Burden of and risk factors for sexual violence among women with and without disabilities in two sub-Saharan African countries

ABSTRACT

Background

Available data suggest that women with disabilities have an increased risk of sexual violence, but little is known about the situation of those women living in resource-limited settings.

Objectives

To assess the burden and examine the drivers of sexual violence among women with disabilities.

Methods

This is a pooled analysis of two population-based surveys conducted in Cameroon and Burundi. Adults with and without disabilities were randomly recruited from the general population. Structured interviews were conducted at both sites to collect data on participants’ functional limitations, life-course history of sexual violence, education, employment, and resources. Only women with disabilities whose impairments started before the age of 10 years (n = 359) and women without disabilities (n = 720) are included in this analysis. The age-adjusted prevalence of violence was computed, and risk factors were assessed using a discrete survival regression and mediation analysis.

Results

At both sites, the participants with disabilities had a lower education level and had an increased risk of food insecurity. The pooled age-adjusted prevalence of lifetime sexual violence was 19.8% (95%CI:15.3–24.3) among women with disabilities and 11.7% (95%CI:9.3–14.1) among those without disabilities (OR_ap: 2.0, 95%CI:1.4–2.8). Women with cognitive limitations and those with visual impairments had the highest risk of sexual violence (OR_ap: 3.5 (95%CI:2.0–6.3) and 2.7 (95%CI:1.4–5.0), respectively). Over the life course, the risk of sexual violence was especially high among women with disabilities who had lived with an intimate partner before the age of 25 years (p < 0.001). Education level mediated approximately one-third of the total association between disability and sexual violence (p = 0.001). There was no evidence of an indirect effect through food insecurity.

Conclusion

This study provides evidence of the high burden of sexual violence among women with disabilities who live in urban African contexts. The social environment and access to education may be key contributors to this vulnerability.

KEYWORDS:

• Disability
• gender-based violence
• Cameroon
• Burundi
• social epidemiology

Responsible Editor Jennifer Stewart Williams

Responsible Editor Jennifer Stewart Williams

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/16549716.2022.2077904.

Acknowledgments

We wish to thank the teams in Cameroon and Burundi involved in the field work for their commitment and the study participants for providing their time and sharing their story to enable this research. We also acknowledge that this paper was edited by American Journal Experts.

Author contributions

Pierre DeBeaudrap: Conceptualization, Methodology, Formal analysis, Writing - Original Draft. Charles Mouté: Data curation, Software, Writing - Reviewing and Editing. Estelle Pasquier: Supervision, Project administration, Writing - Reviewing and Editing. Alice Tchoumkeu: Investigation, Supervision, Writing - Reviewing and Editing. Carole Dongmo Temgoua: Investigation, Writing - Reviewing and Editing. Aida Zerbo: Project administration, Writing - Reviewing and Editing. Muriel Mac-Seing: Conceptualization, Writing - Reviewing and Editing. Gervais Beninguisse: Supervision, Project administration, Writing - Reviewing and Editing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics and consent

The HandiVIH study was approved by the ‘Comité d’Ethique pour la Recherche en Santé Humaine’ in Cameroon (2014/03/431/L/CNERSH/SP), and the HandiSSR study was approved by the ‘Comité National d’Ethique pour la Protection des Êtres Humains participants à la Recherche Biomédicale et Comportementale’ in Burundi (visa n°214/CAB/SN/243/2017). Both studies were also approved by the ‘Comité Consultatif de Déontologie et d’Ethique’ of the Institut de Recherche pour le Développement (IRD).

Paper context

Available data from high-income countries indicates that women with disabilities have an increased risk of sexual violence, but little is known about the situation of those living in resource-limited countries. In this study, women with disabilities in Burundi and Cameroon were twice as likely to report sexual violence compared to women without a disability. Those with cognitive and/or visual limitation were the most vulnerable. Disability mainstreaming in prevention programmes that focus on violence against women is a priority for policy and action.

Additional information

Funding

This work was supported by the Agence National de Recherche sur le Sida et les hépatites under [Grant ANRS 12302] and by the Netherlands Organisation for Scientific Research under [Grant W08.560.00].