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Trauma

Traumatic Stress Among Sexual and Gender Minority Refugees from the Middle East, North African, and Asia who Fled to the European Union

Citation:

Alessi, Edward J., Sarilee Kahn, Leah Woolner, and Rebecca Van Der Horn. 2018. "Traumatic Stress Among Sexual and Gender Minority Refugees From the Middle East, North Africa, and Asia Who Fled to the European Union." Journal of Traumatic Stress 31 (6): 805-15.

Authors: Edward J. Alessi, Sarilee Kahn, Leah Woolner, Rebecca Van Der Horn

Abstract:

In 2015, more than 600,000 individuals from Syria, Iraq, and Afghanistan fled to Europe in search of protection. Among the most understudied of this population are individuals who identify as lesbian, gay, bisexual, transgender, and queer (LGBTQ). These individuals have not only fled war but also violence due to their sexual and/or gender identities. At the same time, LGBTQ individuals from other parts of the Middle East, Central and South Asia, and North Africa have also fled to Europe to escape persecution. The purpose of this multimethod study was to understand how traumatic stress shaped the experiences of 38 LGBTQ individuals who fled to Austria (n = 19) and the Netherlands (n = 19) from these regions. We assessed participants for posttraumatic stress disorder (PTSD) and conducted qualitative interviews to understand their migration experiences. Of the 37 participants assessed for PTSD, 33 (89.2%) reported that their most distressing event occurred prior to migration. For the 24 (64.9%) participants who met criteria for a provisional diagnosis of PTSD, 15 reported that the precipitating event was related to their sexual and/or gender identities and 9 reported that it was related to another type of event (e.g., war). Grounded theory was used to analyze qualitative data. Themes demonstrated that participants encountered targeted violence and abuse throughout migration and upon their arrival in Austria and the Netherlands. Findings indicate that LGBTQ refugees may be vulnerable to ongoing trauma from other refugees and immigration officials. Recommendations for protecting and supporting LGBTQ refugees during humanitarian emergencies are provided.

 

Topics: Armed Conflict, Displacement & Migration, Refugees, Gender, Health, PTSD, Trauma, Humanitarian Assistance, Sexuality, Violence Regions: Africa, MENA, North Africa, Asia, Central Asia, Middle East, South Asia, Europe, Western Europe Countries: Afghanistan, Austria, Iraq, Netherlands, Syria

Year: 2018

Male and LGBT Survivors of Sexual Violence in Conflict Situations: A Realist Review of Health Interventions in Low-and Middle-income Countries

Citation:

Kiss, Ligia, Meaghen Quinlan-Davidson, Laura Pasquero, Patricia Ollé Tejero, Charu Hogg, Joachim Theis, Andrew Park, Cathy Zimmerman, and Mazeda Hossain. 2020. "Male and LGBT Survivors of Sexual Violence in Conflict Situations: A Realist Review of Health Interventions in Low-And Middle-income Countries." Conflict and Health 14: 1-12.

Authors: Ligia Kiss, Meaghen Quinlan-Davidson, Laura Pasquero, Patricia Ollé Tejero, Charu Hogg, Joachim Theis, Andrew Park, Cathy Zimmerman, Mazeda Hossain

Abstract:

Conflict-related sexual violence (CRSV) against women and girls has been the subject of increasing research and scholarship. Less is known about the health of men, boys and lesbian, gay, bisexual, transgender (LGBT) and other gender non-binary persons who survive CRSV. This paper is the first systematic realist review on medical, mental health and psychosocial support (MHPSS) interventions that focusses on male and LGBT survivors of CRSV. The review explores the gender differences in context, mechanisms and outcomes that underpin interventions addressing the health and psychosocial wellbeing of male and LGBT survivors. The aim is to contribute to the design and delivery of gender-sensitive and, when needed, gender-specific approaches for interventions that respond to specific needs of different groups of all survivors. We conducted a systematic search of academic and grey literature to identify medical and MHPSS interventions that included men, boys and LGBT survivors. We identified interventions specifically targeting women and girls that we used as comparators. We then purposively sampled studies from the fields of gender and health, and sexual abuse against men and LGBT people for theory building and testing. We identified 26 evaluations of interventions for survivors of CRSV. Nine studies included male survivors, twelve studies focussed exclusively on female survivors and one study targeted children and adolescents. No intervention evaluation focussed on LGBT survivors of CRSV. The interventions that included male survivors did not describe specific components for this population. Results of intervention evaluations that included male survivors were not disaggregated by gender, and some studies did not report the gender composition. Although some mental health and psychosocial consequences of sexual violence against men and boys may be similar among male and female survivors, the way each process trauma, display symptoms, seek help, adhere to treatment and improve their mental health differ by gender. Initiatives targeting male and LGBT survivors of CRSV need to be designed to actively address specific gender differences in access, adherence and response to MHPSS interventions. Models of care that are gender-sensitive and integrated to local resources are promising avenues to promote the health of male and LGBT survivors of CRSV.

Keywords: conflict-related sexual violence, men, boys, and LGBT survivors, medical interventions, mental health and psychosocial support interventions, systematic realist review, realist synthesis

Topics: Armed Conflict, Conflict, Gender, Men, Boys, Health, Mental Health, Trauma, LGBTQ, Sexual Violence, SV against men

Year: 2020

Aftermath: Women and Women’s Organizations In Postconflict Societies: The Role of International Assistance

Citation:

Kumar, Krishna. 2001. Aftermath: Women and Women’s Organizations In Postconflict Societies: The Role of International Assistance. 28. U.S. Agency for International Development, Washington, DC.

Author: Krishna Kumar

Annotation:

Summary: 
Since the end of the Cold War, intrastate conflicts have increased worldwide. Poverty, the struggle for scarce resources, declining standards of living, ethnic rivalries and divisions, political repression by authoritarian governments, and rapid social and economic modernization—all these factors contribute to intrastate conflicts. All intrastate conflicts share a set of common characteristics that have major implications for women and gender relations. First, the belligerent parties deliberately inflict violence on civilian populations. Second, the intrastate conflicts displace substantial numbers of people, mostly women and children. Third, women’s participation in war contributes to the redefinition of their identities and traditional roles. Fourth, there is usually a conscious attempt to destroy the supporting civilian infrastructure, leading to increased poverty and starvation. Finally, these conflicts leave among the belligerent groups within the countries a legacy of bitterness, hatred, and anger that is difficult to heal.

Both men and women suffer from such conflicts. This study examines specifically the effects on women in six casestudy countries: Cambodia, Bosnia, El Salvador, Georgia, Guatemala, and Rwanda. It looks as well at the rise of indigenous women’s organizations—their role, their impact, their future. Teams from USAID’s Center for Development Information and Evaluation visited those countries during 1999. They found the effects of war on women to fall into three broad categories: Social and psychological. Women often were traumatized by the conflict. After the hostilities, many feared for their physical safety. During the early phases of postconflict transition, unemployed militia continued to pose a serious threat to the lives and property of women and children. Fear of violence and sexual abuse (rape had actually been used as a tool of war, to subjugate, humiliate, terrorize) often kept women from moving about freely. Abject conditions in many postconflict societies contributed to the growth of prostitution.

Economic. A major problem was lack of property rights. Women were denied ownership of land their dead husbands or parents had owned. Rural women who owned no land or other assets worked as laborers or sharecroppers, at minimal wages. Urban women carved out livings mostly by selling foods and household items. During conflict, women could work in many occupations. As ex-combatants returned to civilian life, though, female workers were the first to lose their jobs.

Political. In the absence of men, all six countries witnessed an expansion of women’s public roles during the conflict. Women volunteered in churches, schools, hospitals, and private charities. They often took charge of political institutions, enhancing their political skills—and raising their expectations.

The conflicts created a ripe environment for the emergence or growth of women’s organizations. For one thing, the wars undermined the traditional social order; women found it easier to take part in public affairs. Moreover, governmental reforms after the wars created political space to launch women’s organizations. Another factor was disillusionment. During or in the immediate aftermath of the wars, women’s expectations of increased political participation had risen. Those expectations were never fully realized. Finally, the readiness of the international community to provide assistance to such organizations contributed to their growth.

In the case-study countries, women’s organizations have been active in virtually all sectors: social, educational, economic, political. They have established health clinics, provided reproductive health care, organized mass vaccination programs. They have carried out programs to generate income and employment for women, emphasizing microcredit and vocational training. They have grappled with domestic violence, prostitution, and the plight of returning refugees and internally displaced women. And they have promoted democracy and human rights, supported social reconciliation, and worked to increase women’s participation in political affairs.

International assistance has been important to the development of women’s organizations—and will be far into the foreseeable future. Beyond financial support, international bodies have helped indigenous women acquire managerial, accounting, and technical skills. International assistance has also helped legitimize women’s organizations, for example by sheltering them from government interference.

Attending the emergence of women’s organizations is an array of obstacles. They are social and cultural, imposed from without, and organizational, imposed from within. Chief among the former is women’s low social status. At the family, community, and national levels, women confront a lack of support for their public activities. Another outside encumbrance is the short-term nature of international assistance, which prevents long-term planning. Chief among internal obstacles is the reluctance of women leaders to delegate authority and to train junior staff for future leadership. There is, moreover, a lack of communication and sharing among organizations.

The six individual CDIE country evaluations yielded a number of recommendations aimed at making assistance to women’s organizations more effective. Among them: 
1. Build on women’s economic and political gains. Because the postconflict era provides an opening to build on the progress made by women during conflict, it makes sense for USAID to continue to capitalize on this opportunity. 
2. Pay greater attention to civilian security. USAID can assume a leadership role in publicizing the problem of civilian security and the need for concerted action to protect women. The Agency can also encourage other organizations to carry out programs that can enhance physical security for women.
3. Make concerted efforts with the rest of the international community to prevent sexual abuse of women. Measures might include protecting witnesses, training international peacekeepers in gender issues, and promoting more women to international judicial posts.
4. Promote microcredit. USAID should support microcredit programs but not ignore their limitations. They are not cures for all economic problems facing women in postconflict societies.
5. Support property rights for women. USAID should continue supporting property-rights reforms affecting women. This should include not only constitutional and legislative reforms but also their effective implementation.
6. Consider multiyear funding. The assurance of assistance for periods longer than 6–9 months will help build institutional capacity and boost staff morale.
7. Promote sustainability of women’s organizations. USAID could provide technical assistance, when necessary, to improve management; consider funding a portion of core costs, in addition to program costs, for a limited period; and help organizations become self-reliant by such means as improving skills in advocacy, fundraising, networking, and coalition.
8. Promote greater women’s participation in elections. USAID should consider steps to encourage political parties to field women candidates and assist women candidates on a nonpartisan basis.

Topics: Armed Conflict, Civil Wars, Civil Society, Displacement & Migration, Economies, Poverty, Gender, Women, Gender Roles, Governance, Elections, Health, Trauma, International Organizations, Livelihoods, Political Participation, Rights, Land Rights, Security, Sexual Violence, SV against women, Violence Regions: Africa, Central Africa, East Africa, Americas, Central America, Asia, Central Asia, Southeast Asia, Europe, Balkans, Eastern Europe, South Caucasus Countries: Bosnia & Herzegovina, Cambodia, El Salvador, Georgia, Guatemala, Rwanda

Year: 2001

Cango Lyec (Healing the Elephant): Gender Differences in HIV Infection in Post-conflict Northern Uganda

Citation:

Spittal, Patricia M., Samuel S. Malamba, Martin D. Ogwang, Seggane Musisi, J. Paul Ekwaru, Nelson K. Sewankambo, Margo E. Pearce, Kate Jongbloed, Sheetal H. Patel, Achilles Katamba, Alden H. Blair, Herbert Muyinda, and Martin T. Schechter. 2018. "Cango Lyec (Healing the Elephant): Gender Differences in HIV Infection in Post-conflict Northern Uganda." Journal of Acquired Immune Deficiency Syndromes 78 (3): 257-68. 

Authors: Patricia M. Spittal, Samuel S. Malamba, Martin D. Ogwang, Seggane Musisi, J. Paul Ekwaru, Nelson K. Sewankambo, Margo E. Pearce, Kate Jongbloed, Sheetal H. Patel, Achilles Katamba, Alden H. Blair, Herbert Muyinda, Martin T. Schechter

Abstract:

Background: As previously encamped resettle, potential for rapid HIV transmission in post-conflict Northern Uganda is concerning. Women in particular may be experiencing heightened vulnerability resulting from war-related sexual violence.

Setting: Cango Lyec (Healing the Elephant) Project is a cohort involving conflict-affected people in 3 districts in Northern Uganda.

Methods: Eight randomly selected communities were mapped, and a census was conducted. Participants aged 13–49 years completed questionnaires in Luo on war-related experiences, mental health, sexual vulnerabilities, and sociodemographics. Blood samples were tested for HIV and syphilis. Baseline data from all sexually active participants was used to determine gender differences in HIV prevalence. Multivariate modeling determined correlates of HIV by gender.

Results: Among 2008 participants, HIV prevalence was higher among women [17.2; 95% confidence interval (CI): 14.7 to 19.7] compared to men (10.6; 95% CI: 8.0 to 13.2, ,0.001). Among women, correlates of HIV included: war-related sexual assault [adjusted odds ratio (AOR): 1.95; 95% CI: 1.16 to 3.26]; probable depression (AOR: 2.22; 95% CI: 1.46 to 3.37); probable post-traumatic stress disorder (AOR: 2.03; 95% CI: 1.45 to 2.84); experiencing $12 traumatic events (AOR: 2.04; 95% CI: 1.31 to 3.18); suicide ideation (AOR: 1.67; 95% CI: 1.22 to 2.28); living in a female-headed household (AOR: 2.76; 95% CI: 1.70 to 4.49); first sexual partner $10 years older (AOR: 1.69; 95% CI: 1.07 to 2.67); sex for exchange (AOR: 5.51; 95% CI: 1.76 to 17.31); having 2 (AOR: 2.54; 95% CI: 1.23 to 5.23) or 3+ (AOR: 4.65; 95% CI: 2.65 to 8.18) sexual partners; inconsistent condom use (AOR: 0.40; 95% CI: 0.29 to 0.57); genital ulcers (AOR: 3.08; 95% CI: 2.16 to 4.38); active syphilis (AOR: 4.33; 95% CI: 1.22 to 15.40); and ill health without medical care (AOR: 2.02; 95% CI: 1.22 to 3.34). Among men, correlates of HIV included no condom at sexual debut (AOR: 1.92; 95% CI: 1.30 to 2.83) and genital ulcers (AOR: 4.40; 95% CI: 1.35 to 14.40).

Conclusion: Women are disproportionately impacted by HIV, trauma, and depression in this conflict-affected population. Trauma-informed HIV prevention and culturally safe mental health initiatives are urgently required.

Keywords: HIV/AIDS, conflict-affected people, Northern Uganda, gender, sexual violence, mental health

Topics: Armed Conflict, Conflict, Gender, Women, Health, HIV/AIDS, Mental Health, Trauma, Post-Conflict, Sexual Violence, SV against women Regions: Africa, East Africa Countries: Uganda

Year: 2018

Visual Responses: Women’s Experience of Sexual Violence as Represented in Israeli Holocaust-Related Cinema

Citation:

Meiri, Sandra. 2015. “Visual Responses: Women’s Experience of Sexual Violence as Represented in Israeli Holocaust-Related Cinema.” European Journal of Women’s Studies 22 (4): 443-456.  

Author: Sandra Meiri

Abstract:

This article explores the function of Israeli narrative films’ persistent, albeit marginal, portrayal of women as victims of sexual violence during the Holocaust. While the marginalization of such characters may be attributed to the difficulty of representing sexually-related trauma/post-trauma, their portrayal attests both to the ubiquity of sexually-related crimes in the Holocaust and to its aftermath: namely, the persistence of women’s trauma. The first of the two waves of ‘retro films’ examined here evinces the importance of the visual, cinematic representation of women’s trauma. Its main function is to legitimize its disclosure through cinematic aesthetic/artistic mediation, for sexual violence was a crime committed against helpless victims. The second wave includes films made from the point of view of ‘the second generation’, and explores the topic further by dealing with the transmission of post-traumatic symptoms of women’s trauma to the second generation.

Keywords: cinematic visualization, insanity, sexualized violence, the second generation, transmission of women's trauma, unfit motherhood

Topics: Gender, Women, Gendered Discourses, Gender-Based Violence, Genocide, Health, Mental Health, PTSD, Trauma, Sexual Violence, SV against women Regions: MENA, Asia, Middle East, Europe Countries: Israel

Year: 2015

Coming out in camouflage: A Queer Theory Perspective on the Strength, Resilience, and Resistance of Lesbian, Gay, Bisexual, and Transgender Service Members and Veterans

Citation:

Ramirez, M. Heliana, and Paul R. Sterzing. 2017. “Coming out in Camouflage: A Queer Theory Perspective on the Strength, Resilience, and Resistance of Lesbian, Gay, Bisexual, and Transgender Service Members and Veterans.” Journal of Gay & Lesbian Social Services 29 (1): 68–86. 

Authors: M. Heliana Ramirez, Paul R. Sterzing

Abstract:

Lesbian, gay, bisexual, and transgender (LGBT) service members have made profound contributions to the U. S. military despite serving under anti-LGBT military policies. Little is known about their everyday acts of strength and resistance, which is vital information for developing strengths-based services. This article utilizes a queer theory framework to (a) discuss LGBT military contributions and anti-LGBT military policies, (b) explore three LGBT-specific military minority stressors, and (c) identify four strategies of strength and resistance used to manage an antiLGBT military environment. Clinical suggestions are proposed for integrating military and LGBT identities and designing interventions that blend military and LGBT cultures.

Keywords: LGBT, military, Veteran, strengths-based, Resilience, queer theory

Topics: Combatants, Gender, Health, HIV/AIDS, Mental Health, PTSD, Trauma, LGBTQ, Military Forces & Armed Groups, Militaries, Sexual Violence, Rape Regions: Americas, North America Countries: United States of America

Year: 2017

Mental Health of Transgender Veterans of the Iraq and Afghanistan Conflicts Who Experienced Military Sexual Trauma: MST and Mental Health of Transgender Veterans

Citation:

Lindsay, Jan A., Colt Keo-Meier, Sonora Hudson, Annette Walder, Lindsey A. Martin, and Michael R. Kauth. 2016. “Mental Health of Transgender Veterans of the Iraq and Afghanistan Conflicts Who Experienced Military Sexual Trauma: MST and Mental Health of Transgender Veterans.” Journal of Traumatic Stress 29 (6): 563–67.

Authors: Jan A. Lindsay, Colt Keo-Meier, Sonora Hudson, Annette Walder, Lindsey A. Martin, Michael R. Kauth

Abstract:

Little is known about military sexual trauma (MST) in transgender veterans. To address this gap, we examined archival data regarding transgender veterans from the Iraq and Afghanistan conflicts. There were 332 transgender veterans treated at the Veterans Health Administration between 2000 and 2013 (78 men, 254 women; mean age 33.86 years), with most being non-Hispanic White. Transgender status and mental health conditions were identified using the International Classification of Diseases, 9th Revision (ICD-9; World Health Organization, 1980) codes and chart review. Men and women were analyzed separately, using contingency tables and χ2 testing for categorical variables and t tests for continuous variables. Likelihood of having a mental health condition and MST were examined using logistic regression. Among the 15% of participants who experienced MST, MST was associated with the likelihood of posttraumatic stress disorder, adjusted OR = 6.09, 95% confidence interval (CI) [1.22, 30.44] and personality disorder, OR = 3.86, 95% CI [1.05, 14.22] for men and with depressive, OR = 3.33, 95% CI [1.12, 9.93], bipolar, OR = 2.87, 95% CI [1.12, 7.44], posttraumatic stress, OR = 2.42, [1.11, 5.24], and personality disorder, OR = 4.61, 95% CI [2.02, 10.52] for women. Implications include that medical forms should include gender identity and biological gender and that MST treatment should be culturally competent.

Topics: Combatants, Gender, Health, Mental Health, PTSD, Trauma, LGBTQ, Military Forces & Armed Groups, Militaries, Sexual Violence Regions: MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2016

Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case-Control Study

Citation:

Brown, George R., and Kenneth T. Jones. 2016. “Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case-Control Study.” LGBT Health 3 (2): 122–31. 

Authors: George R. Brown, Kenneth T. Jones

Abstract:

Purpose: There are no large controlled studies of health disparities in transgender (TG) or gender dysphoric patients. The Veterans Health Administration (VHA) is the largest healthcare system in the United States and was an early adopter of electronic health records. We sought to determine whether medical and/or mental health disparities exist in VHA for clinically diagnosed TG veterans compared to matched veterans without a clinical diagnosis consistent with TG status.
 
Methods: Using four ICD-9-CM codes consistent with TG identification, a cohort of 5135 TG veterans treated in VHA between 1996 and 2013 was identified. Veterans without one of these diagnoses were matched 1:3 in a case–control design to determine if medical and/or mental health disparities exist in the TG veteran population.
 
Results: In 2013, the prevalence of TG veterans with a qualifying clinical diagnosis was 58/100,000 patients. Statistically significant disparities were present in the TG cohort for all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. TG Veterans were more likely to have been homeless, to have reported sexual trauma while on active duty, and to have been incarcerated. Significant disparities in the prevalence of medical diagnoses for TG veterans were also detected for 16/17 diagnoses examined, with HIV disease representing the largest disparity between groups.
 
Conclusion: This is the first study to examine a large cohort of clinically diagnosed TG patients for psychiatric and medical health outcome disparities using longitudinal, retrospective medical chart data with a matched control group. TG veterans were found to have global disparities in psychiatric and medical diagnoses compared to matched non-TG veterans. These findings have significant implications for policy, healthcare screening, and service delivery in VHA and potentially other healthcare systems.

Keywords: disparity, gender dysphoria, military, Transgender, Veteran

Topics: Combatants, Health, HIV/AIDS, Mental Health, PTSD, Trauma, LGBTQ, Military Forces & Armed Groups, Militaries Regions: Americas, North America Countries: United States of America

Year: 2016

Sexual Victimization, Health Status, and VA Healthcare Utilization Among Lesbian and Bisexual OEF/OIF Veterans

Citation:

Mattocks, Kristin M., Anne Sadler, Elizabeth M. Yano, Erin E. Krebs, Laurie Zephyrin, Cynthia Brandt, Rachel Kimerling, Theo Sandfort, Melissa E. Dichter, Jeffrey J. Weiss, Jeroan Allison, and Sally Haskell. 2013. “Sexual Victimization, Health Status, and VA Healthcare Utilization Among Lesbian and Bisexual OEF/OIF Veterans.” Journal of General Internal Medicine 28 (S2): S604–8. 

Authors: Kristin M. Mattocks, Anne Sadler, Elizabeth M. Yano, Erin E. Krebs, Laurie Zephyrin, Cynthia Brandt, Rachel Kimerling, Theo Sandfort, Melissa E. Dichter, Jeffrey J. Weiss, Jeroan Allison, Sally Haskell

Abstract:

BACKGROUND: Many lesbian and bisexual (LB) women veterans may have been targets of victimization in the military based on their gender and presumed sexual orientation, and yet little is known regarding the health or mental health of LB veterans, nor the degree to which they feel comfortable receiving care in the VA. 
 
OBJECTIVE: The purpose of this study was to examine the prevalence of mental health and gender-specific conditions, VA healthcare satisfaction and trauma exposure among LB veterans receiving VA care compared with heterosexually-identified women veterans receiving. 
 
DESIGN: Prospective cohort study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) women veterans at two large VA facilities. 
 
PARTICIPANTS: Three hundred and sixty five women veterans that completed a baseline survey. Thirty-five veterans (9.6 %) identified as gay or lesbian (4.7 %), or bisexual (4.9 %). 
 
MAIN MEASURES: Measures included sexual orientation, military sexual trauma, mental and gender-specific health diagnoses, and VA healthcare utilization and satisfaction. 
 
KEY RESULTS: LB OEF/OIF veterans were significantly more likely to have experienced both military and childhood sexual trauma than heterosexual women (MST: 31 % vs. 13 %, p<.001; childhood sexual trauma: 60 % vs. 36 %, p=.01), to be hazardous drinkers (32 % vs. 16 %, p=.03) and rate their current mental health as worse than before deployment (35 % vs. 16 %, p<.001). 
 
CONCLUSIONS: Many LB veterans have experienced sexual victimization, both within the military and as children, and struggle with substance abuse and poor mental health. Health care providers working with female Veterans should be aware of high rates of military sexual trauma and childhood abuse and refer women to appropriate VA treatment and support groups for sequelae of these experiences. Future research should focus on expanding this study to include a larger and more diverse sample of lesbian, gay, bisexual, and transgender veterans receiving care at VA facilities across the country. (C) Society of General Internal Medicine 2013

Keywords: lesbian, health services research, veterans, women

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, LGBTQ, Military Forces & Armed Groups, Militaries, Sexual Violence, SV against women Regions: Americas, North America Countries: United States of America

Year: 2013

Intimate Partner Violence as seen in Post-Conflict Eastern Uganda: Prevalence, Risk Factors and Mental Health Consequences

Citation:

Kinyanda, Eugene, Helen Weiss, Margaret Mungherera, Patrick Onyango-Mangen, Emmanuel Ngabirano, Rehema Kajungu, Johnson Kagugube, Wilson Muhwezi, Julius Muron, and Vikram Patel. 2016. "Intimate Partner Violence as seen in Post-Conflict Eastern Uganda: Prevalence, Risk Factors and Mental Health Consequences." BMC International Health & Human Rights 16 (5): 1-11.

Authors: Eugene Kinyanda, Helen Weiss, Margaret Mungherera, Patrick Onyango-Mangen, Emmanuel Ngabirano, Rehema Kajungu, Johnson Kagugube, Wilson Muhwezi, Julius Muron, Vikram Patel

Abstract:

Background: Conflict and post-conflict communities in sub-Saharan Africa have a high under recognized problem of intimate partner violence (IPV). Part of the reason for this has been the limited data on IPV from conflict affected sub-Saharan Africa. This paper reports on the prevalence, risk factors and mental health consequences of IPV victimization in both genders as seen in post-conflict eastern Uganda.

Methods: A cross-sectional survey was carried out in two districts of eastern Uganda. The primary outcome of IPV victimization was assessed using a modified Intimate Partner Violence assessment questionnaire of the American Congress of Obstetricians and Gynecologists.

Results: The prevalence of any form of IPV victimization (physical and/or sexual and/or psychological IPV) in this study was 43.7 % [95 % CI, 40.1-47.4 %], with no statistically significant difference between the two genders. The factors significantly associated with IPV victimization were: sub-county (representing ecological factors), poverty, use of alcohol, and physical and sexual war torture experiences. The mental health problems associated with IPV victimization were probable problem alcohol drinking, attempted suicide and probable major depressive disorder.

Conclusion: In post-conflict eastern Uganda, in both genders, war torture was a risk factor for IPV victimization and IPV victimization was associated with mental health problems.

Keywords: Intimate partner violence, post-conflict, africa, risk factors, Mental health consequences

Topics: Armed Conflict, Domestic Violence, Economies, Poverty, Health, Mental Health, Trauma, Post-Conflict, Sexual Violence, Torture, Sexual Torture Regions: Africa, East Africa Countries: Uganda

Year: 2016

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