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Health care services for survivors of gender-based violence: a community and clinic-based intervention in Zambézia province, Mozambique.

Authors
  • De Schacht, Caroline1
  • Paulo, Paula2
  • Van Rompaey, Sara1
  • Graves, Erin3
  • Prigmore, Heather L4
  • Bravo, Magdalena1
  • Melo, Francisco2
  • Malinha, João Eduardo2
  • Correia, Della5
  • Cossa, Raquel6
  • Chele, Elsa7
  • Audet, Carolyn3, 8
  • 1 Friends in Global Health (FGH), Maputo, Mozambique. , (Mozambique)
  • 2 Friends in Global Health (FGH), Quelimane, Mozambique. , (Mozambique)
  • 3 Vanderbilt University Medical Center (VUMC), Institute for Global Health, Nashville, TN, USA.
  • 4 Department of Biostatistics, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA.
  • 5 Centers for Disease Control and Prevention (CDC), Maputo, Mozambique. , (Mozambique)
  • 6 National Directorate of Medical Assistance, Ministry of Health (MoH), Maputo, Mozambique. , (Mozambique)
  • 7 Provincial Health Directorate of Zambézia (DPS-Z), Quelimane, Mozambique. , (Mozambique)
  • 8 Department of Health Policy, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA.
Type
Published Article
Journal
AIDS care
Publication Date
May 16, 2022
Pages
1–9
Identifiers
DOI: 10.1080/09540121.2022.2067313
PMID: 35578397
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Mozambique introduced guidelines for integrated gender-based violence (GBV) services in 2012. In 2017, we trained providers on empathetic and supportive services to GBV survivors and introduced home-based services for survivors who are loss-to-follow up. Rate ratios of clinic visits were compared before and after intervention initiation, using exact significance tests. Data of 1,806 GBV survivors were reviewed, with a total of 2005 events. The median age was 23 years (IQR 17-30) and 89% were women. Among those reporting violence, 69% reported physical violence, 18% reported sexual violence (SV), and 12% reported psychological violence. Rates of care-seeking behavior were higher in the intervention period (rate ratio 1.31 [95%CI: 1.18-1.46]); p < 0.01. Among those eligible for post-exposure prophylaxis (PEP), 94% initiated PEP. Uptake of HIV retesting improved in percentage points by 34% (14% to 48%), 34% (8% to 42%) and 26% (5% to 31%) at 1-, 3- and 6-months, respectively. The intervention led to an increase in the rate of GBV survivors seeking health care services, and improved rates of follow-up care among SV survivors initiating PEP. Strengthening of PEP adherence counseling remains crucial for improving GBV services.

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