Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia

Background: Intimate partner violence (IPV) is associated with adverse health and psychosocial outcomes. We analysed the spillover effects of Unite for a Better Life (UBL), an intervention evaluated in a cluster randomised controlled trial using a double-randomised design; previous evidence suggests...

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Autores principales: Leight, Jessica, Deyessa, Negussie, Verani, Fabio, Tewolde, Samuel, Sharma, Vandana
Formato: Journal Article
Lenguaje:Inglés
Publicado: BMJ 2021
Materias:
Acceso en línea:https://hdl.handle.net/10568/142375
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author Leight, Jessica
Deyessa, Negussie
Verani, Fabio
Tewolde, Samuel
Sharma, Vandana
author_browse Deyessa, Negussie
Leight, Jessica
Sharma, Vandana
Tewolde, Samuel
Verani, Fabio
author_facet Leight, Jessica
Deyessa, Negussie
Verani, Fabio
Tewolde, Samuel
Sharma, Vandana
author_sort Leight, Jessica
collection Repository of Agricultural Research Outputs (CGSpace)
description Background: Intimate partner violence (IPV) is associated with adverse health and psychosocial outcomes. We analysed the spillover effects of Unite for a Better Life (UBL), an intervention evaluated in a cluster randomised controlled trial using a double-randomised design; previous evidence suggests UBL reduced IPV in rural Ethiopia among direct beneficiaries. Methods: Villages (n=64) were randomly allocated to control, or to receive UBL delivered to men, women or couples. Each cluster comprised 106 surveyed households, including 21 randomly selected indirect beneficiary households who were not included in the intervention. Primary and secondary IPV outcomes included women’s experience and men’s perpetration of past-year physical or sexual IPV 24 months postintervention. An intention-to-treat analysis was conducted comparing indirect beneficiaries to sampled households in control communities. The analysis includes 2516 households surveyed at baseline in 2014–2015 (1680 households in the control arm, 258 indirect beneficiary households in the couples’ arm, 287 indirect beneficiary households in the women’s arm and 291 indirect beneficiary households in the men’s arm). Follow-up data were available from 88% of baseline respondents and 86% of baseline spouses surveyed in 2017–2018, a total of 4379 individuals. Results: Among indirect beneficiaries, there was no statistically significant intervention effect on women’s past-year experience of physical or sexual IPV, while men’s UBL significantly reduced reported perpetration of past-year sexual IPV (Adjusted Odds Ratio: 0.55; 95% CI 0.38 to 0.80, p=0.002). The intervention effects among indirect beneficiaries were statistically similar to those reported for the direct beneficiaries. In general, the hypothesis of equal effects cannot be rejected. Conclusion: A gender-transformative intervention delivered to men was effective in reducing reported IPV even among indirect beneficiaries, suggesting that the programme had positive spillover effects in diffusing information and changing behaviours within the broader community.
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spelling CGSpace1423752025-04-08T18:26:08Z Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia Leight, Jessica Deyessa, Negussie Verani, Fabio Tewolde, Samuel Sharma, Vandana rural population hiv infections gender human immunodeficiency virus domestic violence disease transmission violence Background: Intimate partner violence (IPV) is associated with adverse health and psychosocial outcomes. We analysed the spillover effects of Unite for a Better Life (UBL), an intervention evaluated in a cluster randomised controlled trial using a double-randomised design; previous evidence suggests UBL reduced IPV in rural Ethiopia among direct beneficiaries. Methods: Villages (n=64) were randomly allocated to control, or to receive UBL delivered to men, women or couples. Each cluster comprised 106 surveyed households, including 21 randomly selected indirect beneficiary households who were not included in the intervention. Primary and secondary IPV outcomes included women’s experience and men’s perpetration of past-year physical or sexual IPV 24 months postintervention. An intention-to-treat analysis was conducted comparing indirect beneficiaries to sampled households in control communities. The analysis includes 2516 households surveyed at baseline in 2014–2015 (1680 households in the control arm, 258 indirect beneficiary households in the couples’ arm, 287 indirect beneficiary households in the women’s arm and 291 indirect beneficiary households in the men’s arm). Follow-up data were available from 88% of baseline respondents and 86% of baseline spouses surveyed in 2017–2018, a total of 4379 individuals. Results: Among indirect beneficiaries, there was no statistically significant intervention effect on women’s past-year experience of physical or sexual IPV, while men’s UBL significantly reduced reported perpetration of past-year sexual IPV (Adjusted Odds Ratio: 0.55; 95% CI 0.38 to 0.80, p=0.002). The intervention effects among indirect beneficiaries were statistically similar to those reported for the direct beneficiaries. In general, the hypothesis of equal effects cannot be rejected. Conclusion: A gender-transformative intervention delivered to men was effective in reducing reported IPV even among indirect beneficiaries, suggesting that the programme had positive spillover effects in diffusing information and changing behaviours within the broader community. 2021-01-01 2024-05-22T12:10:23Z 2024-05-22T12:10:23Z Journal Article https://hdl.handle.net/10568/142375 en https://doi.org/10.1371/journal.pmed.1003274 https://doi.org/10.1371/journal.pmed.1003131 https://doi.org/10.1136/bmjopen-2020-042365 Open Access BMJ Leight, Jessica; Deyessa, Negussie; Verani, Fabio; Tewolde, Samuel; and Sharma, Vandana. 2021. Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia. BMJ Global Health 6(1): e004075. https://doi.org/10.1136/bmjgh-2020-004075
spellingShingle rural population
hiv infections
gender
human immunodeficiency virus
domestic violence
disease transmission
violence
Leight, Jessica
Deyessa, Negussie
Verani, Fabio
Tewolde, Samuel
Sharma, Vandana
Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia
title Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia
title_full Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia
title_fullStr Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia
title_full_unstemmed Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia
title_short Community-level spillover effects of an intervention to prevent intimate partner violence and HIV transmission in rural Ethiopia
title_sort community level spillover effects of an intervention to prevent intimate partner violence and hiv transmission in rural ethiopia
topic rural population
hiv infections
gender
human immunodeficiency virus
domestic violence
disease transmission
violence
url https://hdl.handle.net/10568/142375
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