation, anxiety about COVID), mental health (e.g., depression, anxiety), and other risk factors (e.g., age, gender, socioeconomic status) by HIV status.
Participants were 70% women with mean age 19 years; 40% were living with HIV. Since lockdown, YPLWoH were significantly more likely than YPLWH to perceive community violence as increasing (45% vs. 28%, p < 0.001), and to report household violence (37% vs. 23%, p = 0.006) and perceive it as increasing (56% vs. 27%, p = 0.002) (ref: decreasing violence). YPLWoH were also more likely to report IPV experience (19% vs. 15%, p = 0.41) and perception of IPV increasing (15% vs. 8%, p = 0.92). In adjusted models, COVID-related stressors and common mental health disorders were only associated with household violence. However, indicators of economic status such as living in informal housing (RRR = 2.07; 95% CI = 1.12-3.83) and food insecurity (Community violence: RRR = 1.79; 95% CI = 1.00-3.20; Household violence: RRR = 1.72; 95% CI = 1.15-2.60) emerged as significant risk factors for exposure to increased GBV particularly among YPLWoH.
Findings suggest that for young people in this setting, GBV at community and household levels was more prevalent during COVID-19 compared to IPV, especially for YPLWoH. While we found limited associations between COVID-related stressors and GBV, the perceived increases in GBV since lockdown in a setting where GBV is endemic, and the association of household violence with mental health, is a concern for future pandemic responses and should be longitudinally assessed.
越来越多的证据表明，COVID-19 期间性别暴力（GBV）有所增加。我们调查了大流行对社区、家庭和亲密伴侣（IPV）层面年轻人中 GBV 的影响，以及其与心理健康相关的社会心理幸福感，即与 COVID 相关的压力源和心理健康。
横断面数据来自对居住在南非开普敦城乡地区的年龄在 13-24 岁之间的 HIV 阳性（YPLWH）和 HIV 阴性（YPLWoH）年轻人（N=536）的一项调查。该调查于 2021 年 2 月至 10 月进行，研究了最初封锁对每个层面上 GBV 经验和感知变化的影响，以及与大流行相关的社会心理幸福感。采用描述性统计和二项和多项回归分析，说明自封锁以来 GBV 的暴露和感知变化，以及它们与 COVID 相关的压力因素（如社交隔离、对 COVID 的焦虑）、心理健康（如抑郁、焦虑）和其他风险因素（如年龄、性别、社会经济地位）的关系，按 HIV 状况进行了分析。
参与者中 70%为女性，平均年龄为 19 岁；40%感染了 HIV。自封锁以来，YPLWoH 比 YPLWH 更有可能认为社区暴力有所增加（45%对 28%，p<0.001），并报告家庭暴力（37%对 23%，p=0.006）且认为暴力有所增加（56%对 27%，p=0.002）（参考：暴力减少）。YPLWoH 也更有可能报告 IPV 经历（19%对 15%，p=0.41）和 IPV 增加的感知（15%对 8%，p=0.92）。在调整后的模型中，与 COVID 相关的压力源和常见精神健康障碍仅与家庭暴力有关。然而，经济状况的指标，如居住在非正式住房（RRR=2.07；95%CI=1.12-3.83）和粮食不安全（社区暴力：RRR=1.79；95%CI=1.00-3.20；家庭暴力：RRR=1.72；95%CI=1.15-2.60），成为 YPLWoH 遭受 GBV 增加的显著风险因素，尤其是在这种环境下，GBV 更为普遍。
研究结果表明，在这种情况下，与年轻人的 IPV 相比，COVID-19 期间社区和家庭层面的 GBV 更为普遍，尤其是对于 YPLWoH。虽然我们发现与 COVID 相关的压力源与 GBV 之间的关联有限，但在一个 GBV 流行的环境中，自封锁以来 GBV 的感知增加，以及家庭暴力与心理健康之间的关联，令人担忧，应作为未来大流行应对措施的一部分进行纵向评估。
