Gender-Based Violence and Adolescent Sexual Health in Low- and Middle-Income Countries: A Systematic Review of Reviews Público

Abstract

Background. Gender-based violence (GBV) is a public health and human rights problem across the world, with known consequences for sexual and reproductive health (SRH). A recent review published in the Journal of Sex Research highlighted the lack of sexuality studies focused on the Global South, especially about topics related to intimate partner relationships and sexual violence (Dworkin et al., 2016). Yet there is evidence that physical and sexual intimate partner violence (IPV) and forced sexual debut are prevalent among adolescent girls and young women in low- to middle-income countries (LMICs).

Method. To fill a gap in the literature, this systematic review of reviews synthesized research on the relationship between GBV and SRH among adolescent girls and young women ages 10-24 in LMICs. Five forms of GBV were of interest: child abuse/maltreatment, female genital mutilation/cutting (FGMC), child marriage, IPV, and sexual violence. A search of PubMed, PsycINFO, and Scopus was supplemented with expert consultations, a reference list review, and a grey literature search of key websites.

Results. Results yielded 29 systematic reviews. Data were extracted from a random sample (n = 17) of the 83 unique studies included in the medium and high quality reviews based on AMSTAR criteria (Shea et al., 2007). Studies in the sample were primarily from Africa and tended to examine child abuse/maltreatment, FGMC, and IPV. Results demonstrated a consistent link between GBV exposures and SRH outcomes, such as abortion, sexual dysfunction, decreased sexual pleasure, sexually transmitted infections, and HIV. Findings were less consistent for gynecological and menstrual problems, pregnancy outcomes, sexual behaviors, and sexual empowerment.

Conclusions. This review suggests that GBV must be addressed globally through more longitudinal studies to promote SRH for adolescent girls and young women. Positive aspects of sexuality must be included in research and educational materials in order to combat GBV and improve SRH for all adolescent girls and young women.

Keywords: adolescent girls, gender-based violence, low- middle-income countries, sexual health, reproductive health

Table of Contents

INTRODUCTION........................................................................................................................... 1

METHOD...................................................................................................................................... 10

Study Eligibility Criteria................................................................................................... 10

Procedure........................................................................................................................... 12

RESULTS...................................................................................................................................... 15

Quality Assessment Results.............................................................................................. 15

Characteristics of Included Reviews................................................................................. 16

Characteristics of Extracted Studies.................................................................................. 17

Results from Extracted Studies......................................................................................... 21

DISCUSSION................................................................................................................................ 26

Limitations......................................................................................................................... 28

CONCLUSION............................................................................................................................. 29

REFERENCES.............................................................................................................................. 32

TABLES........................................................................................................................................ 49

Table 1. Eligibility Criteria for the Inclusion or Exclusion of Reviews............................ 49

Table 2. Search Strings and Search Results for PubMed, PsycINFO, and Scopus........... 51

Table 3. Quality Assessment for Included Systematic Reviews....................................... 61

Table 4. Characteristics of the Included Systematic Reviews........................................... 63

Table 5. Characteristics of Empirical Studies................................................................... 65

Table 6. Extracted Results from 19 Unique Analyses Published in 17 Studies................ 72

FIGURES...................................................................................................................................... 76

Figure 1. Flow Chart Showing the Search, Screening, and Selection Process................. 76

APPENDICES............................................................................................................................... 77

Appendix 1. Grey Literature Search Websites.................................................................. 77

Appendix 2. Eligible Studies from Data Extraction Not Yet Extracted............................ 78

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palabra Clave	gender-based violence adolescent girls low- and middle-income countries reproductive health sexual health
Committee Chair / Thesis Advisor	Yount, Kathryn, Emory University
Committee Members	Roof, Katherine, Emory University Grose, Rose, Emory University Rochat, Roger, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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