{"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":"impact-de-lipv-sur-lobservance-de-lart","status":"publish","type":"post","link":"https:\/\/mihealtheurope.org\/fr\/impact-of-ipv-on-art-adherence\/","title":{"rendered":"Violence entre partenaires intimes, adh\u00e9sion \u00e0 la th\u00e9rapie antir\u00e9trovirale et sant\u00e9 des femmes"},"content":{"rendered":"

Au d\u00e9but de cette ann\u00e9e, mes coll\u00e8gues et moi-m\u00eame avons publi\u00e9 un article sur la mani\u00e8re dont la violence exerc\u00e9e par le partenaire intime (IPV) affecte n\u00e9gativement la capacit\u00e9 \u00e0 maintenir des taux \u00e9lev\u00e9s d'adh\u00e9sion \u00e0 la th\u00e9rapie antir\u00e9trovirale (ART). Pour cette \u00e9tude, 410 femmes s\u00e9ropositives qui suivaient un traitement antir\u00e9troviral depuis au moins six mois ont \u00e9t\u00e9 s\u00e9lectionn\u00e9es dans 12 h\u00f4pitaux publics du Kenya. Apr\u00e8s leur examen de routine, on a demand\u00e9 aux femmes qui ont accept\u00e9 de participer \u00e0 l'\u00e9tude si leur partenaire actuel les avait d\u00e9j\u00e0 maltrait\u00e9es physiquement, sexuellement ou \u00e9motionnellement (selon le module sur la violence domestique de l'enqu\u00eate d\u00e9mographique sur la sant\u00e9). On leur a \u00e9galement demand\u00e9 si leur partenaire avait d\u00e9j\u00e0 fait preuve d'un comportement contr\u00f4lant, par exemple en limitant ses contacts avec ses amis et sa famille.<\/p>\n\n\n\n

La violence conjugale est depuis longtemps identifi\u00e9e et prouv\u00e9e comme un facteur de risque d'infection par le VIH chez les femmes. En effet, les femmes qui en sont victimes sont plus susceptibles d'\u00eatre expos\u00e9es \u00e0 des comportements sexuels \u00e0 risque, \u00e0 des actes sexuels violents, \u00e0 des rapports sexuels forc\u00e9s et \u00e0 la violence sexuelle.<\/p>\n\n\n\n

sont rarement en mesure de n\u00e9gocier l'utilisation de pr\u00e9servatifs. Ils ont \u00e9galement rarement acc\u00e8s aux services de sant\u00e9. La litt\u00e9rature r\u00e9cente sugg\u00e8re \u00e9galement que dans les pays o\u00f9 la pr\u00e9valence du VIH est \u00e9lev\u00e9e, les hommes violents sont plus susceptibles d'\u00eatre s\u00e9ropositifs, ce qui accro\u00eet le risque pour les femmes. Il n'est donc malheureusement pas surprenant de constater que 76% des femmes interrog\u00e9es ont subi une forme ou une autre de VPI de la part de leur partenaire actuel. Ce taux de pr\u00e9valence est sup\u00e9rieur \u00e0 la moyenne nationale du Kenya, qui est de 46%.<\/p>\n\n\n\n

Par rapport \u00e0 leur taux d'adh\u00e9sion au traitement antir\u00e9troviral au cours des 30 derniers jours, les femmes qui avaient subi des violences physiques ou sexuelles ou qui avaient \u00e9t\u00e9 victimes d'un comportement contr\u00f4lant \u00e9taient plus susceptibles de d\u00e9clarer avoir pris entre 0 et 94% de leurs doses d'ARV. Celles qui n'avaient jamais subi de VPI d\u00e9claraient le plus souvent prendre 100% de leurs doses d'ARV.<\/p>\n\n\n\n

Les prestataires de soins de sant\u00e9 qui ont interrog\u00e9 les femmes ont fourni quelques explications \u00e0 ce sujet. Les prestataires de soins de sant\u00e9 qui ont interrog\u00e9 les femmes ont fourni quelques explications \u00e0 ce sujet. L'une d'entre elles est que lors d'affrontements violents, certaines femmes sont poursuivies ou forc\u00e9es de fuir leur domicile et ne peuvent donc pas emporter leurs m\u00e9dicaments avec elles. En outre, leur nouveau refuge peut les emp\u00eacher de respecter leur calendrier de prise de m\u00e9dicaments ou leurs rendez-vous \u00e0 la clinique en raison de la distance ou de la peur de divulguer leur \u00e9tat. Notre raisonnement, qui est \u00e9galement \u00e0 la base de notre hypoth\u00e8se de recherche, est que le fait de vivre dans un environnement o\u00f9 il y a de la violence conjugale (qu'elle soit pass\u00e9e ou en cours) affecte la capacit\u00e9 d'une femme \u00e0 suivre un traitement. La recherche a<\/p>\n\n\n\n

Il a d\u00e9j\u00e0 \u00e9t\u00e9 d\u00e9montr\u00e9 que le fait de vivre dans un tel environnement peut entra\u00eener une d\u00e9tresse psychologique, une d\u00e9pression et une mauvaise sant\u00e9 mentale, qui sont \u00e9galement des facteurs pr\u00e9dictifs d'une moins bonne observance du traitement antir\u00e9troviral. En outre, notre \u00e9tude a r\u00e9v\u00e9l\u00e9 que le comportement de contr\u00f4le, qui est souvent simplement consid\u00e9r\u00e9 comme un comportement de surprotection ou de jalousie, peut \u00eatre psychologiquement plus pr\u00e9judiciable qu'on ne l'avait estim\u00e9.<\/p>\n\n\n\n

L'une des raisons pour lesquelles cette \u00e9tude a \u00e9t\u00e9 men\u00e9e \u00e9tait de contribuer \u00e0 l'augmentation des preuves scientifiques des effets n\u00e9fastes de l'alcool sur la sant\u00e9.<\/p>\n\n\n\n

ffets de la VPI sur la sant\u00e9 des femmes. Plus pr\u00e9cis\u00e9ment, la VPI ne devrait pas \u00eatre consid\u00e9r\u00e9e uniquement comme une question sociale ou juridique, mais plut\u00f4t comme un probl\u00e8me de sant\u00e9 publique, m\u00eame lorsqu'elle ne se termine pas par un f\u00e9micide. Des \u00e9tudes men\u00e9es par le Organisation mondiale de la sant\u00e9 (OMS)<\/a> ont \u00e9tabli que les formes de VPI sont des causes sous-jacentes de blessures physiques (morbidit\u00e9), de mauvaise sant\u00e9 mentale conduisant \u00e0 la d\u00e9tresse \u00e9motionnelle et au suicide, de probl\u00e8mes de sant\u00e9 chroniques (syndrome douloureux, maux de t\u00eate s\u00e9v\u00e8res, maladies coronariennes, ulc\u00e8res d'estomac) et de mortalit\u00e9 chez les femmes dans le monde entier. Une analyse que j'ai effectu\u00e9e pour l'UNFPA Swaziland il y a quelques ann\u00e9es a r\u00e9v\u00e9l\u00e9 un taux de VPI significativement plus \u00e9lev\u00e9 chez les femmes ayant des grossesses non d\u00e9sir\u00e9es, les femmes ayant d\u00e9j\u00e0 subi un avortement ou une fausse couche, et les femmes enceintes qui fr\u00e9quentaient moins souvent les cliniques de soins pr\u00e9natals.<\/p>\n\n\n\n

En ce qui concerne la migration, la VPI n'est pas n\u00e9cessairement beaucoup plus \u00e9lev\u00e9e dans les groupes de migrants que dans la population autochtone en g\u00e9n\u00e9ral. La VPI se produit dans tous les domaines sociaux, \u00e9conomiques, raciaux, culturels et religieux. Toutefois, le processus de migration ou le statut migratoire peut aggraver la vuln\u00e9rabilit\u00e9 et les exp\u00e9riences de VPI chez les femmes. Cela se produit \u00e0 diff\u00e9rents niveaux. Tout d'abord, d'un point de vue pratique, les femmes migrantes victimes de VPI peuvent ne pas avoir acc\u00e8s \u00e0 des ressources utiles parce qu'elles n'en connaissent pas l'existence ou ne savent pas comment y acc\u00e9der. M\u00eame lorsqu'elles en ont connaissance, elles peuvent ne pas avoir les moyens financiers ou les comp\u00e9tences linguistiques n\u00e9cessaires pour entrer en contact avec les prestataires de services ou \u00eatre confront\u00e9es \u00e0 la discrimination.<\/p>\n\n\n\n

D'un point de vue social, les femmes migrantes peuvent manquer du soutien social qui les aide \u00e0 surmonter une relation abusive parce qu'elles ont quitt\u00e9 leurs amis et leur famille dans leur pays d'origine. Cet isolement social donne \u00e0 leur partenaire violent encore plus de pouvoir pour les contr\u00f4ler, surtout si la femme n'a pas de contact avec la population d'accueil par le biais du travail, de l'\u00e9ducation, etc.<\/p>\n\n\n\n

Les relations sociales que les migrants forment g\u00e9n\u00e9ralement dans les pays \u00e9trangers peuvent contribuer \u00e0 att\u00e9nuer cet isolement et peuvent \u00e9galement servir de source de soutien et d'information sur les droits et les ressources. Toutefois, en fonction des normes sociales et culturelles de la communaut\u00e9, certaines femmes peuvent craindre de quitter leur relation abusive parce qu'elles ne veulent pas \u00eatre ostracis\u00e9es et perdre le seul lien social qu'elles ont dans le pays d'accueil.<\/p>\n\n\n\n

D'un point de vue juridique, pour de nombreuses femmes migrantes, leur statut juridique est li\u00e9 \u00e0 celui de leur partenaire, par exemple, aux lois sur le regroupement familial. La plupart des<\/p>\n\n\n\n

Les lois sur l'immigration exigent que le couple reste ensemble pendant une certaine p\u00e9riode pour que le partenariat soit l\u00e9galement reconnu et avant qu'une s\u00e9paration ou un divorce puisse \u00eatre demand\u00e9. Par cons\u00e9quent, les femmes endurent les abus en silence parce qu'elles ont peur de compromettre la proc\u00e9dure. Pour les<\/p>\n\n\n\n

pour ceux dont les partenaires sont des citoyens ou des r\u00e9sidents l\u00e9gaux, cette d\u00e9pendance peut \u00eatre utilis\u00e9e pour les faire chanter et les obliger \u00e0 rester dans la relation abusive.<\/p>\n\n\n\n

N\u00e9anmoins, il existe de bons exemples qui montrent qu'avec les interventions et le soutien appropri\u00e9s, tant au niveau gouvernemental qu'au niveau des programmes locaux dans les pays d'accueil, les femmes migrantes victimes de VPI peuvent se soustraire, elles et leurs enfants, \u00e0 des situations abusives et donc dangereuses. C'est le cas des r\u00e9fugi\u00e9s syriens en Allemagne et en Su\u00e8de qui ont utilis\u00e9 les lois des pays d'accueil pour se s\u00e9parer de leurs partenaires violents et construire une vie ind\u00e9pendante pour eux-m\u00eames et leurs enfants.<\/p>\n\n\n\n

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

En savoir plus<\/summary>\n

Pour des conseils en mati\u00e8re de sant\u00e9 et des mesures pr\u00e9ventives dans les situations de crise, consultez notre article sur les\u00a0Journ\u00e9e mondiale du sida : Voici comment r\u00e9duire le risque de contracter le VIH (guide de l'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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