The impact of COVID-19 Pandemic on Domestic Gender Based Violence Against Female HIV and Tuberculosis Patients in Timor-Leste: A Qualitative Study

BackgroundGlobally, there is still widespread of violence against women and girls. Timor Leste reports high prevalence of gender-based violence with 30% women have experienced intimate partner (IPV) or non-partner sexual violence. Several studies reported about the increase of domestic violence gender-based violence (D-GBV) against girls and women worldwide during the COVID-19 pandemic lockdowns. To our knowledge, there are limited numbers of research examining the occurrence of D-GBV against girls and women living with HIV/AIDS and TB during the pandemic in developing countries. This study is commissioned to understand whether women living with these two diseases experienced D-GBV during the lockdowns in Timor Leste. Material and MethodsThis is a qualitative phenomenology study utilizing purposive sampling technic to identify and enroll participants. The study was conducted in eight municipalities from early October 2022 to end of February 2023. It considered eight independent variables - physical violence, verbal violence, phycological violence, sexual violence, sexual harassment, social-economic violence, IPV, stigma and discrimination - to identify the occurrence of D-GBV. The study included 42 in-depth interviews (IDIs) with 19 HIV participants and 23 TB participants, and three focus group discussions (FGDs). Data analysis was performed with NVIVO version 12.1 pro by identifying codes, themes, and categories. ResultThe D-GBV were widely reported from all municipalities. Psychological, socio-economic, verbal, and physical violence were mostly reported from participants. The COVID-19 pandemic exacerbated D-GBV, and impeded participants to apply coping mechanisms in dealing with the violence. Stigma and discrimination were prevalent in all study municipalities. The main causes of the violence were economic factors, jealousy and denial, tradition/cultural issues, and failure to perform household work. The participants reported using various coping mechanisms to deal with D-GBV, including (1) seeking external support or avoidance and (2) staying and facing the perpetrator at home. The study identified a triple vulnerability for female HIV and TB patients from experiencing various forms of D-GBV during the period of lockdown. Discussion and ConclusionWhile this study focused on females living with HIV/AIDS and TB only, its findings have amplified the qualitative information on the magnitude of D-GBV in Timor-Leste. The findings from this study suggest the need to pay more attention to women living with HIV and TB in order to help them to not only survive the disease(s) but also to protect them from domestic and gender-based violence. The triple vulnerabilities identified in this study reveal the weaknesses of system to combat D-GBV, stigma and discrimination against female TB and HIV patients in Timor Leste. It is recommended to train clinician working in the area of infectious diseases and reproductive health on D-GBV subject.