Gender-based violence and HIV sexual risk behavior: Alcohol use and mental health problems as mediators among women in drinking venues, Cape Town
Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use an...
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| creator | Pitpitan, Eileen V. Kalichman, Seth C. Eaton, Lisa A. Sikkema, Kathleen J. Watt, Melissa H. Skinner, Donald |
| description | Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use.
► Women from drinking venues in a Cape Town township engaged in higher sexual risk behavior if they were abused by men. ► There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. ► There was no mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. |
| doi_str_mv | 10.1016/j.socscimed.2012.06.020 |
| format | Article |
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► Women from drinking venues in a Cape Town township engaged in higher sexual risk behavior if they were abused by men. ► There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. ► There was no mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems.</description><identifier>ISSN: 0277-9536</identifier><identifier>EISSN: 1873-5347</identifier><identifier>DOI: 10.1016/j.socscimed.2012.06.020</identifier><identifier>PMID: 22832324</identifier><identifier>CODEN: SSMDEP</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Acquired Immune Deficiency Syndrome ; Adult ; Alcohol Abuse ; Alcohol Drinking - epidemiology ; Alcohol use ; Biological and medical sciences ; Cape Town ; Cape Town, South Africa ; Female ; Females ; Follow-Up Studies ; Gender-based violence ; Health Problems ; HIV ; HIV Infections - epidemiology ; HIV risk ; Human viral diseases ; Humans ; Infectious diseases ; Mediation ; Medical sciences ; Mental Disorders - epidemiology ; Mental Health ; Middle Aged ; Miscellaneous ; Posttraumatic Stress Disorder ; Prospective Studies ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Qualitative Research ; Risk ; Risk Factors ; Risk-Taking ; Sexual Behavior ; Sexual risk ; Socioeconomic Factors ; South Africa ; South Africa - epidemiology ; Victimology ; Violence - statistics & numerical data ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Women ; Young Adult</subject><ispartof>Social science & medicine (1982), 2012-10, Vol.75 (8), p.1417-1425</ispartof><rights>2012 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Ltd. All rights reserved.</rights><rights>2012 Elsevier Ltd. All rights reserved. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c604t-e5994df5c756950192a2a9aa92a36e6241d81a7964c0b1c5c7849b46111a8bc3</citedby><cites>FETCH-LOGICAL-c604t-e5994df5c756950192a2a9aa92a36e6241d81a7964c0b1c5c7849b46111a8bc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.socscimed.2012.06.020$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,33775,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26312847$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22832324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pitpitan, Eileen V.</creatorcontrib><creatorcontrib>Kalichman, Seth C.</creatorcontrib><creatorcontrib>Eaton, Lisa A.</creatorcontrib><creatorcontrib>Sikkema, Kathleen J.</creatorcontrib><creatorcontrib>Watt, Melissa H.</creatorcontrib><creatorcontrib>Skinner, Donald</creatorcontrib><title>Gender-based violence and HIV sexual risk behavior: Alcohol use and mental health problems as mediators among women in drinking venues, Cape Town</title><title>Social science & medicine (1982)</title><addtitle>Soc Sci Med</addtitle><description>Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use.
► Women from drinking venues in a Cape Town township engaged in higher sexual risk behavior if they were abused by men. ► There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. ► There was no mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems.</description><subject>Acquired Immune Deficiency Syndrome</subject><subject>Adult</subject><subject>Alcohol Abuse</subject><subject>Alcohol Drinking - epidemiology</subject><subject>Alcohol use</subject><subject>Biological and medical sciences</subject><subject>Cape Town</subject><subject>Cape Town, South Africa</subject><subject>Female</subject><subject>Females</subject><subject>Follow-Up Studies</subject><subject>Gender-based violence</subject><subject>Health Problems</subject><subject>HIV</subject><subject>HIV Infections - epidemiology</subject><subject>HIV risk</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Mediation</subject><subject>Medical sciences</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Health</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Posttraumatic Stress Disorder</subject><subject>Prospective Studies</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Qualitative Research</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Risk-Taking</subject><subject>Sexual Behavior</subject><subject>Sexual risk</subject><subject>Socioeconomic Factors</subject><subject>South Africa</subject><subject>South Africa - epidemiology</subject><subject>Victimology</subject><subject>Violence - statistics & numerical data</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. 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However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use.
► Women from drinking venues in a Cape Town township engaged in higher sexual risk behavior if they were abused by men. ► There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. ► There was no mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>22832324</pmid><doi>10.1016/j.socscimed.2012.06.020</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acquired Immune Deficiency Syndrome Adult Alcohol Abuse Alcohol Drinking - epidemiology Alcohol use Biological and medical sciences Cape Town Cape Town, South Africa Female Females Follow-Up Studies Gender-based violence Health Problems HIV HIV Infections - epidemiology HIV risk Human viral diseases Humans Infectious diseases Mediation Medical sciences Mental Disorders - epidemiology Mental Health Middle Aged Miscellaneous Posttraumatic Stress Disorder Prospective Studies Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Public health. Hygiene Public health. Hygiene-occupational medicine Qualitative Research Risk Risk Factors Risk-Taking Sexual Behavior Sexual risk Socioeconomic Factors South Africa South Africa - epidemiology Victimology Violence - statistics & numerical data Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Women Young Adult |
| title | Gender-based violence and HIV sexual risk behavior: Alcohol use and mental health problems as mediators among women in drinking venues, Cape Town |
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