Association of Sexual Violence and Human Rights Violations With Physical and Mental Health in Territories of the Eastern Democratic Republic of the Congo

TLDR

An anecdotal record indicates that sexual violence is a persistent problem in the Eastern Region of the Democratic Republic of the Congo. This study aims to quantify the prevalence of sexual violence and human rights abuses and examine their associations with basic needs, health‑care access, and physical and mental health among residents of specific Eastern DRC territories. Using a cross‑sectional, cluster survey of 998 adults aged 18 or older, structured interviews and questionnaires collected data on sexual violence, human rights violations, symptoms of major depressive disorder and post‑traumatic stress disorder, and health‑care needs. The survey found that 39.7% of women and 23.6% of men reported sexual violence, 67% of households reported human rights abuses, and 41% of adults met criteria for major depressive disorder while 50.1% met criteria for PTSD, underscoring the high prevalence and health impact of these violations.

Abstract

<h3>Context</h3>Studies from the Eastern Region of the Democratic Republic of the Congo (DRC) have provided anecdotal reports of sexual violence. This study offers a population-based assessment of the prevalence of sexual violence and human rights abuses in specific territories within Eastern DRC.<h3>Objective</h3>To assess the prevalence of and correlations with sexual violence and human rights violations on residents of specific territories of Eastern DRC including information on basic needs, health care access, and physical and mental health.<h3>Design, Setting, and Participants</h3>A cross-sectional, population-based, cluster survey of 998 adults aged 18 years or older using structured interviews and questionnaires, conducted over a 4-week period in March 2010.<h3>Main Outcome Measures</h3>Sexual violence prevalence and characteristics, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), human rights abuses, and physical and mental health needs among Congolese adults in specific territories of Eastern DRC.<h3>Results</h3>Of the 1005 households surveyed 998 households participated, yielding a response rate of 98.9%. Rates of reported sexual violence were 39.7% (95% confidence interval [CI], 32.2%-47.2%; n = 224/586) among women and 23.6% (95% CI, 17.3%-29.9%; n = 107/399) among men. Women reported to have perpetrated conflict-related sexual violence in 41.1% (95% CI, 25.6%-56.6%; n = 54/148) of female cases and 10.0% (95% CI, 1.5%-18.4%; n = 8/66) of male cases. Sixty-seven percent (95% CI, 59.0%-74.5%; n = 615/998) of households reported incidents of conflict-related human rights abuses. Forty-one percent (95% CI, 35.3%-45.8%; n = 374/991) of the represented adult population met symptom criteria for MDD and 50.1% (95% CI, 43.8%-56.3%; n = 470/989) for PTSD.<h3>Conclusion</h3>Self-reported sexual violence and other human rights violations were prevalent in specific territories of Eastern DRC and were associated with physical and mental health outcomes.