Daslo Research and Development, Timor Leste.
Universidade da Paz (UNPAZ), Timor Leste.
PLoS One. 2024 Aug 12;19(8):e0306106. doi: 10.1371/journal.pone.0306106. eCollection 2024.
Violence against women or gender-based violence (GBV) is a significant public health issue facing women and girls in different settings. It is reported to have worsened globally during the COVID-19 pandemic. Despite the impact of the COVID-19 pandemic on increased violence against women in general, which has been reported in many settings globally, there is a paucity of evidence of its impact on violence against highly vulnerable women living with HIV or tuberculosis (TB). Using a qualitative design, this study aimed to explore the views and experiences of women living with HIV (n = 19) or TB (n = 23) in Timor Leste regarding the GBV they faced during the COVID-19 pandemic. They were recruited using the snowballing sampling technique. Data were collected using one-on-one, in-depth interviews and focus group discussions. The five steps of qualitative data analysis suggested in Ritchie and Spencer's analysis framework were employed to guide the analysis of the findings. Findings indicated that women in this study experienced intensified physical, verbal, sexual and psychological violence by their partners, spouses, in-laws, and parents or other family members during the COVID-19 pandemic. Several prominent risk factors that worsened violence against women during the pandemic were (i) HIV or TB-positive status, (ii) traditional gender roles or responsibilities and expectations, (iii) economic and financial difficulties reflected in the loss of jobs and incomes due to the pandemic, and (iv) individual factors such as jealousy and increased alcohol drinking developed during the lockdowns. The women's experience of GBV during the pandemic also led to various negative psychological impacts. The findings underscore the urgent need for multifaceted interventions to address GBV, which should encompass challenging traditional gender norms, addressing economic inequalities, and targeting individual-level risk factors. The findings also indicate the need for the development of robust monitoring and evaluation systems to assess the effectiveness of policies and interventions addressing GBV where the results can inform future improvement. The findings also indicate the need to include GBV in the protocol or guidelines for HIV and TB management. Future large-scale quantitative studies to capture the magnitude and specific drivers of GBV against women living with HIV and TB during the pandemic are recommended.
暴力侵害妇女或基于性别的暴力（GBV）是不同环境中妇女和女孩面临的一个重大公共卫生问题。据报道，在 COVID-19 大流行期间，这一问题在全球范围内有所恶化。尽管 COVID-19 大流行普遍导致了针对妇女的暴力行为增加，这在全球许多地方都有报道，但关于其对感染艾滋病毒或结核病（TB）的高度脆弱妇女的暴力行为影响的证据很少。本研究采用定性设计，旨在探讨东帝汶感染艾滋病毒的妇女（n=19）或结核病的妇女（n=23）对 COVID-19 大流行期间所面临的 GBV 的看法和经验。他们是通过滚雪球抽样技术招募的。使用一对一的深入访谈和焦点小组讨论收集数据。采用里奇和斯宾塞分析框架中的五步定性数据分析方法来指导分析结果。研究结果表明，在 COVID-19 大流行期间，本研究中的妇女遭受了来自伴侣、配偶、姻亲、父母或其他家庭成员的身体、言语、性和心理暴力的加剧。大流行期间恶化针对妇女的暴力行为的几个突出风险因素包括：(i) HIV 或 TB 阳性状态，(ii) 传统的性别角色或责任和期望，(iii) 由于大流行导致失业和收入损失而反映出的经济和财务困难，以及 (iv) 个人因素，如在封锁期间产生的嫉妒和饮酒增加。妇女在大流行期间遭受的 GBV 也导致了各种负面的心理影响。这些发现强调了迫切需要采取多方面的干预措施来解决 GBV 问题，这些措施应包括挑战传统的性别规范、解决经济不平等问题以及针对个人层面的风险因素。研究结果还表明，需要建立健全的监测和评估系统，以评估针对 COVID-19 大流行期间针对妇女的暴力行为的政策和干预措施的有效性，其结果可用于未来的改进。研究结果还表明，需要将 GBV 纳入艾滋病毒和结核病管理的方案或准则。建议开展未来的大规模定量研究，以捕捉大流行期间感染艾滋病毒和结核病的妇女所遭受的 GBV 的规模和具体驱动因素。
