Lived experience of intimate partner violence among women using antiretroviral therapy and other outpatient services in Wolaita Zone, Ethiopia: a phenomenological study

Abstract

Background Ethiopia is one of the nations which has an enormous burden of intimate partner violence (IPV), and where it is usually difficult to talk about HIV separately from IPV. Objectives This research aimed to explore the lived experience of IPV against women using antiretroviral therapy (ART) and other outpatient services in Wolaita Zone, Ethiopia Methods We used an Interpretive (hermeneutic) Phenomenological Analysis design among purposively selected adult women aged 18–49 years. A total of 43 women participated in this study, of whom 30 were using ART, and 13 women were using other health services. We used an in-depth interview and focus group discussions until data saturation, while conscious of the need to maintain the scientific rigor, dependability, and credibility. The data were transcribed verbatim and translated into English. We read the transcripts repeatedly to understand the content. We used NVivo 11 software to assist with data organisation, and also, we used the framework analysis method. Results We identified five themes, namely: “women's terrifying experiences of violence,” “the effect of violence on women's health,” “support/lack of support /partner’s controlling behaviours,” “women’s feelings about the available services,” and “IPV prevention strategies from the perspective of women.” Interviewees described their violent experiences which included wife-beating, being stigmatised in front of others, having material thrown at the woman’s face, wife’s hand and teeth were broken, forced sex, restriction of movement, name-calling, threats to hurt, being insulted, being left alone, and the withdrawal of finances. The negative health impacts reported included abortion, infection with HIV and other sexually transmitted diseases, disability, child’s death, and depression. The disclosure of HIV test information resulted in violence. Inappropriate punishment of the perpetrator and the lack of a supportive women’s network to avert IPV were perceived as legal limitations. Conclusions IPV is a considerable health burden, varying in its presentation and its negative impact on women’s health. Improved laws should provide justice for all victims. Establishing a women’s network to assist women at risk of violence, should be emphasised. Unwise HIV test result disclosure leads to IPV; hence HIV disclosure should be facilitated through health care providers.

Exploring Lived Experience of Family and Domestic Violence Against Women With Disability: A Scoping Review

“…Tactics involving children were also reported, similarly to women without disability. These included refusing to support parenting, being humiliated, degraded, and sexually assaulted in front of children, and physical violence resulting in miscarriage and the death of children ( McCarthy, 2019 ; Meskele et al, 2021 ).…”

“…However, this could be amplified by tactics specifically targeting women’s disability, for example, by restricting access to medical care ( Tsegay et al, 2018 ). As noted by Hague et al (2011) and Meskele et al (2021) , women were often isolated from external support as a strategy by some abusive partners, often multiplying neglect and creating situations of increased dependence on and vulnerability to their abusive partners for everyday tasks. This was illustrated as an intense and painful experience within participants’ narratives ( Hague et al, 2011 ).…”

“…Participants in the study by Meskele et al (2021) reported serious beatings with sticks, having material thrown in their faces, and having their teeth and hands broken. One participant reported having her chest bone broken from being beaten, and having to sleep through a whole night with a knife in her body after being stabbed by her husband (Meskele et al, 2021). Perpetrators employed tactics targeting women's physical disability, leaving women feeling powerless, inferior and with a reduced sense of their self-worth (Jordan, 2019): "He'd dump me on the middle of the stairs and leave me there, stuck.…”

Characterizing Intimate Partner Violence against Married Women in Ethiopia with Machine Learning

“…Several studies were conducted in Ethiopia on IPV against women but those studies focused on 1) the prevalence of IPV during pregnancy and the factors that contribute to it [18] [19], 2) the prevalence of IPV against HIV-positive women and the factors that lead to it [20][21] [22], 3) the incidence and its in uencing factors of IPV amongst couples during the COVID-19 epidemic restrictions [23][24] [25]. In all the studies, the data used were facility-based such as an antenatal clinic in the public health facilities at a local level, covering a small geographical area with a small sample size.…”

Maternal exposure to intimate partner violence and uptake of maternal healthcare services in Ethiopia: Evidence from a national survey

“…Living in rural areas, low maternal education and poor household wealth, are strong predictors of IPV [ 14 , 15 ]. Literature regarding the effects of IPV on women’s health in Ethiopia found associations between IPV and adverse birth outcomes [ 16 ], unintended pregnancy [ 17 ], pregnancy loss [ 18 ], unmet need for family planning [ 19 ], depression [ 20 , 21 ], Human Immuno-deficiency Virus (HIV) status [ 22 ], and antiretroviral therapy adherences [ 23 ]. Mediation effect of contraceptive use and women’s autonomy on the relationship between IPV and unintended pregnancy has also been documented [ 24 ].…”