A Qualitative Assessment of Social Norms Related to Seeking Help for Intimate Partner Violence in Honduras.

Intimate partner violence (IPV) is a major public health issue in Honduras and other low- and middle-income countries, with few victims seeking help. While structural factors, such as lack of services and economic barriers, are often cited as reasons for not seeking help, social and cultural factors may also play a role. This study aims to describe the normative social environment that may hinder women's help-seeking behaviors for IPV. Thematic analysis was conducted on data from four focus group discussions with 30 women at a busy health center in urban Tegucigalpa, Honduras. Data were coded inductively and themes were identified deductively using the theory of normative social behavior and its components (descriptive and injunctive social norms, expected outcomes, and groups of reference). Four themes emerged: social norms and expected outcomes that discourage IPV help-seeking; factors that determine the direction of a social norm, either discouraging or encouraging help-seeking; groups of reference for IPV victims; and society sets women up for failure. Social norms, expected outcomes, and groups of reference hinder women's help-seeking behavior after IPV. These findings have significant implications for designing effective interventions and policies to support women and their families affected by IPV.

ZIKV-Related Ideations and Modern Contraceptive Use: Cross-Sectional Evidence from the Dominican Republic, El Salvador, Honduras, and Guatemala.

Zika virus (ZIKV) can be sexually transmitted and can lead to severe neonatal and child health issues. The current study examines whether ZIKV-related ideational factors, including awareness of ZIKV and associated birth defects, are related to modern contraceptive use among women and men with sexual partners in four Latin American and Caribbean (LAC) countries. Data used are from cross-sectional household surveys conducted in 2018 in the Dominican Republic, El Salvador, Guatemala, and Honduras with representative samples of men and women aged 18-49 (N = 1,100). The association between self-reported use of modern contraception and measures of Zika knowledge, risk perceptions and social norms, and contraceptive self-efficacy was examined via sex disaggregated multivariate logistic regression models. Both men (OR 3.70, 95% CI 1.36-10.06, P < 0.05) and women (OR 3.71, 95% CI 2.30-5.99, P < 0.0001), who reported discussing family planning with their partner in the last year were more likely to use modern contraception compared with those who did not. Contrary to our hypothesis, knowledge that ZIKV can affect a fetus was negatively associated with modern contraceptive use for women (OR 0.49, 95% CI 0.29-0.85, P < 0.05). Given the cross-sectional nature of the survey, women not using contraception may be more likely to remember that ZIKV can affect a fetus. In the event of a related outbreak, future health promotion and communication efforts in LAC should focus on known determinants of modern contraceptive use, such as knowledge and partner communication, and knowledge of the health effects of ZIKV if pregnant, to influence family planning decision-making behavior.

Use of effective lids reduces presence of mosquito larvae in household water storage containers in urban and peri-urban Zika risk areas of Guatemala, Honduras, and El Salvador.

BACKGROUND: In 2015, an outbreak of Zika virus spread across Latin America and the Caribbean (LAC). Public health programs promoted vector control behaviors, including covering water storage containers with lids. Such approaches disrupt Zika transmission by eliminating the habitats of the Aedes aegypti mosquito, which breeds in stagnant water. METHODS: A quantitative household survey and observation checklist with trained enumerators were undertaken between August and October 2018 in selected urban/peri-urban USAID implementation communities in El Salvador, Guatemala, and Honduras. The survey included questions regarding knowledge, attitudes, and practices related to Zika virus. An accompanying checklist was implemented to observe water storage containers, including for short-term and long-term water use. The characteristics of these containers were tabulated, including the presence of a lid. The lids were examined for key features to determine their potential effectiveness to prevent mosquito breeding: fully covering and sealing the container, not having holes, and not having water on them (potentially creating a secondary breeding site). Multivariate logistic regression was used to estimate the effectiveness of lid types and characteristics on the presence of larvae. RESULTS: Overall, in adjusted models, using an effective lid versus no lid was associated with a 94% decrease in odds of larval presence in long-term water storage containers (odds ratio = 0.06; 95% confidence interval [0.029, 0.152]); however, similar impacts were not observed for washbasins in the adjusted models. Models adjusted for household wealth, receiving a visit from a vector control technician, scrubbing the container in the last 7 days, and perception of more mosquitoes around. CONCLUSIONS: Effective lids, if made available and coupled with complementary behavioral messaging, may reduce transmission of Zika and other Aedes mosquito-borne diseases in the LAC region.

Intimate Partner Violence in Honduras: Ecological Correlates of Self-Reported Victimization and Fear of a Male Partner.

The experience of intimate partner violence (IPV) is influenced by individual, relationship, community, and societal-level factors, including the prevalence and acceptance of societal violence in which the victim lives. These factors transcend a woman's present circumstances and personal history and the gender and power relationships within her household. This is particularly relevant in Honduras, where a high level of IPV occurs within a traditionally patriarchal society and growing societal violence and crime. This study examines the factors-informed by a social ecological theoretical perspective-associated with the experience of IPV. We use data from the Honduras Demographic and Health Survey (ENDESA) 2011-2012 to estimate multilevel, multivariate models predicting the likelihood that a woman experiences emotional, physical, and/or sexual IPV and/or fear of her partner. Our models contain higher level contextual effects that capture regional variations in social violence and aggregated norms capturing acceptance of IPV. We find that a woman's likelihood of experiencing violence is related to individual, relationship, and household-level characteristics, including marital status, age at first cohabitation, employment status, violence within the parental home, women's accepting attitudes toward IPV, autonomy in decision-making, partner's use of alcohol, the nature of the relationship with her partner (i.e., living together or not), and educational and age differences with her partner. Notably, women living in more violent areas-measured by violence statistics and aggregate community-level norms regarding spouse beating-were more likely to experience IPV. These findings contribute to our understanding of the risk of IPV and to the evidence that can be used to identify the most vulnerable women and opportunities for intervention to prevent further victimization. By using an analytical methodology that reflects the complexity of factors that place women at risk for IPV, we can isolate, address, and advocate for changing circumstances that make Honduran women vulnerable to IPV.

Intimate partner violence and mental health in Bolivia.

BACKGROUND: Latin America has among the highest rates of intimate partner violence. While there is increasing evidence that intimate partner violence is associated with mental health problems, there is little such research for developing countries. The purpose of this paper is to examine the relationship between Bolivian women's experiences with physical, psychological, and sexual intimate partner violence and mental health outcomes. METHODS: This study analyzes data from the 2008 Bolivia Demographic and Health Survey. 10,119 married or cohabiting women ages 15-49 are included in the analysis. Probit regression models are used to assess the association between intimate partner violence and mental health, after controlling for other demographic factors and partner characteristics. The questionnaire uses selected questions from the SRQ-20 to measure symptoms of mental health problems. RESULTS: Intimate partner violence is common in Bolivia, with 47% of women experiencing some type of spousal abuse in the 12 months before the survey. Women exposed to physical spousal violence in the past year are more likely to experience symptoms of depression, anxiety, psychogenic non-epileptic seizures, and psychotic disorders, after controlling for other demographic and partner characteristics. Women who experienced sexual abuse by a partner are most likely to suffer from all mental health issues. Psychological abuse is also associated with an increased risk of experiencing symptoms of depression, anxiety, and psychogenic seizures. Women who experienced only psychological abuse report mental health problems similar to those who were physically abused. CONCLUSION: This study demonstrates an urgent need for research on the prevalence and health consequences of psychological abuse in developing countries. Our findings highlight the need for mental health services for victims of intimate partner violence. Because physical and psychological violence are often experienced concurrently, it is recommended that health providers who are treating victims of physical intimate partner violence also screen them for symptoms of potential mental health problems and refer them to appropriate mental health services.

Prevalence and correlates of physical, psychological, and sexual intimate partner violence in Bolivia.

Despite increasing awareness that domestic violence is a major public health problem, existing studies focus on physical and sexual violence and give little attention to psychological violence. This study uses data from the 2008 Bolivia Demographic and Health Surveys (BDHS) to examine the prevalence and correlates of physical, sexual, and psychological intimate partner violence in Bolivia. The results show that psychological intimate partner violence is extremely common (affecting nearly one in two women) and often occurs in addition to physical violence. While physical, psychological and sexual intimate partner violence have several common predictors, there are factors that only affect some types of violence. Common risk factors include urban residence, respondent's employment status and having witnessed interparental violence in childhood. Although marital status is not a risk factor for physical violence, unmarried cohabitation is a strong risk factor for psychological intimate partner violence. Our findings highlight the need for research to assess the potential consequences of psychological intimate partner violence, particularly for women's mental health.

Traditional and social media coverage and charitable giving following the 2010 earthquake in Haiti.

INTRODUCTION: Media reports on disasters may play a role in inspiring charitable giving to fund post-disaster recovery, but few analyses have attempted to explore the potential link between the intensity of media reporting and the amount of charitable donations made. The purposes of this study were to explore media coverage during the first four weeks of the 2010 earthquake in Haiti in order to assess changes in media-intensity, and to link this information to data on contributions for emergency assistance to determine the impact of media upon post-disaster charitable giving. METHODS: Data on newspaper and newswire coverage of the 2010 earthquake in Haiti were gathered from the NexisLexis database, and traffic on Twitter and select Facebook sites was gathered from social media analyzers. The aggregated measure of charitable giving was gathered from the Center for Philanthropy at Indiana University. The intensity of media reporting was compared with charitable giving over time for the first month following the event, using regression modeling. RESULTS: Post-disaster coverage in traditional media and Twitter was characterized by a rapid rise in the first few days following the event, followed by a gradual but consistent decline over the next four weeks. Select Facebook sites provided more sustained coverage. Both traditional and new media coverage were positively correlated with donations: every 10% increase in Twitter messages relative to the peak percentage was associated with an additional US $236,540 in contributions, while each additional ABC News story was associated with an additional US $963,800 in contributions. CONCLUSIONS: While traditional and new media coverage wanes quickly after disaster-causing events, new and social media platforms may allow stories, and potentially charitable giving, to thrive for longer periods of time.

Power, control, and intimate partner sexual violence in Haiti.

This study sought to determine how power and control in intimate relationships influenced women's exposure to sexual violence. Multilevel modeling was used to determine the risk of partner sexual violence in the past 12 months among 2240 women aged 15-49 years who were currently married or cohabiting. The data were drawn from the 2000 Haiti Demographic and Health Survey. Strong positive effects on intimate partner sexual violence were found for husband's jealousy and perpetration of controlling behavior and women's endorsement of traditional norms concerning a husband's rights to beat his wife. Female dominance in decision making about purchases for daily household needs was positively associated with intimate partner sexual violence but its effects were mediated by relationship quality. The effect of wife's education on intimate partner violence was nonlinear. The analysis also showed that high community female headship rates were independently associated with higher risks of partner sexual violence. The findings highlight the importance of adopting a multidimensional approach to the measurement of power in sexual relationships and the need for programs to work at multiple levels to address gender-based norms and the structural factors that put women at increased risk of sexual violence.