Gender based violence among discordant couples in care and associated factors in accessing GBV post care; a cross sectional survey at AIDS Information Center – Uganda as presented by Elizabeth N & Nayiga R at the 14th International Conference on HIV Treatment, Pathogenesis and Prevention Research in Resource Limited Settings.
INTEREST – 2020 VIRTUAL EVENT
Background: Gender based violence poses formidable challenges to HIV prevention, care and Treatment among discordant couples limiting their individual efforts to adopt and maintain protective measures ranging from accessing care to ART adherence thus threatening HIV infection control. AIDS information center carried out a cross sectional survey to review the incidence of GBV and access to post care among discordant clients enrolled on discordance support program from May 2019.
Methods: A 2018 report from discordant meetings at AIC suggested a 47% GBV incidence among discordant couples. AIC then enrolled these clients on a discordance support program for services that included psycho social support and counselling, PrEP, ART initiation and quarterly meetings from April 2019. In December 2019, an analysis of data on GBV reported cases and post care was carried out; this was followed by a cross sectional survey using the national GBV screening tool to conduct client telephone interviews in determining the incidence of GBV after couple HCT that resulted into discordance, reporting status and post GBV care given.
Results: A total of 80 discordant couples (160 clients), 52% Females and 48% Males were enrolled on the discordance program between May and December 2019. According to the survey, 39% of the enrolled clients reported an incidence of GBV (Psychological 82%; Sexual 12%; Physical 6%). GBV was highest among Sero-positive females with 63%. The most affected female age group was 25-34years at 60% followed by 15-24years with 40%. Multiple forms of GBV were mostly experienced by 80% of Sero- negative Females. The occurrence of GBV was lowest in clients aged 35 years and above where 3% reported an incidence of GBV. 76% Males (58% sero positive and 42% sero negative) were reported to be the main perpetrators of GBV.
According to the data analysis, only 10% of GBV victims reported to the health facility while survey showed that 5% reported to other responsible authorities such as police. All those who reported to a health facility received the post GBV care package. The major reasons for not reporting of 85% victims were cultural customs, ignorance and the feeling that it can be solved by them as couples. Those who reported to other authorities were never linked back to the health facility for GBV post care services.
Conclusion: There was an 8% decline in GBV occurrence among discordant clients who were enrolled on the program in six months. Voluntary reporting among victims was noted to be low posing an even more significant challenge. There is an increased need for GBV screening by health workers during client care with further awareness and education on GBV, its effects and post care. The GBV linkage pathway for Authorities like police is emphasized for referral of GBV victims for post care services.