BMJ global health · 2025
The association between sexual violence and mental disorders among women victim-survivors in sub-Saharan Africa: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Woldie Sintayehu Abebe, Walker Genevieve, Bergman Sarah, Diemer Kristin, Block Karen, Armstrong Gregory, Kaba Mirgissa, Vaughan Cathy
Аннотация
BACKGROUND: Sexual violence is a serious public health and human rights problem with both short-term and long-term consequences. This review aims to systematically assess the link between sexual violence and poor mental health among sub-Saharan African women.
METHODS: Systematic review and meta-analyses of observational studies were performed. MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane, Global Health and the University of Melbourne library electronic databases were used to find relevant published literature over 12 years from 2012 to 2024 in sub-Saharan Africa with stringent eligibility criteria. Random effects meta-analyses were used to pool estimates of ORs and 95% CIs. The I2 statistic was used to assess heterogeneity.
RESULTS: This systematic review and meta-analysis of 76 observational studies included a total of 80 313 participants and found a consistent small-to-medium association between lifetime sexual violence and experiences of poor mental health. The pooled ORs suggest that women who were exposed to sexual violence were more than twice as likely to experience post-traumatic stress disorder (OR 2.75; 95% CI 1.96 to 3.86; I2=73.4%), depression (OR 2.38; 95% CI 2.04 to 2.77; I2=56.6%), anxiety (OR 2.81; 95% CI 1.67 to 4.72; I2=77.2%), common mental disorders (OR 2.12; 95% CI 1.70 to 2.64; I2=0.0%), suicidal behaviour (OR 2.44; 95% CI 1.92 to 3.10; I2=68.0%) and emotional distress (OR 3.14; 95% CI 1.73 to 5.69; I2=79.6%) compared with women who have not experienced sexual violence.
CONCLUSIONS: Exposure to lifetime sexual violence was consistently associated with small to medium effects on poor mental health among women in sub-Saharan Africa. Thus, policy-makers should develop response strategies as well as mental health screening tools for all violence response service delivery points. In addition, health practitioners must prioritise screening for mental health conditions in patients who present with a history of sexual violence.
METHODS: Systematic review and meta-analyses of observational studies were performed. MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane, Global Health and the University of Melbourne library electronic databases were used to find relevant published literature over 12 years from 2012 to 2024 in sub-Saharan Africa with stringent eligibility criteria. Random effects meta-analyses were used to pool estimates of ORs and 95% CIs. The I2 statistic was used to assess heterogeneity.
RESULTS: This systematic review and meta-analysis of 76 observational studies included a total of 80 313 participants and found a consistent small-to-medium association between lifetime sexual violence and experiences of poor mental health. The pooled ORs suggest that women who were exposed to sexual violence were more than twice as likely to experience post-traumatic stress disorder (OR 2.75; 95% CI 1.96 to 3.86; I2=73.4%), depression (OR 2.38; 95% CI 2.04 to 2.77; I2=56.6%), anxiety (OR 2.81; 95% CI 1.67 to 4.72; I2=77.2%), common mental disorders (OR 2.12; 95% CI 1.70 to 2.64; I2=0.0%), suicidal behaviour (OR 2.44; 95% CI 1.92 to 3.10; I2=68.0%) and emotional distress (OR 3.14; 95% CI 1.73 to 5.69; I2=79.6%) compared with women who have not experienced sexual violence.
CONCLUSIONS: Exposure to lifetime sexual violence was consistently associated with small to medium effects on poor mental health among women in sub-Saharan Africa. Thus, policy-makers should develop response strategies as well as mental health screening tools for all violence response service delivery points. In addition, health practitioners must prioritise screening for mental health conditions in patients who present with a history of sexual violence.