Contesting everyday violence: Resilience pathways of gay and transgender youth in Peru.

Within Peru, lesbian, gay, bisexual, transgender, intersex, and queer/questioning (LGBTIQ) groups experience significant levels of violence, particularly LGBTIQ youth. This study explored youth responses to violence in two cities: Lima and Ayacucho. We sought to formulate key factors facilitating LGBTIQ youth resilience to inform local practice and policy. Focus groups were conducted with youth that self-identified as gay and transgender. We used thematic analysis to identify both inductive and deductive themes. Deductive themes were driven from resilience and structural violence theories. Structural and direct violence was reported by all youth with differences regarding the role of self, place and people in their resilience pathways. Despite experiencing everyday violence, LGBTIQ youth participants displayed remarkable resilience, though the resilience strategies and experiences of violence were distinctive for each group. Transgender youth relied more on their collective rather than individual resilience. In contrast, gay youth revealed a high level of individual resilience. Overall, the participants exhibited a fluidity of resilient and resistant behaviours toward violence. The use of place theory and a social resistance framework is suggested for interventions that effectively honour and foster the courageous resilience of LGBTIQ youth and effectively equalize their opportunities.

Scoping Review of Interventions Supporting Mothers with Mental Illness: Key Outcomes and Challenges.

Despite the fact that more than 60 % of women experiencing mental distress also care for dependent children, little is known about the efficacy of interventions supporting parents with mental illness. A scoping review of the literature published between 1997 and 2014 was conducted to obtain an overview of empirically evaluated interventions and to typify their outcomes. Our review identified 19 publications reporting on 9 interventions. The efficacy of programs was apparent and key components used by programs were recognized. To enhance the well-being of mothers with mental illness and their children an increased knowledge transfer in this field is required.

An open debate about the object and purpose of global health knowledge in the context of an interdisciplinary research partnership on HIV/STI prevention priorities in Peru.

BACKGROUND: With the failure of the latest vaccine trial, HVTN-505, HIV prevention efforts remain critical. Social and structural factors contributing to HIV and STI transmission include stigma regarding sexual violence, HIV infection and sexual orientation. For instance, HIV prevention and overall sexual health programs in Peru have been implemented yet key populations of youth (sex workers, male and transgender youth) continue to be overrepresented in new cases of HIV and STI. This suggests that interventions must take new directions and highlights the need for additional research. DISCUSSION: While interdisciplinary, international research collaborations often are indicated as best practice in developing new knowledge in global health and an important component of the leadership in health systems, this does not mean they are free of challenges. In this debate we document our reflections on some of the challenges in developing an interdisciplinary and international research team to understand HIV and STI prevention priorities among youth in two culturally diverse cities in Peru: Lima, the capital city, and Ayacucho, in the Andean region. SUMMARY: Rather than offering solutions we aim to contribute to the debate about the object and purpose of global health research in the context of developing international research partnerships that genuinely promote a reciprocal and bidirectional flow of knowledge between the Global South and the Global North, and researchers at intersections of these locations.

Two decades later: The resilience and post-traumatic responses of Indigenous Quechua girls and adolescents in the aftermath of the Peruvian armed conflict.

OBJECTIVES: In comparison to other traumatic events, the impact of a childhood during war on resilience later in life has been seldom examined. The aim of this study was therefore to examine the long term outcomes of post-traumatic responses and resilience of a sample of adult Indigenous Quechua women, who were girls or adolescents during the Peruvian armed conflict (1980-1995). METHODS: The study instruments (Harvard trauma questionnaire part I and IV; Connor-Davidson resilience scale; life stress questionnaire) were translated to Quechua and cross-culturally validated. A cross sectional survey design was used in 2010 to collect data from a convenience sample of 75 participants (25-45 years old) in Ayacucho, Peru, the region most affected by the conflict. Data was examined using hierarchical regression analyses. RESULTS: Participants reported extreme exposure to violence (e.g., sexual violence, torture, combat, death of family members, and forced displacement) during the armed conflict, but surprisingly, only 5.3% reported a current level of symptoms that may indicate a possible post-traumatic stress disorder (PTSD). Resilience scores and number of years exposed to conflict as a child were not associated with PTSD symptoms; instead only the degree of exposure to violence, and current level of stress contributed to the variance of PTSD-related symptoms. Conversely, resilience and current stress contributed to the variance of trauma symptoms when measured by local idioms of distress. CONCLUSIONS: Findings should be interpreted with caution, due to limitations in the content validity of instruments, risk of inaccurate recall, use of individual explanations of distress (such as PTSD) for collective experiences of violence, use of non-indigenous frameworks to examine Indigenous resilience, and other methodological concerns. The study however highlights the high degree of traumatic exposure of these former war children. While the prevalence of potential PTSD was astonishingly low in this sample, a number of women still suffer from significant distress two decades after the traumatic events. Therefore, post-conflict interventions should renew efforts to foster the resilience of marginalized populations disproportionately targeted by violence and advocate for enhanced protection of women and children in current armed conflicts.