Tuesday, November 24, 2015

Strategies to reduce intimate partner violence and reduce vulnerability to HIV

Strategies and action implemented at the community level to address intimate partner violence are critical to reducing young women’s and adolescent girls’ vulnerability to HIV. Two randomized controlled trials have shown positive outcomes. The Raising Voices SASA!3 kit was designed to inspire, enable and structure effective community mobilization to prevent violence against women and HIV  Community activists spearheaded a wide range of activities in their own neighbourhoods designed to decrease the social acceptability of violence by influencing knowledge, attitudes, skills and behaviours on gender, power and violence. When implemented in four communities in Kampala, Uganda, the SASA! kit was associated with significantly lower social acceptance of intimate partner violence among both men and women. It was also associated with lower incidence of intimate partner violence and more supportive community responses to women who experienced such violence . SASA! has been implemented by over 25 organizations in sub-Saharan Africa in diverse settings such as religious, rural, refugee, urban and pastoralist communities. The Safe Homes and Respect for Everyone (SHARE) project in Rakai, Uganda aimed to reduce physical and sexual intimate partner violence and HIV incidence using two main approaches: community-based mobilization to change attitudes and social norms that contribute to intimate partner violence and HIV risk, and a screening and brief intervention to reduce HIV disclosure-related violence and sexual risk in women seeking HIV counselling and testing. Evaluation of the project showed significant decreases in both intimate partner violence and HIV incidence. The SHARE model could inform other HIV programmes’ efforts to address intimate partner violence and HIV and could be adopted, at least partly, as a standard of care for other HIV programmes in Africa . In both approaches outlined above, engaging men and boys has been essential to tackle harmful masculinities and redress power imbalances in the private and public spheres. These interventions also contribute to the broader goal of challenging cultural and social norms that are harmful to women and girls and communities as a whole. For example, MenCare+, a community-based intervention in Rwanda and South Africa, engages young men and women together in group sessions on gender equality, sexual and reproductive health and rights, maternal and child health, fatherhood and care, and uses reflection groups with men who have used violence with their partners. The One Man Can campaign, launched by Sonke Gender Justice, is another example of engaging men in advocating the elimination of gender-based violence and gender equality, while at the same time responding to HIV

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