The Effects of a Brief Intervention to Identify and Address Gender-Based Violence Among Women Drug Users in Kyrgyzstan

Background and Purpose:  A recent national surveillance survey found extremely high rates of intimate partner violence (IPV) and gender-based violence (GBV) against women in Kyrgyzstan.  Although evidence suggests these rates are magnified among women drug users (WDU) in Kyrgyzstan, to date, there are no evidence-based screening and brief interventions that have been developed and tested to redress the widespread problem of IPV and GBV among WDU in Kyrgyzstan or other Central Asian countries.  This study aimed to adapt and test the feasibility, acceptability, and effectiveness of implementing a two-session evidence-based intervention in two harm reduction non-governmental organizations (NGOs) in Kyrgyzstan.

Methods: We screened 88 women recruited by two NGOs in Osh and Bishkek, Kyrgyzstan of whom 73 met study criteria (reported using drugs or binge drinking in the past 90 days, reported having a male or female intimate partner in the past year, and over 18 years old), completed a computerized assisted baseline survey, and the 2-session facilitated intervention. The core components of this brief intervention included psycho-education on IPV/GBV, an IPV/GBV screening tool based on the revised conflict tactics scale (CTS2) as well as social support enhancement, IPV service linkage, safety planning, and goal setting. 66 women (90% retention rate) completed repeated measures at 3-month post-intervention. We conducted pre/post analyses on primary IPV/GBV CTS2 outcomes using the Paired-Sample Wilcoxon Signed Rank Test.

Results: The average age of the participants was 41 (SD=8.3). At baseline, 73% reported experiencing any physical or sexual IPV and 60% reported any physical or sexual GBV in the past year. Half of the participants (52%) reported severe physical IPV in the past year, 33% injurious abuse, 32% severe sexual IPV, and severe psychological abuse. Women also reported high rates of severe GBV by someone other than an intimate partner: 33% reported severe physical GBV, 22% injurious GBV, 30% severe sexual GBV, and 32% severe psychological GBV. The most frequently identified perpetrator of GBV was the police. Pre/post-test analyses of IPV/GBV in the 3-months prior to baseline to the 3-month follow-up revealed significant declines in the number of incidents of minor physical abuse by partners (IPV) and others (GBV) (p < 0.05), severe physical IPV and GBV (p < 0.05), severe psychological IPV (p < 0.001), and injurious GBV (p < 0.05). There were also declines in number of incidents of injurious IPV (p = 0.054) and severe sexual GBV (p = 0.056), but not significant at .05 alpha level. No significant changes were found for sexual IPV, psychological IPV or GBV or minor sexual GBV.

Conclusions and Implications: The high rates of participation, attendance, and retention and absence of reported adverse events suggest the feasibility, safety, and acceptability of implementing this brief intervention in low resource harm reduction settings in Kyrgyzstan. The significant reductions in the extremely high rates of GBV and IPV suggest the effectiveness of the intervention. The high rates of police violence underscore the need for structural interventions with the police to improve their accountability and responsiveness to IPV and GBV incidents.