Health care services for survivors of gender-based violence: a community and clinic-based intervention in Zambézia province, Mozambique

AIDS Care. 2023 Jan;35(1):16-24. doi: 10.1080/09540121.2022.2067313. Epub 2022 May 16.

Abstract

Mozambique introduced guidelines for integrated gender-based violence (GBV) services in 2012. In 2017, we trained providers on empathetic and supportive services to GBV survivors and introduced home-based services for survivors who are loss-to-follow up. Rate ratios of clinic visits were compared before and after intervention initiation, using exact significance tests. Data of 1,806 GBV survivors were reviewed, with a total of 2005 events. The median age was 23 years (IQR 17-30) and 89% were women. Among those reporting violence, 69% reported physical violence, 18% reported sexual violence (SV), and 12% reported psychological violence. Rates of care-seeking behavior were higher in the intervention period (rate ratio 1.31 [95%CI: 1.18-1.46]); p < 0.01. Among those eligible for post-exposure prophylaxis (PEP), 94% initiated PEP. Uptake of HIV retesting improved in percentage points by 34% (14% to 48%), 34% (8% to 42%) and 26% (5% to 31%) at 1-, 3- and 6-months, respectively. The intervention led to an increase in the rate of GBV survivors seeking health care services, and improved rates of follow-up care among SV survivors initiating PEP. Strengthening of PEP adherence counseling remains crucial for improving GBV services.

Keywords: Gender-based violence (GBV); Mozambique; access; adherence; post-exposure prophylaxis (PEP).

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Counseling
  • Female
  • Gender-Based Violence* / prevention & control
  • Gender-Based Violence* / psychology
  • HIV Infections* / prevention & control
  • HIV Infections* / psychology
  • Health Services Accessibility
  • Humans
  • Male
  • Mozambique
  • Survivors / psychology
  • Young Adult