The health effects associated with physical, sexual and psychological gender-based violence against men and women: a Burden of Proof study
Stein C., Flor LS., Gil GF., Khalil M., Herbert M., Aravkin AY., Arrieta A., Baeza de Robba MJ., Bustreo F., Cagney J., Calderon-Anyosa RJC., Carr S., Chandan JK., Chandan JS., Coll CVN., de Andrade FMD., de Andrade GN., Debure AN., DeGraw E., Hammond B., Hay SI., Knaul FM., Lim RQH., McLaughlin SA., Metheny N., Minhas S., Mohr JK., Mullany EC., Murray CJL., O’Connell EM., Patwardhan V., Reinach S., Scott D., Spencer CN., Sorensen RJD., Stöckl H., Twalibu A., Valikhanova A., Vasconcelos N., Zheng P., Gakidou E.
The health impacts of exposure to physical, sexual or psychological gender-based violence (GBV) against men and women are substantial yet not well delineated. We systematically reviewed and meta-analysed 40 studies to evaluate the associations between GBV (including but not limited to intimate partner violence) and eight health outcomes: sexually transmitted infections excluding HIV, maternal abortion and miscarriage, HIV/AIDS, major depressive disorder, anxiety disorders, drug use disorders, alcohol use disorders and self-harm. Using the Burden of Proof methods, we generated conservative metrics of association—including star ratings from one to five—reflecting both effect size and evidence strength. Sexual violence was associated with six outcomes, with moderate, three-star evidence of association for sexually transmitted infections, maternal abortion and miscarriage, and major depressive disorder—increasing the risk by at least 104%, 101% and 50%, respectively. Seven outcomes were associated with physical GBV with two- or one-star associations, reflecting weak associations and/or inconsistent evidence. Of the four health outcomes analysed in relation to psychological GBV, one, major depressive disorder, had a significant association with a one-star rating. These findings emphasize the serious health consequences of GBV for survivors and the necessity of additional data to further our understanding of this complex public health issue.