Trapped in Circle of Threats: Violence Against Sex Workers in Thailand

Most researchers studying sex work have focused on the risks of sexually transmitted diseases, predominantly HIV, for sex workers, their clients, and subsequent partners. Violence against these women often goes undocumented and unnoticed. Consequently, few researchers have addressed violence against sex workers, and these few have generated limited evidence about the nature of violence from the sex-worker perspective—especially the street sex worker perspective. In this study, we used qualitative methods to explore characteristics of violence against street sex workers and how violence influences personal and societal health risks. The participants were 28 female street sex workers. The data were collected through in-depth interviews with 23 women, one focus group with 5 women, and observations of these women in their working and social environment. The results revealed that violence against sex workers can be clustered into three categories, threat to their life and health, threat to control of work and financial security, and finally, threat to humanity. Because they are disadvantaged, and engage in illegal employment, theses women were trapped in a circle of threats. To reduce violence, sex work should be decriminalized along with strategies to decrease poverty and social inequality. A special agency needs to be established to protect the rights and safety of sex workers.     

Parent Refugee Status, Immigration Stressors, and Southeast Asian Youth Violence

Purpose: To assess the effects of parents’ experience of traumatic events on violence among Southeast Asian and Chinese youth. The study examines independent effects of parents’ refugee camp experiences and immigration stress on serious or family/partner violence among youth. Findings contribute evidence on the intergenerational effects of community-level trauma that can help policy makers better integrate family and community strategies to reduce youth violence. Methods: Obtained cross-sectional, face-to-face interview data including peer delinquency, parental engagement, parental discipline, serious violence, and family/partner violence from a sample of 329 Chinese and Southeast Asian adolescents. Measures of socioeconomic status, refugee status, and immigration stressors were collected from their respective parents. Data were analyzed using LISREL 8.54 for structural equation modeling. Results: Findings show that parents’ refugee status facilitated serious violence, and was fully mediated by peer delinquency and parental engagement, but for Vietnamese only. Parents’ refugee status was also significantly related to family/partner violence, and mediated by peer delinquency. This relationship was not observed among the other Asian ethnic groups. The immigration stress variable had no significant effects on either serious violence or family/partner violence. Conclusions: Refugee communities may not transform easily into stereotypical immigrant Asian communities characterized by little youth violence. Results suggest that the refugee process, as experienced second-hand through the children of refugees, has a strong effect on externally oriented violence (serious violence) and on family/partner violence for particular subgroups. Therefore, community-oriented policy makers should join social workers in developing programs to address youth violence in Southeast Asian families and communities. Findings have implications for other forms of community trauma such as natural disasters.     

Women experiencing the intergenerationality of conjugal violence

Objective:

to analyze the family relationship, in childhood and adolescence, of women who experience conjugal violence.

Method:

qualitative study. Interviews were held with 19 women, who were experiencing conjugal violence, and who were resident in a community in Salvador, Bahia, Brazil. The project was approved by the Research Ethics Committee (N. 42/2011).

Results:

the data was organized using the Discourse of the Collective Subject, identifying the summary central ideas: they witnessed violence between their parents; they suffered repercussions from the violence between their parents: they were angry about the mother''s submission to her partner; and they reproduced the conjugal violence. The discourse showed that the women witnessed, in childhood and adolescence, violence between their parents, and were injured both physically and psychologically. As a result of the mother''s submission, feelings of anger arose in the children. However, in the adult phase of their own lives, they noticed that their conjugal life resembled that of their parents, reproducing the violence.

Conclusion:

investment is necessary in strategies designed to break inter-generational violence, and the health professionals are important in this process, as it is a phenomenon with repercussions in health. Because they work in the Family Health Strategy, which focuses on the prevention of harm and illness, health promotion and interdepartmentality, the nurses are essential in the process of preventing and confronting this phenomenon.     

Mobilising culture against domestic violence in migrant and ethnic communities: practitioner perspectives from Aotearoa/New Zealand

Studies on domestic violence in ethnic minority communities highlight that social norms, family structures and cultural practices are among the key triggers of violence against women. Not surprisingly, most anti‐violence interventions in these communities aim to redeem women from the oppressive features of these cultures. More recently, however, emergent scholarship advocates mobilising, rather than erasing, culture within existing anti‐violence strategies. This paper explores the nature of culturally informed interventions used by front‐line workers. It presents the findings of a small‐scale qualitative study in Aotearoa/New Zealand, where around 13% of the population are currently deemed to be from minority ethnic communities. Interviews and one focus group were conducted with nine practitioners – including social workers, counsellors and the police – in Hamilton, Aotearoa in 2013–2014. Based on thematic analysis, the paper identifies two core strands: (a) the distinctive profile of ethnic violence and (b) the strategies that mobilise culture in anti‐violence interventions. Specifically within the former strand, it was found that violence in the ethnic community was distinctive for the following reasons: the heightened sense of stigma surrounding disclosure and the consequent silence by women who suffer from it; the lack of trust in authority; and the fear of conventional safety plans necessitating longer time periods for rapport‐building. Among the strategies that mobilise culture, the study found that practitioners used a family approach; engaged men in their interventions, at times reinforcing gendered roles; utilised micro‐interventions; and deployed cultural tropes, especially around spirituality, as a strategy. The conclusion points to the gap between interventions that challenge and mobilise cultures. While anecdotally, the latter are perceived to be relevant and effective in anti‐violence interventions, there is need for a fuller assessment and better codification of these strategies within the training of practitioners who work in these communities.     

Disability status and violence against women in the home in North Kivu,Democratic Republic of Congo

ABSTRACT

Few studies have investigated how women’s disability status may influence violence against women within conflict settings. A mixed-methods analysis of formative qualitative research and cross-sectional baseline pilot data from a violence prevention program in North Kivu, eastern Democratic Republic of Congo (DRC), was used to examine violence against disabled adult women within the home. Logistic regression models were constructed to examine the relationship between past-month physical/sexual intimate partner violence, disability status, and older age (N?=?98 women). Deductive thematic analysis of focus groups and individual interviews (N?=?57 men, 59 women) was used to identify community norms and perceptions of violence against women with disabilities in the home. Women who reported mild disability reported higher experiences of past-month physical and/or sexual IPV (85.0%) compared to those who reported severe or no disability (76.5% vs. 70.8%, respectively). Older women with mild disability were more likely to report physical IPV compared to their younger counterparts as well (OR?=?1.23, 95%CI: 1.01, 1.49, p?<?0.039). Qualitative findings suggested family members may be deterred from perpetrating abuse against older women. These findings highlight a complex relationship between women’s disability status and violence perpetration, underscoring the importance of having inclusive, contextual violence against women prevention and response programming in conflict settings.     

Intimate Partner Violence Associated With Poor Health Outcomes in U.S. South Asian Women

To assess the associations between Intimate Partner Violence (IPV) victimization and health outcomes of South Asian women in Greater Boston. To explore the nature of the health experiences of victimized women in this population. Cross-sectional surveys with a community-based sample of women in relationships with males (n = 208) assessed demographics, IPV history, and health. In-depth interviews were conducted with a separate sample of women with a history of IPV (n = 23). Quantitative data were assessed by logistic regression, qualitative data by a grounded theory approach. Twenty-one percent of the quantitative sample reported IPV in the current relationship. Abused women were significantly more likely than those with no history of IPV in their current relationship to report poor physical health (95% CI = 1.3–12.0), depression (95% CI = 1.8–9.3), anxiety (95% CI = 1.3–6.4), and suicidal ideation (95% CI = 1.9–25.1). Qualitative subjects described how victimization resulted in injury and chronic health concerns and how IPV-induced depression and anxiety affected their sleep, appetite, energy, and wellbeing. Experiences of IPV are related to increased poor health among South Asian women. This elevated risk demands intervention. Healthcare providers should be trained to screen and refer South Asian patients for partner violence. This work was presented as a poster at the Third International Conference on Urban Health, Boston, MA, October 2004. It was awarded Honorable Mention in the Student Abstract Contest (Masters Level). Conflict of Interest: Anita Raj is a volunteer with and advisor to Saheli, the local South Asian CBO of volunteers providing cultural programs in the South Asian community and helping women in crisis. She has provided domestic violence advocacy and community education in the local South Asian community, and she has served as a South Asian Advisor to Asian Task Force Against Domestic Violence (ATFADV), the local Asian domestic violence program in Boston. Both Saheli and ATFADV assisted with recruitment for the current study. Saheli events that were not domestic violence-specific served as venues for recruitment for the cross-sectional study. Saheli and ATFADV cases of domestic violence were referred to the qualitative study.     

Violence against women: a study in a primary healthcare unit

OBJECTIVES: There is scarce information on violence against women in the Brazilian society. This fact is rarely reported in medical records as part of the diagnosis and case management, despite evidence showing the significant impact of violence on the population's health. The study aim was to estimate the occurrence of violence against women, and to determine the nature and magnitude of the violent action and the relationship between women and her aggressors. METHODS: The study was conducted among women seen in a primary care unit of the city of S?o Paulo, Brazil, in a two-month period in 1998. The occurrence of violence cases was ascertained using standardized interviews to all women aged 15 to 49 years who sought health care during the study. Three-hundred and twenty-two women were interviewed. RESULTS: Of the participants, 143 (44.4%; IC95%=38.9-49.8%) reported at least one episode of physical violence in their adult life, 110 of those perpetrated by their partners or family members (34.1%; IC95%=28.9-39.3%). Thirty-seven women (11.5%; IC95%=8.0-14.9%) reported at least one episode of sexual violence in their adult life, 23 of those perpetrated by their partners or family members (7.1%; IC95%=4.3-9.9%). CONCLUSIONS: As reported in other countries, physical and sexual violence is highly frequent among women seen in primary care services. In most cases their partners and family members are the perpetrators and the episodes are mostly serious and recurrent.     

Caregiver and community insights on coping strategies used by adolescents living in conflict-affected communities

The aim of this qualitative study was to provide a context-specific understanding of adolescent (10–15 years of age) exposure and coping with trauma from the perspective of mothers/female caregivers and key informants in rural conflict-affected villages. Focus groups were conducted with mothers/female caregivers (4 groups with total participants n?=?26) and interviews were conducted with key informants (n?=?9) in four villages in the Walungu Territory, Eastern Democratic Republic of Congo. Focus group and interview guides were designed to elicit responses by participants on adolescent exposures to trauma and coping strategies. A grounded theory approach was used to identify emergent themes. Mothers/female caregivers and key informants reported use of both cognitive and behavioural coping strategies by adolescents. Cognitive coping strategies included avoidance and trying to forget. Behavioural strategies included self-imposed isolation, risk-taking and social-support-seeking behaviours. Findings indicated community social support was a critical resource for adolescents, particularly for adolescents that did not have adequate support from their family. Supporting positive peer, family and community relationships can help prevent risk-taking behaviours and teach positive coping strategies to break a cycle of violence reported in these communities. Recommendations for gender-specific intervention programming are highlighted.

Abbreviations: DRC: Democratic Republic of Congo; PAIDEK: Programme d’Appui aux Initiatives Economiques; PFP: Pigs for Peace; RFR: Rabbits for Resilience     

Adolescents with attention deficit hyperactivity disorder and exposure to violence: parents' opinion

Objective:

to identify the opinion of parents or guardians of adolescents diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) about their children''s exposure as perpetrators or victims of violence situations in family life or outside.

Method:

qualitative study with use of thematic oral history. Nine parents of 07 adolescents with ADHD participated. Data were collected from April to September of 2013 using thematic interview. The interviews were recorded at scheduled times at the participants'' home, with an average duration of 30 minutes. The findings were submitted to inductive thematic analysis.

Results:

data analysis allowed the identification of the occurrence of "Conflicts in family life" and "Conflicts in the context of school and community". Parents reported the involvement of their children as victims, perpetrators and witnesses of physical and psychological violence, and the difficulty of them and the school to understand and handle these situations.

Conclusion:

violence occurs in ADHD adolescents'' interpersonal relationships. Communication between health professionals, school and families is precarious. Through the systematization of nursing care, nurses can plan strategies that articulate support networks and interpersonal relationships of adolescents with the disorder (family and school).     

Incarcerated women’s relationship-based strategies to avoid drug use after community re-entry

ABSTRACT

While recent research has stressed the supportive role that family and friends play for incarcerated persons as they re-enter the community, drug-using incarcerated women re-entering the community often have to rely on family, community, and intimate relationships that have played a role in their substance abuse and criminalization. In this study the authors conducted qualitative analysis of clinical sessions with rural, drug-using women (N = 20) in a larger prison-based HIV risk reduction intervention in Kentucky during 2012–2014 to examine incarcerated women’s perceptions of the role of their family, community, and intimate relationships in their plans to decrease their substance abuse upon community re-entry. Women stressed the obstacles to receiving support in many of their family and drug-using relationships after community re-entry. Nonetheless, they asserted that changes in their relationships could support their desires to end their substance abuse by setting limits on and using their positive relationships, particularly with their children, to motivate them to change. Interventions to promote incarcerated women’s health behavior changes—including substance abuse—must acknowledge the complex social environments in which they live.     

Violence against women by their intimate partner and common mental disorders

The World Health Organization considers gender violence a cause of anxiety, depression and suicidal thoughts among women. This study investigated the association between violence committed against women by their intimate partners, defined by psychologically, physically and sexually abusive acts, and common mental disorders, assessed by using the Self Reporting Questionnaire (SRQ-20). A population-based household survey was carried out among women aged 15–49 years in two sites: São Paulo, the largest Brazilian city, and Zona da Mata of Pernambuco, a region with both urban and rural areas in the Northeast of the country. A large proportion of women reported violence (50.7%). The most frequent forms were psychological violence alone (18.8%) or accompanied by physical violence (16.0%). The prevalence of mental disorders was 49.0% among women who reported any type of violence and 19.6% among those who did not report violence (p < 0.0001). After adjustment for demographic and socioeconomic characteristics, the nature of the relationship, stressful life events and social support, all the forms of violence studied, with the exception of sexual violence alone or accompanied by either physical or psychological violence (p = 0.09), were significantly associated with mental disorders: physical violence alone (OR 1.91; CI 95% 1.2–3.0), psychological violence alone (OR 2.00; CI 95% 1.5–2.6), sexual violence alone or accompanied by either physical or psychological violence (OR 1.80; CI 95% 0.9–3.6), both psychological and physical violence (OR 2.56; CI 95% 1.9–3.5) and all three forms of violence (OR 2.68; CI 95% 1.8–4.0).This is the first population-based study on the association between intimate partner violence and mental health in Brazil. It contributes to the existing body of research and confirms that violence, frequently experienced by women in the country, is associated with mental disorders. Policies and strategies aimed at reducing gender-based violence are necessary for preventing and reducing anxiety and depression among women.     

The Relationship Between Birth Predictedness and Violence During Pregnancy Among Women in La Paz and El Alto,Bolivia

Objectives: The main objectives were to estimate the prevalence of predicted and unpredicted last births using a prospective approach and to estimate the prevalence of violence during the last pregnancy. In addition, the relationship between birth predictedness and violence during pregnancy was examined. Methods: The target population for this study was women who had participated in the 1994 Demographic and Health Survey (DHS) and lived in El Alto and La Paz Bolivia (n = 1308). In 1997, 816 women were located and re-interviewed. During this three-year interval, 127/816 women had given birth to their last child. Results: Of the last births that occurred during the three-year interval, 82% were unpredicted (18% were to women who stated in 1994 that they wanted to postpone childbirth for more than three years and 64% were to women who stated they wanted to wanted to forego childbearing entirely). Twenty-eight percent of women reported that they had experienced violence during their last pregnancy. No statistically significant relationship was found between birth predictedness and violence during their pregnancy. Conclusions: The majority of births that occurred in the three-year study interval were unpredicted. The prevalence of violence during pregnancy was alarmingly high among this sample of women. Further investigation on violence during pregnancy is needed and should be expanded to examine how violence during pregnancy impacts maternal and infant outcomes, which have remained poor in this country. In addition, the high rates of unpredicted births illustrate that work remains to be done in addressing womens ability to control their fertility.     

Reports of violence against women in different life cycles

Objective

to analyze the reports and factors associated with violence against women.

Method

this was a cross-sectional, exploratory and analytical study with information about the cases of reported violence, extracted from the Civil Police Report Bulletin, in a mid-sized city in Minas Gerais, Brazil.

Results

out of the 7,487 reports of violence against women, it was found that 44.6% of the cases were threats, 28.5% aggression, 25.1% bodily injury, 1.1% rape, and 0.7% some other type of injury. In the bivariate analysis, a higher number of cases (p=0.000) committed by partners was evidenced, for all kinds of violence except for rape. Children, adolescents and adults experienced violence by partners, followed by family members. Regarding older women, violence was committed by family members.

Conclusion

there is the need for programs to be established to prevent violence against women in various sectors of society, permeating the life cycle.     

Intimate Partner Violence and Help-Seeking Among Ethiopian Women

Although intimate partner violence (IPV) is a widespread phenomenon in Ethiopia, the relationship between help-seeking sources and IPV is not well understood. Better understanding of this relationship could play a role in preventing IPV. We used data collected in the 2016 Ethiopia Demographic and Health Survey and limited our study to women who have ever been married, aged 15 to 49 years (n?=?4469). Overall, the proportions of women who have ever experienced emotional abuse, physical, or sexual violence were 24%, 23.1%, and 10.1%. Women who sought informal help (family) were 2.42 times more likely (OR?=?2.42; CI 1.29–4.55) to have ever experienced emotional abuse than women who did not seek family help. Neither formal nor informal help-seeking significantly associated with physical or sexual violence. The results may indicate difficulties women face in seeking help and cultural and social norms that tolerate IPV as an acceptable part of family life in Ethiopia.

     

Practitioner perspectives on the nexus between acquired brain injury and family violence

Family violence has been highlighted by the World Health Organization as a major public health concern. Although family violence occurs to all genders, a higher prevalence of victims are female. Estimates report around 30% of all women experience intimate partner violence worldwide. Experiencing assault in the family violence context can lead to an acquired brain injury (ABI); however, the connection between these two phenomena has not been well established. The aim of this qualitative study was to explore the extent of, and factors contributing to, ABI and family violence. We conducted 22 semi‐structured interviews and one focus group (n = 4) with practitioners working with family violence victims and/or perpetrators. Thematic data analysis utilised inductive and deductive coding approaches. The Social Determinants of Health Framework was used to guide analysis. Practitioners estimated 30%–40% of the clients on their caseloads had a suspected or diagnosed ABI. They identified that contributing factors were extremely complex. These included acquiring an ABI through assault (past family violence or other criminal act), and transport crashes. Complicating factors of ABI were identified as mental health conditions, alcohol and drug use, and post‐traumatic stress disorder. Additional factors contributing to family violence were recognised as biological (age of parent, twin births, pregnancy, premature births, and children with congenital abnormalities), relationships (intimate partner, father, boyfriend, mother and siblings), previous trauma (family violence), and life stressors (unemployment, financial, and lack of housing). Social determinants of health included cultural (ethnicity, societal attitudes, values, and beliefs) and organisational (legislation and policy) factors which influenced behaviours and outcomes across all sectors. A model of Brain injury Family violence Nexus (BFN) was created to understand the interaction between these phenomena. Utilising the BFN model to understand the interaction can enhance the methods used within health and social services for a more efficacious approach.     

Partner violence: implications for health and community settings.

OBJECTIVE: To assist in the design and implementation of strategies to address partner violence, the objective of this study was to evaluate differences in mental health, health behaviors, and use of health care and specific community services between women who do or do not report experiences of partner violence as an adult. METHODS: During interviews with 392 women enrolled in a Medicaid managed care organization, measures of mental health status, health behaviors, use of health care and community services, and experiences of partner violence were collected. Using bivariate statistical analyses, characteristics between women reporting or not reporting partner violence were compared. Chi-square tests were used to assess significant differences between the groups. The relationships between outcomes of interest and violence were estimated with logistic regression models adjusting for significant demographic and health characteristics. RESULTS: Overall, 28% of women reported experiences of partner violence. Women reporting partner violence had twice the adjusted odds of depression and three times the adjusted odds of negative self-esteem compared with women not reporting experiences of partner violence. Women reporting partner violence, compared with those who did not, indicated higher use of specific types of health and community services such as mental health services [odds ratio (OR) 2.9; confidence interval (CI) 1.5-5.6] and individual counseling (OR 3.6; CI 2.2-6.1). CONCLUSIONS: A communitywide effort that establishes linkages between health care settings and community services may be important in addressing the needs of women who are experiencing partner violence.     

‘Business before pleasure’: the golden rule of sex work,payment schedules and gendered experiences of violence

Abstract

A widespread rule of sex work is that payment occurs before service provision. Drawing on a subset of data collected as part of an ethnographic study conducted in metro Vancouver, Canada, this paper explores the temporal and gendered connections between payment and financial violence in a semi-criminalised indoor sex industry. A detailed examination of the timing of payment with 51 independent indoor sex workers reveals the gendered nature of the violence and its direct connection to anti-violence strategies indoor sex workers employ. We found that women (including transgender women) (n = 26) and men (n = 25) use payment schedules to minimise potential violence, but in divergent ways. Sex workers adhere to, negotiate and reject the golden rule of payment in advance based on different experiences of gendered violence. Through a gendered relational analysis, we show the contextual relationship between men and women as they negotiate payment schedules in their sex work interactions. These findings offer insight into the significance that the timing of payment has in sex workers’ anti-violence practices.     

Prevalence of violence against women users of health services

OBJECTIVE: Intimate partner abuse is a complex phenomenon and a public health problem and health care services are one of the places sought by women in this situation. The objective of this study was to assess the prevalence of violence against women attending a health care center. METHODS: This study was carried out in a municipality of Southeastern Brazil, in 2003. A sample of 265 women, aged 18 to 49 years old, was interviewed using a questionnaire administered face-to-face. Violence was classified as psychological, physical, sexual and general. Statistical analyses utilized were exact logistic regression and Fisher's exact test. RESULTS: Psychological violence, at least once in life, was reported by 41.5%, physical violence by 26.4%, and 9.8% reported sexual violence. "General violence", which refers to anyone of the above mentioned types of violence, was reported by 45.3% of the women, and, in 20.3% of the cases, they stated it had occurred during the last 12 months before the interview. However, when asked whether they had suffered any kind of violence in life, only 22.3% answered affirmatively. The multivariate analysis indicated that the risk factors for each type of violence were: drug use by the partner, socioeconomic status and family history of violence for both psychological and general violence; drug use by the partner, schooling and family history of violence for physical violence; and, socioeconomic status and family history of violence for sexual violence. CONCLUSIONS: This study indicates that the prevalence of violence among women attending the health center is high and consistent with the results of other investigations. It also suggests that most of the violence is invisible to the health center.     

VIOLENCE AGAINST WOMEN: AN EDUCATION PROGRAM FOR RURAL COMMUNITY HEALTH WORKERS

ABSTRACT: This study aimed to identify the educational needs of community-based rural health professionals regarding violence against women, and was funded under the Rural Health Support, Education and Training (RHSET) program. Focus groups and teleconferences were conducted with health workers, organisations and key individuals in the Wide Bay Region, Queensland, Australia. As a result, an education package has been designed that will provide specific training in violence against women for rural and remote health professionals working in the field. Rural health community workers identified the need to enhance their intervention skills and understanding on the issue of violence against women. A distance education framework based on adult and guided learning principles has been developed to meet this need. Six areas were identified as important learning needs and included: (i) violence against women as a public health concern; (ii) The role of the community health worker; (iii) How the community health worker can empower women experiencing violence in their lives; (iv) Enhancing and developing supportive networks; (v) Building on community development action; and (vi) Where to next for community health workers.