Interventions to reduce gender-based violence among young people living with or affected by HIV/AIDS in low-and middle- income countries.
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 thirteen databases and grey literature. We screened randomised 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 multi-level random effects meta-analyses were conducted. Results: We included 18 studies evaluating 21 interventions. Intervention arms were categorised as: a) sexual health and social empowerment (SHSE) (n=7); b) SHSE plus economic strengthening (n=4); c) self-defence (n=3); d) safer schools (n=2); e) economic only (n=2); f) GBV sensitisation (n=2) and g) safer schools plus parenting (n=1). Risk of bias was moderate/high and quality of evidence low. For self-defence and GBV sensitisation interventions, meta-analyses could not be conducted due to insufficient number of studies. Narrative syntheses indicated promising effects on GBV exposure, but no or mixed effects on GBV perpetration and attitudes. For SHSE interventions and SHSE plus economic strengtheening, meta-analysis showed a small reduction in GBV exposure, but not perpetration. Conclusions: SHSE, SHSE plus and self-defence and gender sensitisation 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.
gender-based violence, HIV/AIDS, adolescents and young people, prevention, intimate partner violence, low-and middle-income countries