Interventions to reduce gender-based violence among young people living with or affected by HIV/AIDS in low-income and middle-income countries

Franziska Meinck*, Marija Pantelic, Thees F. Spreckelsen, Luisa Orza, Madison T. Little, Vasileios Nittas, Vanessa Picker, Amy A. Bustamam, Rocio Herrero Romero, Eric P. Diaz Mella, Heidi Stöckl

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective(s): This study explored the effectiveness of gender-based violence (GBV) interventions on young people living with or affected by HIV in low- and middle-income countries (LMICs).Design: Systematic review and meta-analysis.

Methods: We pre-registered a protocol, then searched 13 databases and grey literature. We screened randomized and quasi-experimental studies (n = 2199) of young people (aged 10–24) living with or affected by HIV in LMICs. Outcomes were GBV and/or GBV-related attitudes. We appraised the data for risk of bias and quality of evidence. Narrative syntheses and multilevel random effects meta-analyses were conducted.

Results: We included 18 studies evaluating 21 interventions. Intervention arms were categorized as: sexual health and social empowerment (SHSE; n = 7); SHSE combined with economic strengthening (n = 4); self-defence (n = 3); safer schools (n = 2); economic strengthening only (n = 2); GBV sensitization (n = 2) and safer schools and parenting (n = 1). Risk of bias was moderate/high and quality of evidence low. Narrative syntheses indicated promising effects on GBV exposure, but no or mixed effects on GBV perpetration and attitudes for self-defence and GBV sensitization interventions. Safer school interventions showed no effects. For SHSE interventions and SHSE combined with economic strengthening, meta-analyses showed a small reduction in GBV exposure but not perpetration. Economic-only interventions had no overall effect.

Conclusion: SHSE, SHSE plus and self-defence and gender sensitization interventions may be effective for GBV exposure and GBV-related attitudes but not for GBV perpetration. However, the quality of evidence is poor. Future intervention research must include both boys and girls, adolescents living with HIV and key populations.
Original languageEnglish
Pages (from-to)2219-2236
Number of pages18
JournalAIDS
Volume33
Issue number14
Early online date1 Aug 2019
DOIs
Publication statusPublished - 15 Nov 2019

Keywords

  • adolescents and young people
  • gender-based violence
  • HIV/AIDS
  • intimate partner violence
  • low-income and middle-income countries
  • prevention

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