Sexual Risk Behavior, Sexual Violence, and HIV in Persons With Severe Mental Illness in Uganda: Hospital-Based Cross-Sectional Study and National Comparison Data

Lundberg, Patric; Nakasujja, Noeline; Musisi, Seggane; Thorson, Anna; Cantor‐Graae, Elizabeth; Allebeck, Peter

doi:10.2105/ajph.2014.302479

Cited by 12 publications

(12 citation statements)

References 44 publications

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“…Table 3 displays measurement of violence within the 174 included manuscripts and reports. Of the included manuscripts and reports, n = 134 measured multiple types of violence, whereas n = 18 focused only on sexual violence [ 41 , 45 , 53 , 56 , 58 , 59 , 66 , 85 , 86 , 88 , 93 , 100 , 108 , 109 , 118 , 122 – 124 ], n = 13 focused only physical violence [ 76 , 77 , 84 , 103 , 112 , 116 , 125 – 132 ] and one study focused only on economic abuse [ 133 ]. Physical violence was assessed in n = 146 manuscripts or reports, sexual violence was assessed in n = 144, psychological violence (including items defined by authors as emotional abuse or controlling behaviors, verbal abuse and threats) was assessed n = 87 and economic violence was assessed in n = 17 manuscripts or reports.…”

Section: Resultsmentioning

confidence: 99%

A scoping review of measurement of violence against women and disability

et al. 2022

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Introduction Existing evidence indicates that prevalence of violence against women with disability is elevated compared to women without disability. We conducted a scoping review with a focus on measurement to assess the forms of measurement and study design utilized to explore the intersection of violence against women with disabilities, and to identify strengths and limitations in current approaches to measuring violence against women with disabilities. This scoping review is designed to inform current debates and discussions regarding how to generate evidence concerning violence against women with disabilities. Methods and results We conducted systematic searches of the following databases: PubMed, PsycINFO, Embase, CINAHL, PILOTS, ERIC, Social Work Abstracts, International Bibliography of the Social Sciences, Social Services Abstracts, ProQuest Criminal Justice, and Dissertations & Theses Global, and conducted structured searches of national statistics and surveys and grey literature available on-line. We identified 174 manuscripts or reports for inclusion. n = 113 manuscripts or reports utilized acts-specific measurement of violence. In terms of measurement of disability, we found that amongst the included manuscripts and reports, n = 75 utilized measures of functioning limitations (n = 20 of these were Washington Group questions), n = 15 utilized a single question approach and n = 67 defined participants in the research as having a disability based on a diagnosis or self-report of a health condition or impairment. Discussion This scoping review provides a comprehensive overview of measurement of violence against women with disabilities and measurement of violence within disability-focused research. We identified several important gaps in the evidence, including lack of sex and disability disaggregation, limited evidence concerning adaptation of data collection methods to ensure accessibility of research activities for women with disabilities, and limited evidence concerning differential relationships between types of disability and violence exposure. This scoping review provides directions for sub-analyses of the included studies and further research to address gaps in evidence.

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Section: Resultsmentioning

confidence: 99%

A scoping review of measurement of violence against women and disability

et al. 2022

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“…Over time, evidence of dangerous sexual behaviors between men and women has been cited in the literature. Lundberg et al [24] found a high presence of multiple sexual partners among men with a mental illness compared to women, and a higher association between high-risk sexual behaviors and being HIV-infected among men. Contradictory findings from previous studies, however, attributed a higher risk of HIV infection from high risk behavior to women [7,25,26].…”

Section: Discussionmentioning

confidence: 99%

Self-Reported Prevalence of HIV Infection, Sexually Transmitted Infections and Risky Sexual Behavior among Mental Health Care Users Accessing Healthcare Services in Tshwane District, South Africa

Mokgatle

2021

Healthcare

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The rate of HIV and sexually transmitted infections among mental patients is higher than that of the general population worldwide. Many risky sexual behaviors are associated with mental illness. However, mental health care users (MHCUs) are not specifically targeted for HIV preventative care, and routine HIV testing is not done among this population. Limited studies have investigated self-reported HIV and STI prevalence and associated risky sexual behavior in persons with mental illnesses accessing health care services in South Africa in particular. This study set out to determine both the Sexually Transmitted Infections (STI) and human immunodeficiency virus (HIV) self-reported prevalence and sexual practices of MHCUs. A descriptive cross-sectional survey using purposive sampling was used to select 107 MHCUs across five clinics within Gauteng Province of South Africa who were above the age of 18, had a mental illness, and were currently stable and receiving chronic medication. Descriptive statistics were performed using Stata IC version 16. The chi square test was used to indicate statistical significance (p < 0.05) of differences in frequency distributions. More males (52.5%) than females were currently in a sexual relationship (50.0%), having multiple sexual partners (n = 4.13%), and having alcohol-driven sex (n = 4.19%). The majority of MHCUs (n = 82.77%) had an STI in the past six months, and a quarter (n = 21.25%) were HIV-positive with over two-thirds of MHCU (n = 69.70%) perceiving themselves not at risk for HIV. MHCUs engaged in risky behaviors had a low perception of the risks of contracting HIV. Bivariate analysis of gender by sexual behavior revealed that female MHCUs are more at risk of being forced to have sex compared to males (p = 0.006). Integrated interventions should be put in place to ensure that MHCUs’ sexual and reproductive health are not left behind and issues such as sexual education, safe sex, and sexually transmitted infections should form part of the care of MHCUs.

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“…The rate of syphilis comorbidity in this Ugandan study was twice that reported in a Brazilian study (1.1%) a country where the general prevalence of syphilis is reported at 7.7% among women attending antenatal care (38). Both vulnerability to HIV and syphilis which are predominantly transmitted through heterosexual relationships in the SMI context in Uganda are underlined by a common vulnerability to risky sexual behaviour and sex violence which Lundberg and colleagues (2015) in their Ugandan study reported to be more prevalent in SMI than in the general population (39).…”

Section: Discussionmentioning

confidence: 99%

Physical and psychiatric comorbidity among patients with severe mental illness as seen in Uganda

Mpango

Ssembajjwe

Rukundo

et al. 2020

Preprint

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This study established the prevalence of physical and psychiatric comorbidity and associated risk factors among 1,201 out-patients with severe mental illness (SMI) attending Butabika and Masaka hospitals in Uganda. Participants completed an assessment battery; structured, standardized and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidity and risk factors. Prevalence of physical and psychiatric comorbidity was 13.1 %. Childhood sexual abuse (aOR 1.06, 95% CI 1.03 -1.10, P=0.001), sexual abuse in adulthood (aOR 2.22, 95% CI 1.60 - 3.08, P<0.001), childhood physical abuse (aOR 1.07, 95% CI 1.03 - 1.10, P<0.001) and physical abuse in adulthood (aOR 1.69, 95% CI 1.30 - 2.20, P<0.001) were associated with an increased risk of having comorbid psychiatric and physical disorders. Emerging healthcare models in Uganda should optimise care for people with physical and psychiatric comorbidity.

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Sexual Risk Behavior, Sexual Violence, and HIV in Persons With Severe Mental Illness in Uganda: Hospital-Based Cross-Sectional Study and National Comparison Data

Abstract: Findings suggest that SMI exacerbates Ugandan women's sexual vulnerability. Public health practitioners, policymakers, and legislators should act to protect health and rights of women with SMI in resource-poor settings.

Cited by 12 publications

References 44 publications

A scoping review of measurement of violence against women and disability

A scoping review of measurement of violence against women and disability

Self-Reported Prevalence of HIV Infection, Sexually Transmitted Infections and Risky Sexual Behavior among Mental Health Care Users Accessing Healthcare Services in Tshwane District, South Africa

Physical and psychiatric comorbidity among patients with severe mental illness as seen in Uganda

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