{"id":947,"date":"2021-11-22T11:59:00","date_gmt":"2021-11-22T11:59:00","guid":{"rendered":"https:\/\/mihealth.418staging.co.uk\/?p=947"},"modified":"2024-06-13T15:48:57","modified_gmt":"2024-06-13T14:48:57","slug":"impacto-de-la-ipv-en-la-adherencia-al-arte","status":"publish","type":"post","link":"https:\/\/mihealtheurope.org\/es\/impact-of-ipv-on-art-adherence\/","title":{"rendered":"Violencia de pareja, cumplimiento de la terapia antirretrov\u00edrica y salud de la mujer"},"content":{"rendered":"

A principios de este a\u00f1o, mis colegas y yo publicamos un art\u00edculo sobre c\u00f3mo la violencia de pareja afecta negativamente a la capacidad de mantener altas tasas de adherencia a la terapia antirretrov\u00edrica. Para este estudio, se tomaron 410 muestras de mujeres seropositivas que hab\u00edan estado en tratamiento antirretroviral durante al menos seis meses en 12 hospitales p\u00fablicos de Kenia. Tras su chequeo rutinario, se pregunt\u00f3 a las mujeres que aceptaron participar en el estudio si su pareja actual hab\u00eda abusado alguna vez de ellas f\u00edsica, sexual o emocionalmente (seg\u00fan la definici\u00f3n del m\u00f3dulo sobre violencia dom\u00e9stica de la Encuesta Demogr\u00e1fica y de Salud). Tambi\u00e9n se les pregunt\u00f3 si sus parejas hab\u00edan mostrado alguna vez un comportamiento controlador, como limitar su contacto con amigos y familiares.<\/p>\n\n\n\n

Hace tiempo que se ha identificado y demostrado que la violencia de g\u00e9nero es un factor de riesgo de infecci\u00f3n por VIH entre las mujeres. Esto se debe a que las mujeres que la sufren tienen m\u00e1s probabilidades de verse expuestas a comportamientos sexuales de riesgo, actos sexuales violentos, relaciones sexuales forzadas a<\/p>\n\n\n\n

Rara vez est\u00e1n en condiciones de negociar el uso del preservativo. Tampoco suelen tener acceso a los servicios sanitarios. La literatura reciente tambi\u00e9n sugiere que en pa\u00edses con una alta prevalencia del VIH, los hombres violentos tienen m\u00e1s probabilidades de ser seropositivos, lo que aumenta el riesgo para las mujeres. Por lo tanto, desgraciadamente, no fue sorprendente descubrir que 76% de las mujeres entrevistadas hab\u00edan sufrido alg\u00fan tipo de IPV por parte de su pareja actual. Esta tasa de prevalencia es superior a la media nacional de Kenia, 46%.<\/p>\n\n\n\n

En comparaci\u00f3n con su tasa de adherencia al tratamiento antirretroviral en los \u00faltimos 30 d\u00edas, las mujeres que hab\u00edan sufrido VPI f\u00edsica, VPI sexual o conductas de control eran m\u00e1s propensas a informar de que tomaban entre 0 y 94% de sus dosis de antirretrovirales. Las que nunca hab\u00edan sufrido violencia de g\u00e9nero declararon en su mayor\u00eda una adherencia de 100%.<\/p>\n\n\n\n

tasas. Los profesionales sanitarios que entrevistaron a las mujeres ofrecieron algunas explicaciones al respecto. Una de ellas es que, durante los encuentros violentos, algunas mujeres son perseguidas u obligadas a huir de sus casas y, por tanto, no pueden llevar consigo la medicaci\u00f3n. Adem\u00e1s, que su nuevo refugio puede dificultarles mantener su horario de medicaci\u00f3n o sus citas en la cl\u00ednica debido a la distancia o al miedo a la divulgaci\u00f3n. Nuestro razonamiento, que tambi\u00e9n fue la base de nuestra hip\u00f3tesis de investigaci\u00f3n, es que vivir en un entorno en el que se produce IPV (ya sea en el pasado o en la actualidad) afecta a la capacidad de una mujer para cumplir el tratamiento. La investigaci\u00f3n tiene un<\/p>\n\n\n\n

Ya se ha demostrado que vivir en un entorno de este tipo puede provocar malestar psicol\u00f3gico, depresi\u00f3n y mala salud mental, que tambi\u00e9n son factores predictivos de una menor adherencia al tratamiento antirretroviral. Adem\u00e1s, nuestro estudio revel\u00f3 que el comportamiento controlador, que a menudo se descarta simplemente como comportamiento sobreprotector o celoso, puede ser psicol\u00f3gicamente m\u00e1s perjudicial de lo que se estimaba anteriormente.<\/p>\n\n\n\n

Uno de los motivos de la realizaci\u00f3n de este estudio era contribuir a la creciente evidencia cient\u00edfica de los efectos adversos de la gripe aviar.<\/p>\n\n\n\n

fectos de la VPI en la salud de las mujeres. En concreto, que la VPI no debe considerarse \u00fanicamente una cuesti\u00f3n social o jur\u00eddica, sino un problema de salud p\u00fablica, incluso cuando no acaba en feminicidio. Los estudios de la Organizaci\u00f3n Mundial de la Salud (OMS)<\/a> han establecido formas de VPI como causas subyacentes de lesiones f\u00edsicas (morbilidad), mala salud mental que conduce a la angustia emocional y al suicidio, problemas cr\u00f3nicos de salud (s\u00edndrome de dolor, fuertes dolores de cabeza, cardiopat\u00edas coronarias, \u00falceras de est\u00f3mago) y mortalidad entre las mujeres a nivel mundial. Un an\u00e1lisis que realic\u00e9 para UNFPA Suazilandia hace unos a\u00f1os revel\u00f3 una tasa significativamente m\u00e1s alta de IPV entre las mujeres con embarazos no deseados, las mujeres que hab\u00edan tenido alguna vez un aborto o un aborto espont\u00e1neo y las mujeres embarazadas que acud\u00edan con menos frecuencia a las cl\u00ednicas de atenci\u00f3n prenatal.<\/p>\n\n\n\n

En lo que respecta a la migraci\u00f3n, la IPV no es necesariamente significativamente mayor entre los grupos de migrantes en comparaci\u00f3n con la poblaci\u00f3n nativa en general. La VPI se produce en todos los \u00e1mbitos sociales, econ\u00f3micos, raciales, culturales y religiosos. Sin embargo, el proceso de migraci\u00f3n o el estatus migratorio pueden agravar la vulnerabilidad y las experiencias de VPI entre las mujeres. Esto ocurre a diferentes niveles. En primer lugar, desde un punto de vista pr\u00e1ctico, las mujeres migrantes que sufren IPV pueden carecer de acceso a recursos \u00fatiles porque pueden no saber de su existencia o c\u00f3mo llegar a ellos. Incluso cuando lo saben, pueden carecer de los medios econ\u00f3micos o de los conocimientos ling\u00fc\u00edsticos necesarios para ponerse en contacto con los proveedores de servicios o pueden sufrir discriminaci\u00f3n.<\/p>\n\n\n\n

Desde un punto de vista social, las mujeres inmigrantes pueden carecer del apoyo social que ayuda a superar una relaci\u00f3n de malos tratos porque han dejado a sus amigos y familias en sus pa\u00edses de origen. Este aislamiento social da a su pareja maltratadora a\u00fan m\u00e1s poder para controlarlas, especialmente si la mujer no tiene contacto con la poblaci\u00f3n de acogida a trav\u00e9s del trabajo, la educaci\u00f3n, etc. En este caso, las comunidades informales<\/p>\n\n\n\n

que los emigrantes suelen formar en tierras extranjeras puede ayudar a mitigar este aislamiento y actuar tambi\u00e9n como fuente de apoyo e informaci\u00f3n sobre derechos y recursos. Sin embargo, dependiendo de las normas sociales y culturales de la comunidad, algunas mujeres pueden temer abandonar su relaci\u00f3n abusiva porque no querr\u00edan ser condenadas al ostracismo y perder la \u00fanica conexi\u00f3n social que tienen en el pa\u00eds de acogida.<\/p>\n\n\n\n

Desde el punto de vista jur\u00eddico, para muchas mujeres inmigrantes su situaci\u00f3n legal est\u00e1 vinculada a la de sus parejas, por ejemplo, a las leyes de reagrupaci\u00f3n familiar. La mayor\u00eda<\/p>\n\n\n\n

Las leyes de inmigraci\u00f3n exigen que la pareja permanezca junta durante cierto tiempo para que la uni\u00f3n sea reconocida legalmente y antes de que pueda solicitarse la separaci\u00f3n o el divorcio. Por ello, las mujeres soportan los malos tratos en silencio porque temen poner en peligro el proceso. Para<\/p>\n\n\n\n

En el caso de las parejas que son ciudadanas o tienen residencia legal, esta dependencia puede utilizarse para chantajearlas con el fin de que permanezcan en la relaci\u00f3n abusiva.<\/p>\n\n\n\n

No obstante, hay buenos ejemplos que demuestran que, con las intervenciones y el apoyo adecuados, tanto a nivel gubernamental como de los programas locales de los pa\u00edses de acogida, las mujeres inmigrantes que sufren violencia de g\u00e9nero pueden alejarse ellas y sus hijos de situaciones abusivas y peligrosas. Un ejemplo son las refugiadas sirias en Alemania y Suecia, que se acogieron a las leyes de los pa\u00edses de acogida para separarse de sus parejas maltratadoras y construir vidas independientes para ellas y sus hijos.<\/p>\n\n\n\n

<\/p>\n\n\n\n

M\u00e1s informaci\u00f3n<\/summary>\n

Para obtener orientaci\u00f3n sanitaria y medidas preventivas en situaciones de crisis, consulte nuestro art\u00edculo sobre\u00a0D\u00eda Mundial del Sida: As\u00ed se reduce el riesgo de contraer el VIH (gu\u00eda de la OMS)<\/a>.<\/p>\n<\/details>","protected":false},"excerpt":{"rendered":"

Earlier this year, my colleagues and I published a paper on how experiencing intimate partner violence (IPV) negatively affects the ability to maintain high rates of antiretroviral therapy (ART) adherence. For this study, 410 HIV positive women who had been on ART for at least six months were sampled from 12 public hospitals in Kenya. […]<\/p>\n","protected":false},"author":1,"featured_media":948,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-947","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-community-blog"],"acf":[],"yoast_head":"\nImpact of IPV on ART Adherence: Insights & Challenges - Mi-Health Europe<\/title>\n<meta name=\"description\" content=\"Discover the Impact of IPV on ART Adherence & Women\u2019s Health. 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