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Research uptake is achieved when research findings are translated into meaningful change in capacity to understand development problems, policies and practice, and funding streams. While there is c...

ObjectivesTo describe associations between men’s poor mental health (depressive and post-traumatic stress symptomatology) and their perpetration of intimate partner violence (IPV) and non-partner sexual violence (NPSV), and women’s mental health and their experiences of IPV and NPSV in five settings in the Global South.DesignA pooled analysis of data from baseline interviews with men and women participating in five violence against women and girls prevention intervention evaluations.SettingThree sub-Saharan African countries (South Africa, Ghana and Rwanda), and one Middle Eastern country, the occupied Palestinian territories.Participants7021 men and 4525 women 18+ years old from a mix of self-selecting and randomly selected household surveys.Main outcome measuresAll studies measured depression symptomatology using the Centre for Epidemiological Studies-Depression, and the Harvard Trauma Scale for post-traumatic stress disorder (PTSD) symptoms among men and women. IPV and NPSV were measured using items from modified WHO women’s health and domestic violence and a UN multicountry study to assess perpetration among men, and experience among women.FindingsOverall men’s poor mental health was associated with increased odds of perpetrating physical IPV and NPSV. Specifically, men who had more depressive symptoms had increased odds of reporting IPV (adjusted OR (aOR)=2.13; 95%CI 1.58 to 2.87) and NPSV (aOR=1.62; 95% CI 0.97 to 2.71) perpetration compared with those with fewer symptoms. Men reporting PTSD had higher odds of reporting IPV (aOR=1.87; 95% CI 1.44 to 2.43) and NPSV (aOR=2.13; 95% CI 1.49 to 3.05) perpetration compared with those without PTSD. Women who had experienced IPV (aOR=2.53; 95% CI 2.18 to 2.94) and NPSV (aOR=2.65; 95% CI 2.02 to 3.46) had increased odds of experiencing depressive symptoms compared with those who had not.ConclusionsInterventions aimed at preventing IPV and NPSV perpetration and experience must account for the mental health of men as a risk factor, and women’s experience.

Alcohol and drug misuse (ADM) pose a significant disease burden globally. Yet, there remains a gap in understanding risk factors associated with women's ADM, particularly those in marginalised settings. We investigated risk factors associated with ADM amongst young women in urban informal settlements in South Africa. Bivariate and multivariable logistic regression analyses were conducted on a sample of 680 young women assessing associations between sociodemographic factors, mental health, relationship factors and past year ADM. Alcohol misuse was assessed using the 10 item Alcohol Use Disorders Identification Test (AUDIT) scale, with scores ≥8 defining misuse, a single item assessed past year illegal drug use. Alcohol and drug misuse were reported by 23.1% and 31.8% of the women respectively. In multivariable regression, alcohol misuse was associated with experiencing past year non-partner sexual violence, transactional sex with a main partner, past year drug use, and past week depressive symptoms, while drug misuse was associated with alcohol misuse, transactional sex with a casual partner, past year experience of physical and/or sexual IPV and having a functional limitation (disability). Results indicate ADM in informal settlements are shaped by violence and poor mental health. Interventions geared towards strengthening women's economic position and mental healthcare are recommended.

Alcohol, tobacco, and other drug (ATOD) use by adolescents are major contributors to death and disability in sub-Saharan Africa (SSA). This paper reviews the extent of adolescents' ATOD use, risk and protective factors, and studies evaluating prevention interventions for adolescents in SSA. It also describes the harms associated with adolescents' ATOD use in SSA, which mainly include interpersonal violence, sexual risk behaviours, and negative academic outcomes. We use the socio-ecological model as our framework for understanding ATOD use risk and protective factors at individual, interpersonal, peer/school, and societal/structural levels. We used two strategies to find literature evaluating ATOD interventions for adolescents in SSA: (a) we sought systematic reviews of adolescent ATOD interventions in SSA covering the period 2000-2020; and (b) we used a comprehensive evidence review strategy and searched for studies that had evaluated ATOD interventions in all SSA countries between 2000 and 2020. Only two community interventions (a brief intervention and an HIV prevention intervention), out of four that were identified, were partially effective in reducing adolescent ATOD. Furthermore, only one school-based intervention (HealthWise), out of six that we uncovered, had any effect on ATOD use among adolescents. Possible reasons why many interventions were not effective include methodological limitations, involvement of non-evidence-based education-only approaches in some studies, and shortcomings in adaptations of evidence-based interventions. The scale of ATOD and related problems is disproportionate to the number of evaluated interventions to address them in SSA. More ATOD interventions need to be developed and evaluated in well-powered and well-designed studies.

Background: Informal settlements have high rates of poor mental health, yet little research has looked at PTSD-depression co-occurrence in these settings. We investigated the prevalence of depression, PTSD, and comorbid PTSD-depression amongst a non-clinical sample of 18–30 year old women, in informal settlements in South Africa. Methods: Cross-sectional analysis of self-selecting young women, enrolled at baseline of an intervention trial. We assessed the occurrence of depression, PTSD and co-occurring PTSD and depression, and used multinomial and logistic regressions to assess risk factors for these. Results: Depression, PTSD and comorbid PTSD-depression were reported by 45.2%, 21.0% and 18.6% of the women respectively. Depression was associated with social group membership (ß -0.74, p = 0.022), food insecurity (ß. 0.97, p = 0.001), stress related to lack of work (ß 0.61, p = 0.022), childhood traumas (ß 0.07, p = 0.004), IPV (ß 0.58, p = 0.007), other lifetime traumas (ß 0.51, p = 0.021) and alcohol misuse (ß 0.04, p = 0.002). Comorbid PTSD-depression was associated with social group membership (ß -0.73, p = 0.008), lack of work stress (ß 1.13, p = 0.009), disability (ß 0.99, p = 0.002), childhood traumas (ß 0.19, p

ObjectivesTo test associations between men’s past year alcohol use and patterns of drinking, and their perpetration of intimate partner violence (IPV) and non-partner sexual violence (NPSV). To test the associations between women’s reports of partner alcohol use and their experience of IPV, in three countries in Africa.DesignPooled analysis of cross-sectional baseline data from men and women participating in four IPV prevention studies across Africa and Asia.SettingData from five data sets generated by four violence against women and girls prevention studies in three countries in sub-Saharan Africa, South Africa, Ghana and Rwanda.Participants8104 men 18+ years old and 5613 women 18+ years old from a mix of volunteer and randomly selected samples.Main outcome measuresStudies employed comparable measures of past year alcohol use, harmful alcohol use (Alcohol Use Disorder Identification Test scale) and items from modified WHO Women’s Health and Domestic Violence to measure physical IPV and NPSV perpetration among men and IPV experience among women.FindingsOverall harmful alcohol use among men was associated with a substantially increased odds of perpetrating physical IPV (adjusted OR (aOR)=3.45 (95% CI 2.56 to 4.64)) and NPSV (aOR=2.64 (95% CI 1.85 to 3.76)) compared with non-drinkers. Women who had seen their partner occasionally drunk (aOR=2.68 (95% CI 2.13 to 3.36)) or frequently drunk (aOR=5.94 (95% CI 4.19 to 8.41)) in the past 12 months had an increased odds of experiencing physical IPV.ConclusionsAlcohol use is associated with increased IPV and NPSV perpetration for men and (physical) IPV experience for women. Reported frequency of IPV and NPSV increase with increasing levels and frequency of alcohol use. Interventions aimed at reducing alcohol may also lead to reductions in IPV and NPSV perpetration and experience.

Violence against women and girls (VAWG) is a barrier to gender equality and women’s empowerment. For the first time, ending VAWG is a core part of the 2030 agenda for sustainable development under Goal 5. Two southern lead initiatives, What Works and SVRI, are supporting intervention development, adaptation and evaluation of VAWG prevention programmes in over 30 low and middle-income countries. This poster will present cutting edge results from the projects and share innovative approaches to capacity development of researchers and programme staff and effective research uptake. Key themes and findings on effectiveness of VAWG programmes will be shared, along with an overview of the most important drivers of VAWG and the latest evidence on what works to prevent it. Results from three case studies will be showcased on prevention of violence against children from a schools-based intervention in Pakistan, a multipronged intervention aimed at reducing violence against women and girls/youth (VAWG) in Zambia by addressing identified risk factors (e.g., childhood abuse, domestic violence, alcohol use) and a framework for addressing family based violence developed in Uganda. Through this poster SVRI and What Works will also share lessons learned across these programmes on capacity development and research uptake efforts to empower southern programmers and researchers to disseminate findings to demonstrate programmatic and policy impacts.

Background : Alcohol is a risk factor for the leading causes of mortality and morbidity among young people globally. Youth drinking, initiated in early adolescence and continued into early adulthood, is influenced by maternal socio-demographic factors and maternal education. Limited prospective data exists in South Africa on the prevalence of alcohol use during adolescence and adolescent and maternal socio-demographic correlates. Objective : To examine the prevalence of lifetime alcohol use during early (13 years) and late (18 years) adolescence in Soweto, South Africa, and its association with child and maternal socio-demographic factors. Methods : Data on alcohol use in early adolescence (age 13 years) and late adolescence (age 18 years) were collected using self-completed pen and paper and self-completed computer-based questionnaires, respectively. Univariate analyses were conducted on child (gender and number of school years repeated by grade 7), maternal socio-demographic correlates (education, marital status, and age), and household socioeconomic status (SES). Bivariate logistic regression analyses examined associations between alcohol use and all child and maternal socio-demographic factors. Multivariate logistic regression analyses were conducted on all the variables found to be significantly (p< 0.10) associated with alcohol use to examine the predictive value on alcohol use at early and late adolescence. Results : Lifetime alcohol use increased from 22% at early adolescence to 66% at late adolescence. In multivariate analyses, gender, maternal education, and SES predicted lifetime alcohol use at early adolescence, while gender, maternal education, marital status, and SES were predictive of the same at late adolescence. Conclusion : This study aids researchers and practitioners to identify maternal and child socio-demographic risk profiles for alcohol use to inform policies and programmes. Keywords : adolescent alcohol use; alcohol prevalence; maternal correlates; socio-economic status (Published: 24 January 2013) Citation: Glob Health Action 2013, 6 : 19274 - http://dx.doi.org/10.3402/gha.v6i0.19274

Excessive alcohol consumption constitutes a significant public health problem for South Africans. Alcohol use by South African (SA) adolescents is characterised mainly by binge/heavy episodic drinking. Levels of binge drinking have been high, but relatively stable, among males since 2002, while there has been a significant increase in binge drinking by females since then. Binge drinking is a major risk factor for a range of alcohol-related harms in SA, including traffic-related accidents and deaths, interpersonal violence, fetal alcohol spectrum disorder (FASD), crime, sexual risk behaviour, HIV, tuberculosis and the resultant burden of all of these on the economy. Clinicians may play a key role in addressing adolescent alcohol use and alcohol-related harm. Such a role may involve screening, brief interventions and referrals to treatment. There are several assessment, screening and diagnostic tools to detect alcohol use and misuse, specifically among adolescents. Furthermore, various pharmacological and psychological approaches are available to treat adolescent alcohol problems. Special issues to consider when dealing with alcohol use problems among adolescents in SA include recognising the risk factors, and acknowledging and addressing the harms associated with alcohol use (including sexual risk behaviour and FASD) and the possible existence of comorbid mental health problems.

Objectives. To understand alcohol use trends and alcohol-related harm among youth in South Africa (SA) between 1998 and 2008, and discuss implications for the current alcohol policy process.Methods. A review was conducted of 4 national prevalence and 2 sentinel surveillance studies. Data were extracted to Epi Info (version 7) and chi-square analyses undertaken.Results. Lifetime alcohol use remained stable but high at 20 - 25% and 49.1 - 49.6% according to South African Demographic and Health Survey (SADHS) and Youth Risk Behaviour Survey (YRBS) data, respectively. Age of initiation remained stable; 12% of adolescents initiated alcohol use prior to age 13 years. Significant gender differences existed with more males having ever consumed alcohol, engaged in binge drinking, and driven or walked under the influence of alcohol (DUI and WUI, respectively). Binge drinking among females increased significantly from 27% to 36% (SADHS) and 18% to 27% (YRBS). DUI and WUI increased. Homicide/violence, suicide and unintentional deaths were significantly associated with blood alcohol concentration (BAC).Conclusions. Although SA has made significant strides in alcohol control and prevention of alcohol-related harm over the past decade, early alcohol initiation remains a concern and binge drinking is increasing, especially among females. Significant associations exist between BAC and alcohol-related fatalities. Findings imply that regulatory policies are inadequate; additional efforts are required to ensure that control strategies translate into a reduction in harmful alcohol use by SA youth.S Afr Med J 2012;102(7):609-612