Social comorbidities? A qualitative study mapping syndemic theory onto gender-based violence and co-occurring social phenomena among Brazilian women

Abstract

Background: Gender-based violence is a globally recognized social problem impacting women and girls worldwide. Intimate partner violence (IPV) represents the most common form of gender-based violence. Among the countries grappling with gender-based violence is Brazil, which has identified high rates of IPV along with co-occurring social conditions such as adverse childhood experiences, community violence, and substance use. While the syndemic framework has incorporated IPV into understandings of HIV and other diseases, none have explicitly applied syndemic framework to understand IPV and co-occurring social conditions-referred to here as "social comorbidities"-in the absence of a biological outcome. This study aims to: (1) Examine perspectives on violence and relevant social comorbidities (substance use, community violence, and childhood abuse) among women living in Santo André, São Paulo State, Brazil; and (2) Apply the syndemic framework to a set of social comorbidities among women living in Santo André, São Paulo State, Brazil. Methods: This thematic analysis applies a syndemic framework to 28 in-depth interviews with women in Santo André, Brazil. Interviews were recorded and transcribed verbatim in Portuguese. Our analysis examined themes relating to IPV, community violence, substance use, and other individual experiences and community issues using syndemics as an organizing framework (e.g. diseases, adverse interactions, disparity conditions, and enhanced disease transmission). Results: Most participants described experiencing multiple social comorbidities including IPV, adverse childhood experiences, community violence, family violence, and substance use. Adverse interactions included increased financial conflicts, a sense of isolation, and increased severity of violence due to substance use. Long term enhanced "disease" progression included injury, increased mental health symptoms, femicide, and death. Conclusions: Our results suggest that using a syndemic framework to understand IPV in the context of social comorbidities could be useful for understanding how these social phenomena may mutually reinforce each other and cause adverse interactions. Similar applications across other social phenomena may also be possible.

Intimate partner violence and its correlates in middle-aged and older adults during the COVID-19 pandemic: A multi-country secondary analysis

“…There was strong evidence that having isolated due to COVID-19 was associated with increased odds of IPV compared to those who did not isolate among middle-aged and older adults. This finding coincides with a broader base of literature that identifies social isolation as a risk factor for IPV (38–40) and conversely that social support is protective (41). During the pandemic, many people self-isolated (42).…”

Intimate partner violence and its correlates in middle-aged and older adults during the COVID-19 pandemic: A multi-country secondary analysis

“…There was strong evidence that having isolated due to COVID-19 was associated with increased odds of IPV compared to those who did not isolate among middle-aged and older adults. This finding coincides with a broader base of literature that identifies social isolation as a risk factor for IPV [ 25 , 55 , 56 ] and conversely that social support is protective [ 26 ]. During the pandemic, many people self-isolated [ 57 ].…”

Women Abused: Analysis of Assistance Provided by Urgency Mobile Service

“…Among the findings of this study, the use of some type of drug was verified, but there was no correlation between this variable and the severity or nature of the attacks. It is known, however, that the use/abuse of legal and/or illicit drugs, whether by the victim or the aggressor, is another factor that appears to be associated with the occurrence of violent acts [33,34].…”