Using Cultural Ceremonies to Reduce Intimate Partner Violence and HIV Transmission

Study Overview
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Brief Summary
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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.

Official Title
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Using Cultural Ceremonies to Reduce Intimate Partner Violence and HIV Transmission

Conditions
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HIV

Intervention / Treatment
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* Behavioral: Intervention to reduce IPV and HIV


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 49 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Women Only<br>Groups of women will receive the behavioral intervention to reduce IPV and HIV. Sessions will be led by female facilitators. | Behavioral: Intervention to reduce IPV and HIV<br>* 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.<br>|
| Experimental: Men Only<br>Groups of men will receive the behavioral intervention to reduce IPV and HIV. Sessions will be led by male facilitators. | Behavioral: Intervention to reduce IPV and HIV<br>* 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.<br>|
| Experimental: Couples<br>Couples will receive the behavioural intervention to reduce IPV and HIV. Sessions will be led by a male and a female facilitator. | Behavioral: Intervention to reduce IPV and HIV<br>* 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.<br>|
| No Intervention: Control Group<br>Community members in the control villages will receive a short informational session on violence reduction. | |

What is the study measuring?
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Primary Outcome Measures

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

Secondary Outcome Measures

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

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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HIV, Gender, Physical Violence, Sexual Violence, AIDS, Prevention, Community Intervention, Ethiopia, Intimate Partner Violence