Long-Term Impact of Exposure to a Gender-Transformative Program Among Young Men: Findings From a Longitudinal Study in Bihar, India.

PURPOSE: Gender-transformative programs with men and boys are recognized as a promising strategy for reducing violence against women and girls (VAWG). Reviews of such programs have underscored the need for investments in high-quality studies that measure effects on bio-behavioral outcomes and downstream effects. This article extends the limited evidence on long-term effects of gender-transformative programs with men and boys in India. METHODS: We used data from a cluster randomized trial of a gender-transformative life-skills education cum sports coaching program that sought to promote gender egalitarian attitudes and rejection of VAWG among boys and men aged 13-21 and a follow-up study. Young men were interviewed thrice-before the launch, after the completion, and 5 years after the completion of the trial (N = 853). We used generalized estimating equations models to estimate the short- and long-term effects of the intervention and effect modification by participation level and intervention exposure in early/late adolescence. RESULTS: The intervention succeeded in promoting gender equitable attitudes and notions of positive masculinity (ß = 0.319; p = .012), and attitudes rejecting men's controlling behaviors (ß = 0.428; p = .068) and VAWG (ß = 0.673; p = .051) among young men in the long- erm. It reduced their perpetration of intimate partner violence (odds ratio 0.639; p = .062). The long-term positive effects were observed for regular participants only, and greater effects were observed among those exposed to the intervention in early than late adolescence. DISCUSSION: Exposing boys to gender-transformative programs early on and ensuring their regular intervention participation can have sustained impact on promoting gender egalitarian attitudes and reducing their perpetration of VAWG.

Non-consensual sex within pre-marital relationships: experiences of young women in India.

In India, little is known about the prevalence of non-consensual sex within pre-marital relationships and factors correlated with such experience, although a sizeable proportion of young people engage in pre-marital relationships. Drawing on qualitative and quantitative data from a representative study of youth in six Indian states, this paper examines the extent to which young women who had had pre-marital sex had experienced non-consensual sex, that is, sex by persuasion or force, and factors associated with it. Analysis is restricted to 821 young women who reported pre-marital sex. Of those who had had pre-marital sex, 33% reported that they were either persuaded (14%) or forced (19%) to engage in sex. Young women residing in urban areas and in communities reportedly characterised by physical fights among youth were more likely than their respective counterparts to have experienced sex by persuasion. Young women who had delayed sexual initiation and those who displayed self-efficacy were less likely than others to experience forced sex. Young women who had experienced geographic mobility in adolescence and who had witnessed parental violence were more likely than others to report forced sex. Finally, those in southern states were less likely than their northern counterparts to experience forced sex.

Adoption and continuation of contraception following medical or surgical abortion in Bihar and Jharkhand, India.

OBJECTIVE: This study was carried out to explore whether the rates of postabortion adoption of a contraceptive method, and continuation of contraception over 6 months, differ among women undergoing medical abortion (MA) or surgical abortion by manual vacuum aspiration (MVA). METHODS: The study was conducted in Bihar and Jharkhand, 2 of the least-developed states of India. The analysis focused on 679 married women who were followed up 6 months after they underwent MA (n=308) or MVA (n=371) at clinics run by Janani, a nonprofit organization. RESULTS: The rates of adoption and continuation of contraception were similar in the 2 groups, although with some notable distinctions in the timing of adoption of contraception and the method of contraception adopted. While the women who underwent MA were significantly less likely to adopt contraception in the month following abortion (58% vs 86%), this difference had narrowed considerably by the end of the second month (82% vs 91%); and by the end of the sixth month (89% vs 94%), respectively. There were no significant differences between the MA and the MVA groups with respect to the continuation of reversible contraception. CONCLUSIONS: The findings indicate that, in a setting that offers comprehensive counseling and a range of contraceptive methods, and where adoption of contraception is voluntary, a large majority of women will adopt and continue to use a method of contraception after an abortion even in these less developed parts of India.