Identifying the women most vulnerable to intimate partner violence: a decision tree analysis from 48 low and middle-income countries

Background Primary prevention strategies are needed to reduce high rates of intimate partner violence (IPV) in low- and middle-income countries (LMICs). The effectiveness of population-based approaches may be improved by adding initiatives targeted at the most vulnerable groups and tailored to context-specificities. Methods We applied a decision-tree approach to identify subgroups of women at higher risk of IPV in 48 LMICs and in all countries combined. Data from the most recent Demographic and Health Survey carried out between 2010 and 2019 with available information on IPV and sociodemographic indicators was used. To create the trees, we selected 15 recognized risk factors for IPV in the literature which had a potential for targeting interventions. Exposure to IPV was defined as having experienced physical and/or sexual IPV in the past 12 months. Findings In the pooled decision tree, witnessing IPV during childhood, a low or medium empowerment level and alcohol use by the partner were the strongest markers of IPV vulnerability. IPV prevalence amongst the most vulnerable women was 43% compared to 21% in the overall sample. This high-risk group included women who witnessed IPV during childhood and had lower empowerment levels. These were 12% of the population and 1 in 4 women who experienced IPV in the selected LMICs. Across the individual national trees, subnational regions emerged as the most frequent markers of IPV occurrence. Interpretation Starting with well-known predictors of IPV, the decision-tree approach provides important insights about subpopulations of women where IPV prevalence is high. This information can help designing targeted interventions. For a large proportion of women who experienced IPV, however, no particular risk factors were identified, emphasizing the need for population wide approaches conducted in parallel, including changing social norms, strengthening laws and policies supporting gender equality and women´s rights as well as guaranteeing women´s access to justice systems and comprehensive health services. Funding Bill and Melinda Gates Foundation (Grant INV-010051/OPP1199234), Wellcome Trust (Grant Number: 101815/Z/13/Z ) and Associação Brasileira de Saúde Coletiva (ABRASCO)

Licit drug (alcohol, tobacco) and illicit (recreational) drug use among students of the Federal University of Pelotas

The present study aimed the increase of knowledge about the consumption of licit and illicit drugs in the college students and the additive behavior. Drug abuse in general is characterized as a widespread phenomenon worldwide with serious consequences, posing a significant threat to the health and social and economic structure of families, communities and nations. The main aim of study was to evaluate the prevalence of alcohol, tobacco and illicit drug use, as well as its associated factors among freshmen students from the Federal University of Pelotas. In particular it aimed to determine the simultaneous consumption of alcohol and illicit drugs and the simultaneous consumption of alcohol, cigarettes and illicit drugs, thus identifying individuals with greater health risk. His results will be used to draw future interventions against smoking, alcohol and illicit drugs use among young people, especially in college students. The instruments proposed to respond to the objectives were the AUDIT questionnaire, to evaluate alcohol consumption, 3 questions to evaluate smoking, 10 questions to evaluate the consumption of five kind of illicit drugs in lifetime and in the last 30 days. We found that the lifetime use of alcohol was 92.00%, current smoker prevalence was 11.02%, and the lifetime use of at least one illicit drug was 43.91% and at least one illicit drug use in the last 30 days was 23.30%. The simultaneous consumption of alcohol, tobacco, and illicit drugs was 5.21% and the associated risk factors were higher economic class, younger drug experimentation age and exact and agrarian sciences. Regarding the simultaneous consumption of alcohol and illicit drugs, the prevalence was 13.61% and associated risk factors were being male, from higher economic class, depressed, younger alcohol experimentation age, courses from linguistics, letters and arts area and living alone or with friends.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESO presente estudo visou o aumento de conhecimento sobre o consumo de drogas lícitas e ilícitas na população universitária e o comportamento aditivo. O abuso de drogas em geral caracteriza-se como fenômeno disseminado em todo o mundo, com consequências graves, representando uma ameaça significativa para a saúde e para a estrutura social e econômica das famílias, comunidades e nações. O objetivo principal do estudo foi avaliar a prevalência de consumo de álcool, tabaco e drogas ilícitas, bem como seus fatores associados nos ingressantes na Universidade Federal de Pelotas.Em particular, visou determinar o consumo simultâneo de álcool e drogas ilícitas e o consumo simultâneo de álcool, cigarro e drogas ilícitas, identificando assim os indivíduos com maior risco à saúde. Seus resultados poderão ser utilizados para desenhar futuras intervenções no combate ao tabagismo, ao uso de álcool e drogas ilícitas entre jovens, sobretudo nas populações universitárias.Os instrumentos propostos para responder aos objetivos foram o questionário AUDIT, para avaliar consumo de álcool, 3 perguntas para avaliar tabagismo, 10 perguntas para avaliar o consumo de cinco tipos de drogas ilícitas na vida e nos últimos 30 dias. Encontramos que 92,00% referiram já ter consumido álcool na vida;11,02% eram fumantes atuais, e 43,90% referiram uso de pelo menos uma droga na vida, e 23,30%, de pelo menos uma droga nos últimos 30 dias. O consumo simultâneo de álcool, cigarro e drogas foi de 5,21%, sendo os fatores de risco associados a este consumo classe econômica mais elevada, idade mais jovem quando da experimentação de drogas e área de concentração do curso exatas e agrárias. Quanto ao consumo simultâneo de álcool e drogas, a prevalência foi 6 de 13,61%, e os fatores de risco associados foram sexo masculino, classe econômica A, presença de depressão, idade mais jovem quando da experimentação de álcool, área de concentração de curso linguística, letras e artes e o fato de morar sozinho ou com amigos