Screening for Traumatic Experiences and Mental Health Distress Among Women in HIV Care in Cape Town, South Africa
“Traumatic events can negatively affect clinical outcomes among HIV positive women, particularly when those events result in ongoing psychological distress. Consequently, there have been calls to integrate screening and treatment of traumatic experiences and associated mental health disorders into HIV care. In South Africa, screening for traumatic experiences and mental health is not a routine part of HIV care. […]
Participants [of this study] almost unanimously agreed that it would be appropriate and acceptable to screen all women in the clinic setting for trauma and mental health symptoms. […]
The high prevalence of traumatic experiences and psychological distress in this study highlights an urgent need to integrate screening into routine HIV care. The study provides evidence of the acceptability of screening for trauma and mental health symptoms among HIV positive women, at the critical points of care engagement when they are initiating ART or have defaulted on ART. In addition, there is need to link women screened to interventions and services, as part of trauma informed HIV care.”
Full text available on Sage Journals
Abuse at the hands of one’s partner is rife across the world. And even though South Africa has the highest levels of this type of violence, healthcare providers are not trained to deal with it and it is still regarded as a taboo subject.
In South Africa, shocking statistics reveal that:
– half of all women killed are slain by their intimate partners
– this is the highest femicide rate in the world
– more than 50% of women report experiencing intimate partner violence, often during pregnancy
– 20% of women surveyed in antenatal clinics in Soweto reported sexual violence by an intimate partner
– 68% reported psychological abuse and
– more than a third of girls report having been sexually violated and
– 45% of children have witnessed their mothers being beaten
Simone Honikman, director of the Perinatal Mental Health Project (PMHP) in Cape Town, has hailed the new open-source curriculum, saying it will be very useful in South Africa. “I think this is an excellent resource for capacity building that may be easily adapted for our local setting. Over the years of working with health and social development workers of all types, we at the PMHP, have been struck by the need for improved access to accessible, competency-based training on addressing intimate partner violence and sexual violence.”
Prevalence and Risk Factors in South Africa
Violence against women is a global problem which exacts a high burden of suffering on millions of women and families, including women who are pregnant and postpartum.
In South Africa, studies have shown that 36-40% of pregnant women experience physical IPV, while 15-19% experience sexual IPV.
In this vulnerable population, IPV is associated with a range of physical and mental health consequences for the mother including pregnancy loss, depression and post-traumatic stress disorder.
South African data have suggested a direct link between violence and HIV infection, where HIV-positive women are more likely than HIV-negative women to have experienced physical violence perpetrated by their partner. Alcohol and other drug use have been identified as another risk factor for IPV during pregnancy, as intoxication may lead to irresponsible behaviour such as violence
In South Africa, the mortality rate attributed to IPV is the highest globally and is double that of the United States. For the infant, there are increased risks associated with preterm delivery and low birth weight.
Read our policy brief on violence against women in South Africa and how to break the cycle on our website