Using Cultural Ceremonies to Reduce Intimate Partner Violence and HIV Transmission

Overview

Violence against women (VAW), the most extreme manifestation of the unequal power balance between women and men, is a major global public health concern. One of the most common forms of VAW is that perpetrated by a husband or other intimate partner. In Ethiopia, 70.9% of women reported having experienced physical and/or sexual intimate partner violence (IPV) in their lifetime, demonstrating the pervasiveness of the problem. A growing body of evidence has also linked IPV and HIV risk. This study is a cluster randomized controlled trial assessing the impact of a community-based intervention focused on Intimate Partner Violence and HIV delivered in the context of the Ethiopian coffee ceremony, a culturally established forum for community discussion and conflict resolution. Villages will be randomly assigned to one of 4 study arms (3 intervention and one control arm): 1) Women only participate in the intervention, 2) Men only participate, 3) Both men and women (couples) participate, 4) Women and men receive the control intervention comprising a short informational session on violence reduction.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: None (Open Label)
  • Study Primary Completion Date: April 2018

Interventions

  • Behavioral: Intervention to reduce IPV and HIV
    • The Ethiopian traditional coffee ceremony will be used as an entry point for a community based intervention to provide information, change behaviour around IPV and improve gender equity and intra-couple relations. The coffee ceremony is a culturally established forum for community discussion and conflict resolution and an integral part of Ethiopian life. The intervention will involve regular coffee ceremonies, during which approximately 20 members of the community will participate in education and discussions centred on gender issues, sexuality, communication and conflict resolution, HIV/AIDS and its link with violence, as well as HIV/AIDS prevention. Each coffee ceremony will be moderated by a female or male facilitator trained in participatory learning, moderation, HIV/AIDS prevention, counselling, and gender issues. The intervention will involve 14 two-hour session per group of participants.

Arms, Groups and Cohorts

  • Experimental: Women Only
    • Groups of women will receive the behavioral intervention to reduce IPV and HIV. Sessions will be led by female facilitators.
  • Experimental: Men Only
    • Groups of men will receive the behavioral intervention to reduce IPV and HIV. Sessions will be led by male facilitators.
  • Experimental: Couples
    • Couples will receive the behavioural intervention to reduce IPV and HIV. Sessions will be led by a male and a female facilitator.
  • No Intervention: Control Group
    • Community members in the control villages will receive a short informational session on violence reduction.

Clinical Trial Outcome Measures

Primary Measures

  • Experience of physical violence by an intimate partner in the previous 12 months (among married or co-habitating women)
    • Time Frame: 12 months
  • Experience of sexual violence by an intimate partner in the previous 12 months (among married or co-habitating women)
    • Time Frame: 12 months

Secondary Measures

  • Perpetration of physical violence towards an intimate partner in previous 12 months (among married or co-habitating men)
    • Time Frame: 12 months
  • Perpetration of sexual violence towards an intimate partner in previous 12 months (among married or co-habitating men)
    • Time Frame: 12 months
  • Proportion with comprehensive HIV/AIDS knowledge (among married or co-habitating men or women)
    • Time Frame: 18 months
  • Proportion using a condom at last high risk sexual intercourse (among married or co-habitating men or women)
    • Time Frame: 18 months

Participating in This Clinical Trial

Inclusion Criteria

  • currently married or cohabitating with partner – residing in selected village for at least 6 months Exclusion Criteria:

  • eligible women who do not consent

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 49 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Abdul Latif Jameel Poverty Action Lab
  • Collaborator
    • Ethiopian Public Health Association
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Vandana Sharma, MD, MPH, Principal Investigator, Massachusetts Institute of Technology
    • Jessica Leight, PhD, Principal Investigator, Williams College
    • Negussie Deyessa, PhD, Principal Investigator, Addis Ababa University

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