Interventions to reduce gender-based violence among young people living with or affected by HIV/AIDS in low- and middle- income countries
August 2019
| Journal article
| AIDS
<p><strong>Objective(s):</strong><br/> 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).</p><br/> <p><strong>Design:</strong><br/> Systematic review and meta-analysis.</p><br/> <p><strong>Methods:</strong><br/> 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.</p><br/> <p><strong>Results:</strong><br/> 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 strengthening 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. Narrative syntheses indicated promising effects on GBV exposure, but no or mixed effects on GBV perpetration and attitudes for self-defence and GBV sensitisation interventions. Safer schools interventions showed no effects. For SHSE interventions and SHSE plus economic strengthening, meta-analysis showed a small reduction in GBV exposure but not perpetration. Economic-only interventions had no overall effect.</p><br/> <p><strong>Conclusions:</strong><br/> 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.</p>
HIV/AIDS, intimate partner violence, adolescents and young people, low- and middle-income countries, gender-based violence, FFR, prevention