Exploring the impact of COVID-19 on women’s alcohol use, mental health, and experiences of intimate partner violence in Wakiso, Uganda

Abstract

Introduction Uganda confirmed its first COVID-19 case in March 2020, leading to country-wide closures and a stay-at-home order. Infectious disease pandemics can overwhelm adaptive coping capacity (e.g., general self-efficacy and resilience) and increase the risk for mental distress. For individuals experiencing intimate partner violence (IPV) and cohabitating with a perpetrator, stay-at-home orders can also increase risk of violence, which can further exacerbate mental distress. The present study explores women’s perceived self-efficacy and resilient coping, mental health outcomes (depression and COVID-19 related anxiety), hazardous alcohol use and IPV in the context of Uganda’s national 2020 lockdown. Methods A phone-based survey was undertaken from June-August of 2020 in Wakiso District, Uganda. The study sample consisted of Africa Medical and Behavioral Sciences Organization (AMBSO) Population Health Surveillance (APHS) study participants who agreed to be contacted for future research. The analytic sample was restricted to women aged 13–80 years. Bivariate analysis and multivariable models explored associations between experiences of IPV and measures of adaptive coping, mental health and alcohol use. Results A total of 556 women aged 13–79 years (mean age of 33.4 years) participated. Over half (55%) were currently married. The majority (60%) reported a decrease in alcohol use during the lockdown. Nearly half of the sample were experiencing physical or verbal IPV and reported an increase in violence during the lockdown. In adjusted analysis, alcohol use was associated with four times greater odds of recent physical IPV (aOR 4.06, 95% CI = 1.65–10.02, p = 0.0024), while participants had lower odds of experiencing any form of IPV as general self-efficacy increased (aOR 0.95, 95% CI = 0.91–0.99, p = 0.0308). Conclusion Lockdown measures in Uganda may have mitigated increased alcohol consumption. IPV was exacerbated during lockdown; more than 2 in 5 IPV victims experienced increased physical or verbal violence. Development of programming and policies aimed at mitigating women’s risk of IPV during future lockdowns are needed.

A Comparative Analysis of Gender Discrepancy Stress, Attitudes toward Intimate Partner Violence, and Perpetration among Young Adults in the USA and Uganda

“…Recent research in the U.S. indicates that there was a substantial increase in alcohol use during the COVID-19 pandemic [ 43 ] and also a significant increase in Alcohol Use Disorder-related mortality rates during the pandemic [ 44 ]. In Uganda, on the other hand, there is some indication that alcohol consumption may have been somewhat reduced during the pandemic, at least among women [ 45 ]. These differing patterns may partially explain the relatively higher levels of problem drinking in the U.S. sample, as well as the higher levels of IPV perpetration, but this conjecture would need to be confirmed in future studies.…”

The Effects of COVID-19 Social Restrictions and Subsequent Informal Support Limitations on Intimate Partner Violence: An Opinion Piece

“…COVID-19 and the associated restrictions have resulted in an escalation of three key socially related risk factors. Namely, restrictions have resulted in survivors being socially isolated, having greater dependence on the perpetrator, and experiencing poorer mental health ( 14 – 16 ).…”

“…Emerging evidence also indicates that while women are more likely to experience poor mental health during the pandemic, the severity of these symptoms is greater in women who are experiencing IPVAW ( 4 ). For example, in a study of Ugandan women, Miller et al ( 16 ) found that women who had experienced IPVAW during the pandemic had significantly higher scores on measures of depression and COVID-19 anxiety.…”

“…It is clear that the restrictions imposed to address the spread of COVID-19 has had a deleterious impact on IPVAW. While there are numerous risk factors of IPVAW, the three socially driven risk factors of poor psychological health, social isolation / interruption, and perpetrator dependence have been independently found to increase risk of IPVAW during the pandemic ( 14 – 16 ). However, it is proposed by the present authors that these three social factors are interconnected and together influence the risk of IPVAW.…”

“Right now we are scared of each other, we fear everyone, the whole world has COVID”: The impact of COVID-19 on young female sex workers in Kampala, Uganda, during national lockdowns in 2020–2021

“…Further, studies in Uganda, on COVID-19 have reported how the COVIDrelated public health restrictions affected people living in informal lower income settings as well as adolescent boys and young men through increased mental health challenges, poor access to food and a reduction in income [15,16]. Studies in the country have also emphasized increased rates of child abuse and intimate partner violence as well as violence in general during lockdowns [17][18][19].…”