Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA.
Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
BMC Public Health. 2024 Feb 15;24(1):481. doi: 10.1186/s12889-024-17871-w.
Intimate partner violence (IPV) occurs at alarmingly high rates towards pregnant women in South Africa. Experiences of emotional, physical, and sexual IPV in pregnancy can adversely impact the health and safety of mother and fetus. Furthermore, IPV is associated with increased risk of HIV, exacerbating the public health impact of violence among pregnant women in this HIV endemic setting. In-depth understanding of cultural and contextual drivers of experiences of IPV is a critical precursor to development of interventions effectively addressing this issue among pregnant women in South Africa. The present study examines factors contributing to IPV among pregnant women to identify potential points of intervention. We conducted twenty in-depth interviews with postpartum women who used oral pre-exposure prophylaxis (PrEP) in pregnancy and reported recent experiences of IPV and/or ongoing alcohol use in a township near Cape Town, South Africa that experiences a heavy burden of both HIV and IPV. Interpretive thematic analysis was used. Several patterns of IPV during pregnancy were identified and violence was frequently described as co-occurring with male partner alcohol use. A majority of women referenced oral PrEP as their preferred method for HIV prevention, highlighting the agency and discretion it provided as beneficial attributes for women experiencing IPV. Fear of judgement from peers for remaining with an abusive partner and a lack of clear community messaging around IPV were identified as barriers to disclosure and support-seeking. Addressing the lack of social support received by women experiencing IPV during pregnancy in South Africa is essential to comprehensive IPV programming.
南非孕妇遭受亲密伴侣暴力（IPV）的比例高得惊人。怀孕期间经历情感、身体和性 IPV 会对母婴健康和安全产生不利影响。此外，IPV 与 HIV 感染风险增加有关，这加剧了在这个 HIV 流行地区孕妇中暴力对公共卫生的影响。深入了解 IPV 经历的文化和背景驱动因素是在南非孕妇中有效开展干预措施的关键前提。本研究旨在探讨导致孕妇遭受 IPV 的因素，以确定潜在的干预点。我们对居住在开普敦附近的一个城镇的 20 名产后妇女进行了深入访谈，这些妇女在怀孕期间使用了口服暴露前预防（PrEP），并报告了最近经历过 IPV 和/或持续饮酒的情况，该城镇同时面临着 HIV 和 IPV 的沉重负担。我们采用了解释性主题分析。确定了怀孕期间发生的几种 IPV 模式，暴力行为经常被描述为与男性伴侣饮酒同时发生。大多数妇女提到口服 PrEP 是她们预防 HIV 的首选方法，这突出了它为经历 IPV 的妇女提供的自主权和酌处权，这是有益的属性。对因与虐待伴侣在一起而受到同伴评判的恐惧以及对 IPV 的社区信息缺乏明确认识，被认为是披露和寻求支持的障碍。解决南非孕妇在怀孕期间遭受的社会支持不足问题，对于全面的 IPV 规划至关重要。
