Domestic Violence and Sexual Health among Young Women in Zambia

This paper aims at describing the prevalence and correlates of domestic violence, and evaluating their associations with key health outcomes among Zambian young females aged 15–24 years.Data from the 2007 Zambia Demographic Health Survey was utilized. The survey was carried out by Central Statistical Office with the technical assistance from Macro International through MEASURE DHS programme. The 2007 ZDHS is based on a nationally representative sample of 7146 ever married women of 15-49 age group covering 320 Standard Enumeration Areas (clusters). In this paper, the data analysis was only restricted to young women aged 15-24.The results show that among the various forms of violence against women, 22% of the women faced sexual violence, followed by emotional violence (21%) and physical violence (16%). The results further revealed  that age, religion, educational level, working status, condom use during last sex and had any STDs in the last 12 months, had genital sores/ulcers in the last 12 months were the most prominent factors significantly explaining variation in the prevalence of physical, emotional and sexual violence. Domestic violence is a complex societal scourge which is unlikely to be attributed to one single determinant.Keywords: Domestic Violenc

Family Domestic Violence: Impact on Children in Lusaka, Zambia

Aim: To explore the experiences of children exposed to domestic violence in Lusaka District, Zambia. Study Design: A qualitative exploratory approach was adopted for this study. Place and Duration of the Study: The study took place in Lusaka district over a period of 8 months. The study population included domestic violence survivor children and their parents. The study sample consisted of fifty-two participants divided into thirty children (boys and girls), sixteen parents or guardians, and six key informants. Data was collected using detailed interviews with children and key informants, while focus group discussions were conducted with the parents or guardians. Results: The findings of the study revealed that children were exposed to different forms of domestic violence including physical abuse, emotional (verbal) abuse, and economic abuse. The children were both witnesses and victims of domestic violence. The study also revealed that exposure to violence had negative effects on the children such as physical injury, fear and anxiety, loss of confidence and self-esteem, academic under performance, guilt and shame, and poor relationships with peers and parents. Conclusion and Recommendations: Domestic violence is still prevalent in Lusaka District and has negative long-term effects on children who witness it and are victimised by it. Interventions are necessary to address the size, nature, and complexity of the problem. It is recommended that professionals who have regular contact with families and children, including teachers, child care workers, health and mental health care providers, law enforcement officers, child welfare workers, and court officials should receive ongoing training on domestic violence and its impact on children, and necessary interventions to combat it

Gender Differentials in Consistent Condom Use among Young People in Zambia

The aim of this paper is to determine socio-economic and demographic factors that influence gender differentials in consistent use of condoms among young people in Zambia. Data for this paper were collected from a household questionnaire that was administered to sexually active youth (N=3554) between the ages of 15-24 during the 2013 Demographic Health survey. Cross tabulation and chi-square results revealed a relationship between age, gender, place of location, socio-economic background, employment status, level of education media exposure, alcohol consumption and perceived risk of contracting HIV with the consistent use of condoms. For females, regression analyses revealed that wealth status, work status, educational level and drinking alcohol were positively associated with reporting consistent use of condoms. For males, age, work status, educational level, perceived risk of contracting HIV and drinking alcohol are associated with increased likelihood of reporting consistent condom use within the last 6 months.Key Words: Gender Differentials, Condom use, Youth, Zambi

Dating Violence Experienced by Students at the University of Zambia

Dating violence is a complex problem determined by multiple factors. Poverty, cultural and social environmental factors are a major contributor to the gender based violence. The aim of this study was to examine the nature and extent of dating violence experienced by students at the University of Zambia. Eighteen students (nine males and nine females) aged fifteen to thirty years were recruited from the University of Zambia hostels. In-depth interviews with semi-structured interviews were used for data collection. This study has found that various forms of dating violence exists at the University of Zambia. The study further found risk factors that were associated with dating violence such as consumption of alcohol and/or use of entertaining substances, as well as being involved in aggressive activities such as fighting or insulting; other factors included; poverty, experiencing of inter-parental violence and prior experience with violence. The psychological and emotional implications were that some students became depressed and stressed, insecure, ideated suicide, feared sex, distrusted people and were worried and uneasy. Under physiological and health outcomes, some students contracted STDs and HIV, body injuries, became pregnant, and others lost or terminated their pregnancy. Furthermore, social implications were that some students became aggressive, went into self-isolation, and began living recklessly. Physical abuse, verbal abuse, sexual abuse and psychological or emotional abuse where the most common types of dating abuse found at the University of Zambia. Conclusively, In addition to awareness against gender based violence, youth friendly corners should be considered during the treatment of gender based violence in universities

Types of episodic disability among people living with HIV in Zambia.

HIV is increasingly recognized as a chronic illness which may result in episodic disability related to the effects of the virus, side effects of medication, co-morbidities and consequences of aging. Little is known about the episodic disability experiences of people living long-term with HIV in resource-limited countries, which is best understood by following people over time. This qualitative longitudinal study examined the episodic disability experiences and the applicability of four types of episodic disability among people living with HIV and on anti-retroviral therapy in Zambia. We interviewed 31 men and women living with HIV on 3 occasions at 6-month intervals (total of 93 interviews) examining the processes of change over time. We used disability models to inform the interviews exploring impairments/symptoms, activity limitations and participation restrictions. Longitudinal analyses of transcribed interviews confirmed the applicability of four types over time: stable, increasing disability, decreasing disability and significant fluctuations. Analyses highlighted the extent to which determinants of health contributed to the disability experienced. The use of disability models revealed the importance of environmental and social influences on disability and quality of life. The indicators of the type of episodic disability could be used clinically to help understand the nature and potential triggers of the episodes

Written Advice Given by African American Smokers to Their Peers: Qualitative Study of Motivational Messages

BACKGROUND: Although African Americans have the lowest rates of smoking onset and progression to daily smoking, they are less likely to achieve long-term cessation. Interventions tailored to promote use of cessation resources in African American individuals who smoke are needed. In our past work, we demonstrated the effectiveness of a technology-assisted peer-written message intervention for increasing smoking cessation in non-Hispanic White smokers. In this formative study, we have adapted this intervention to be specific for African American smokers. OBJECTIVE: We aimed to report on the qualitative analysis of messages written by African American current and former smokers for their peers in response to hypothetical scenarios of smokers facing cessation challenges. METHODS: We recruited African American adult current and former smokers (n=41) via ResearchMatch between April 2017 and November 2017. We asked participants to write motivational messages for their peers in response to smoking-related hypothetical scenarios. We also collected data on sociodemographic factors and smoking characteristics. Thematic analysis was conducted to identify cessation strategies suggested by the study participants. RESULTS: Among the study participants, 60% (25/41) were female. Additionally, more than half (23/41, 56%) were thinking about quitting, 29% (12/41) had set a quit date, and 27% (11/41) had used electronic cigarettes in the past 30 days. Themes derived from the qualitative analysis of peer-written messages were (1) behavioral strategies, (2) seeking help, (3) improvements in quality of life, (4) attitudes and expectations, and (5) mindfulness/religious or spiritual practices. Under the behavioral strategies theme, distraction strategies were the most frequently suggested strategies (referenced 84 times in the 318 messages), followed by use of evidence-based treatments/cessation strategies. Within the seeking help theme, subthemes included seeking help or support from family/friends or close social networks (referenced 56 times) and health care professionals (referenced 22 times). The most frequent subthemes that emerged from improvements in the quality of life theme included improving one\u27s health (referenced 22 times) and quality of life (referenced 21 times). Subthemes that emerged from the attitude and expectations theme included practicing positive self-talk (referenced 27 times), autonomy/independence from the smoking habit (referenced six times), and financial cost of smoking (referenced five times). The two subthemes that emerged from the mindfulness/religious or spiritual practices theme were use of self-awareness techniques (referenced 36 times) and religious or spiritual practices to cope (referenced 13 times). CONCLUSIONS: Our approach to adapt a prior peer-message intervention to African American smokers yielded a set of evidence-based messages that may be suitable for smokers at all phases of motivation to quit (ready to quit or not ready to quit). In future research, we plan to assess the impact of texting these messages to African American smokers in a smoking cessation trial. H Williams, Dalton Mourao, Oluwabunmi M Emidio, Maryann Davis, Lori Pbert, Sarah L Cutrona, Thomas K Houston, Rajani S Sadasivam. Originally published in JMIR Formative Research (https://formative.jmir.org), 30.04.2021

Posttraumatic Stress among women with HIV in Zambia

Objective: To examine whether HIV-positive women in Lusaka District, Zambia, displays a higher degree of PTSD-symptoms than a HIV-negative control group. Method: The study targeted 50 HIV-positive women from four ART-clinics and 42 HIV-negative women from corresponding VCT-units. All sites were located in Lusaka District, Zambia. The HIV-positive women were compared with the control group in regard for PTSD, PTSD-symptoms, dissociative symptoms and history of traumatic experiences. The instruments used were PCL-C, DES-T and LYLES-A. Prior to the main study, the validity of the instruments were assessed with a pilot-sample. Results: Three participants in the HIV-positive group fulfilled the criteria for clinical PTSD (10.7 %), as compared to none in the control group. The HIV-positive group also displayed a significantly higher degree of PTSD-symptoms and previous traumatic experiences, with strong effect sizes, but not for dissociative symptoms. The significant difference in PTSD-symptoms remained while trauma-history was controlled for. Conclusions: The results of this study clearly indicates that women with HIV are vulnerable to PTSD and that contracting HIV in itself can constitute a psychological trauma in itself. Since PTSD among persons with HIV has been associated with transmission risk behaviours, reduced treatment adherence and a faster disease progression, these findings are important to consider in actions against HIV and AIDS. Funding Agency:Office of Global AIDS/US Department of State</p

Cognitive impairment in Zambians with HIV infection and pulmonary tuberculosis

BACKGROUND: HIV infection may result in neurocognitive deficits, but the effects of pulmonary tuberculosis (TB+), a common comorbid condition in HIV infection, on cognition in HIV infections are unknown. Accordingly, we examined the effects of TB+, on neurocognitive functioning in HIV-infected (HIV+) Zambian adults. SETTING: All participants were drawn from HIV clinics in and around Lusaka, the capital of Zambia. METHODS: Participants were 275 HIV+, of whom 237 were HIV+ and TB-negative (HIV+/TB-), and 38 also had pulmonary TB+ (HIV+/TB+). Controls were 324 HIV- and TB-uninfected (HIV-) healthy controls. All HIV+ participants were prescribed combination antiretroviral treatment (cART). Published, demographically corrected Zambian neuropsychological norms were used to correct for effects of age, education, sex, and urban/rural residence. RESULTS: Neuropsychological deficits, assessed by global deficit scores, were more prevalent in this order: 14% (46 of 324) of HIV- controls, 34% (80 of 237) of HIV+/TB-, and 55% (21 of 38) of HIV+/TB+ group. Thus, both HIV-infected groups evidenced more impairment than HIV- controls, and the HIV+/TB+ group had a higher rate of neurocognitive impairment than the HIV+/TB- group. HIV+/TB+ patients were more likely to be male, younger, less-educated, and have lower CD4 counts and detectable HIV RNA in blood compared with the HIV+/TB- patients. CONCLUSIONS: In HIV infection, TB may contribute to cognitive impairment, even after controlling for lower CD4 counts and viral load. Thus, systemic inflammation from HIV and TB and more advanced immune deficiency at diagnosis of HIV may contribute to impaired cognition in HIV+/TB+ patients.This study was supported by the NORAD’s master program (NOMA) NOMAPRO-2007/10046 and The Inland Norway University of Applied Sciences (to Knut A. Hestad). Additional support was provided by the National Institutes of Health grant 5P30MH062512–15 (to Robert Heaton).acceptedVersio