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Gender and Health

Current Projects

Principle Investigator: Prof. Naeemah Abrahams (

Synopsis: The GHRU conducted the 3rd national femicide study as the murder of women and girls, in acts of femicide, remains the most extreme form of gender-based violence (GBV). With South Africa being known for having one of the highest rates of femicide in the world, hardly a day passes without another case highlighted in the media. The GHRU has been studying femicide in South Africa for more than 20 years, with previous research showing that in 1999 four women, and in 2009 three women were killed every day by their husband or boyfriend (intimate partner).  The 3rd national femicide study (using 2017 data) found a consistent decline in all forms of femicide seen across the 18 years.

Principle Investigator: Prof. Naeemah Abrahams (

Synopsis: We are currently undertaking the 4th national femicide study: We have employed the same methods used in the previous national female homicide studies (1999 and 2009 and 2017) to collect data for the 2020 COVID-19 year. It is crucial that research is done to begin to understand the extent and depth of the impact that the COVID-19 restrictions have had on GBV in South Africa.


PI Contacts:

Dr Pinky

Dr Carrie Brooke-Sumner:

Dr Mercilene Machisa:

Synopsis: This ongoing project research aims to contribute to evidence-based, combined interventions in South African higher education campuses that reduce mental ill-health and the experience of SV among (i) first-year female students who partner with men, and (ii) lesbian, bisexual or queer women (LBQ). The research  involves adaptation, preliminary testing, and evaluation of Ntombi Vimbela!  and an evidence-based mental health intervention . Ntombi Vimbela! (NV!) is a manualised intervention that combines elements of sexuality education, gender transformation, and risk reduction strategies and has shown promise in reducing sexual assault incidence among South African first- year female students.

PI: Prof. Yandisa Sikweyiya (E-mail:

Synopsis: This research project aims to contribute to evidence-based, combined interventions in South African higher education campuses that reduce mental ill-health and perpetration of sexual violence among male students who partner with women. The project will be conducted with enrolled male students at a South African university.

The Advancing Disability Inclusive Research in Africa Network (ADIRA) aims to increase innovative and high quality research in Africa, led by African researchers, to improve the lives of people with disabilities in Africa.

ALIGHT Botswana: Increasing participation of women and girls with disabilities in gender-based violence prevention programs in Botswana

Providing access to Comprehensive Sexuality Education and Sexual and Reproductive Health and Rights to Young People with Disabilities in Southern and Eastern Africa.

The Breaking the Silence (BtS) project has set out to generate more knowledge and data on the sexual and reproductive health and rights of persons with disabilities. It is based at the Gender and Health Research Unit (GHRU) of the SAMRC. This site provides links to key publications from the GHRU and BtS team, information on the BTS flagship project on Comprehensive Sexuality Education (BtS-CSE) and initiatives supported by the BtS team.


Principle Investigator:  Associate Professor. Yandisa Sikweyiya (E-mail:

Synopsis: The overall objective of this project is to increase the pool of under-represented South African scientists conducting rigorous, interdisciplinary health social science research focused on better engaging men in the HIV continuum of prevention, treatment and care. Research regarding men, masculinities and HIV is a critical element of improving the country’s response to HIV, as men have consistently poorer rates of engagement with HIV services and worse antiretroviral treatment outcomes. The project is designed to provide intensive support and mentoring to two early-career researchers from under-represented groups who will also serve as Co-Investigators on the application. To facilitate independence, these Co-Investigators will be responsible for leading, designing and implementing two mixed methods comparative case studies in Cape Town and Johannesburg exploring the factors affecting the delivery, uptake and impact of services for HIV-positive men in South Africa.

The Disability Data Initiative is a global disability rights monitoring initiative that includes a hub for Sub-Saharan Africa. The initiative screens and analyses regularly national censuses and surveys to monitor disability rights.

Investigator: Dr . Andy Gibbs (Email

Synopsis: This is a large repeat cross-sectional evaluation of the DREAMS (Determined, Resilient, Empowered, AIDS-Free, Mentored and Safe) initiative, led by EpiCentre, and supported by SAMRC. The overall objective is to evaluate whether the DREAMS initiative can reduce HIV-incidence by 40% over a two-year period, amongst young women and girls (12-24) in four health districts in KwaZulu-Natal, and Gauteng, South Africa. The unit is providing support around measuring intimate partner violence, and analysis of this, as part of a series of secondary objectives of the study. The first cross-sectional survey was completed in September 2018, and a second cross-sectional survey will begin in 2019.


Principle Investigator: Associate Professor. Yandisa Sikweyiya (E-mail:

Synopsis: Collective violence in the form of mass protest is an increasingly common occurrence during mass protests in post-apartheid South Africa. In recent times, one of the most extreme cases of such violence is that which broke out in 2012 during a mass protest among mineworkers in Marikana, North-West province. This was arguably the longest strike action in the mining sector since the advent democracy in 1994, lasting over 18 weeks. Men are often at the forefront of violent mass protests, and as they become increasingly common in South Africa, the applicability of the dominant theory (i.e. hegemonic masculinity) on men's use of violence comes into question. The aim of the study is to explore the socio-cultural issues that informed the constructions of masculinities during the Marikana mineworkers’ strike of 2012. Furthermore, the study will explore the versions of masculinities that were performed during the strike.


Principle Investigator: Dr Pinky Mahlangu

Synopsis: This ongoing research aims to generate knowledge about the impact and links of COVID-19 and lockdown to experiences of violence against women and children in the homes in South Africa. The findings of the study will address the question about the impact of pandemics on GBV experiences, in particular, whether violence against women and children is intensified during lockdown, how and why? Furthermore, the study will extend knowledge on how being on the frontline during pandemics like COVID-19 impacts on the lives of frontline health care workers.


  1. Mahlangu P, Sikweyiya Y, Gibbs A, Shai N, Machisa M. "I Carry the Trauma and Can Vividly Remember": Mental Health Impacts of the COVID-19 Pandemic on Frontline Health Care Workers in South Africa. International Journal of Environmental Research and Public Health. 2023 Jan 29;20(3):2365.
    DOI: 10.3390/ijerph20032365
  2. Mahlangu P, Gibbs A, Shai N, Machisa M, Nunze N, Sikweyiya Y. Impact of COVID-19 lockdown and link to women and children’s experiences of violence in the home in South Africa. BMC Public Health. 2022 May 21;22(1):1029.
    DOI: 10.1186/s12889-022-13422-3

Principle Investigator: Dr. Leane Ramsoomar-Hariparsaad

Co-I’s: Prof Rachel K Jewkes

Prof Naeemah Abrahams

Dr Nwabisa Shai

Dr Samantha Willan

Synopsis: South Africa has extremely high levels of Gender-Based Violence (GBV) and population prevalence rates of rape and intimate partner femicide (IPF) among the highest in the world. Research on IPF (defined as the murder of a woman by a current or ex-husband or boyfriend, rejected would-be lover, or same-sex partner) conducted over the last two decades by the SAMRC’s Gender & Health Research Unit showed that South Africa has an Intimate Femicide (IF) rate six times higher than the global rate, and 48% of all women killed are murdered by intimate partners. We are uncertain, from interviews with Investigating Officers, how many women who are killed had POs, and whether they were adhered to by the women themselves, as many return to, or keep contact with violent partners for multiple reasons, including related to children. It seems likely that many had POs as they often had histories of severe IPV prior to the IPF. We aim to understand the circumstances that lead to women seeking Protection Orders (POs) for intimate partner violence (IPV), their experiences in so doing, and more about the perceived impact of IPV and seeking a PO on their livelihoods, housing, mental health and children in the immediate aftermath of seeking the PO. This qualitative study will collect data from women through individual in-depth interviews (IDIs) at two time points and a narrative group interview. The study will provide insights into women’s experiences of seeking a PO, the context of their application and the aftermath for their lives, and provide much needed evidence to inform a new strategy on IPF prevention.


Dr. Mercilene Machisa (E-mail:
Dr. Pinky Mahlangu (Email:
Associate Professor. Yandisa Sikweyiya (E-mail:

Synopsis: Comprehensive literature reviews conducted by the HEAIDS Task Team that is developing the national policy framework to prevent and respond to sexual assault and gender-based violence (SGBV) in the higher education sector found that there is a lack of rigorously tested and evaluated campus-based interventions in South Africa. In particular, evidence-informed, campus-based interventions that combine sexuality, gender transformation and self-defense components currently do not exist in South Africa. Therefore, research is needed to understand the prevalence and context in which SGBV occurs on South African Higher Education Institutions (HEIs) and to inform the development of primary prevention interventions which address its underlying drivers among young women.  To fill this critical gap in knowledge and practice, we are conducting formative research and intervention development in South African TVET colleges and universities. The project is expected to contribute to the national policy framework through providing evidence to inform SGBV programming. Moreover, the study will produce a rigorously tested intervention that can be brought to scale for the higher education sector.

For more information contact
Dr Mercilene Machisa ( and Dr Pinky Mahlangu (


  • Machisa MT, Chirwa ED, Mahlangu P, Sikweyiya Y, Nunze N, Dartnall E, Pillay M, Jewkes R. Factors associated with female students’ past year experience of sexual violence in South African public higher education settings: A cross-sectional study. PLoS One. 2021 Dec 02;16(12):e0260886.
    DOI: 10.1371/journal.pone.0260886
  • Machisa MT, Chirwa ED, Mahlangu P, Nunze N, Sikweyiya Y, Dartnall E, Pillay M, Jewkes R. Suicidal Thoughts, Depression, Post-Traumatic Stress, and Harmful Alcohol Use Associated with Intimate Partner Violence and Rape Exposures among Female Students in South Africa. International Journal of Environmental Research and Public Health. 2022 Jun 28;19(13):7913.
    DOI: 10.3390/ijerph19137913
  • Mahlangu P, Machisa MT, Sikweyiya Y, Nunze N, Pillay M, Dartnall L, Jewkes R. Preliminary evidence of promise of a sexual violence risk reduction intervention for female students in South African tertiary education institutions. Global Public Health. 2022 Nov 30;17(11):2720-2736. Epub 2021 Nov 13.
    DOI: 10.1080/17441692.2021.1998574



Principle Investigator: Associate Professor. Yandisa Sikweyiya (E-mail:

Synopsis: This study aims to evaluate knowledge, attitudes and practices on HIV and TB among farm workers in Limpopo, following the introduction of the PHAMSA interventions around HIV at the workplace. The objectives of this study are to 1) To determine the HIV and TB knowledge, attitudes, behaviour and practices in people working in the farms at Mopani and Vhembe districts, Limpopo, 2) To measure the changes in knowledge, attitudes and practices towards HIV and TB by comparing current results with the baseline study, 3) To determine access and challenges on access to health services amongst farmworkers, 4) to establish the current prevalence of HIV in the farming community, 4) To explore gender dimensions and challenges related to gender based violence amongst farm workers, including Men who have Sex with Men (MSM) and Lesbian, Gay, Bisexual and Transgender (LGBT) communities.


  1. Mlangeni N, Malotle M, Made F, Ramodike J, Sikweyiya Y, Du Preez C, Thompson NS, Sebe N, Zungu M. Factors Associated with TB Screening Among Farmworkers in Limpopo, South Africa. Global Health Action. 2023 Dec 31;16(1):2162227. Epub 2023 Jan 20.
    DOI: 10.1080/16549716.2022.2162227



Developing a gender-enhanced PrEP information-motivation workshop for young South African women 

The Masibambane - Ladies Chat PrEP project aims to develop and pilot an intervention workshop to increase PrEP uptake among young women who are at risk of HIV infection using a peer-driven recruitment and gender-enhanced approaches.  

Read more about the Masibambane - Ladies Chat (PrEP Project) study


Principle Investigator: Dr Samantha Willan

Synopsis: To explore women’s experiences and conceptualization of shame, self-blame and self-stigma post rape, and understand the impact of these on their mental health and well-being and their risk of contracting HIV post-rape to understand the implications for improving post-rape care services and interventions and to inform measurement. In 2022 sixteen female rape survivors, between 18-40 years, from the original RICE cohort participated in our study, they were each involved in 2-3 interviews, which were a combination of in-depth interviews and Life History interviews. Results are currently being written up.


Investigator: Dr. Andy Gibbs (Email

Synopsis: The objective of this study is to assess whether point of care testing for STIs can improve treatment outcomes, and included expedited partner therapy. The study was an open cohort pilot study and followed women up over 12 weeks. Overall, rates of STI clearance were very high, and feasibility and acceptability of point of care STI testing and treatment was high. The majority of women who tested positive for an STI, were provided with treatment for their partner, and a small number of women refused expedited treatment. There was a trend whereby those who were provided with treatment for their partner had a higher rate of STI clearance, compared to those who refused expedited treatment (p<0.1). No social harms were reported, and women were happy about the expedited partner therapy.

Citation: Garrett , N. J., Osman, F., Maharaj, B., Naicker, N., Gibbs, A., Norman, E., ... & Karim, S. S. A. (2018). Beyond syndromic management: Opportunities for diagnosis-based treatment of sexually transmitted infections in low-and middle-income countries. PloS one, 13(4), e0196209.


Field Testing a Quality Assurance Tool for Assessing the Quality of Post Gender-Based Violence Care Services in Clinical Settings in South Africa

This study focuses on adapting and developing a Quality Assurance Tool for Post-GBV services that is also inclusive of person with different ages, gender, sexual orientation and ability/disability.

Principle Investigator: Prof. Naeemah Abrahams (


South Africa is a country known for high levels of HIV infection and sexual violence. The Rape Impact Cohort Evaluation (RICE) study overall aim was to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a three-year post-rape period, through comparison with a cohort of women who have not been raped.

The study was based in Durban KZN and we started enrolment in 2015 and the last follow-up interview was in March 2020. Using a longitudinal study design, we enrolled 852 women who reported a rape to services and 853 women who have not experienced a rape from health services. Women were then followed-up for a period of between 12- 36 months (depending on the enrolment date). Outcome measures included exposure to risk factors, mental health status, cardio-metabolic risks, biomarkers for HIV, STIs, pregnancy and stress. The primary analysis was to compare HIV incidence in the two groups

This study provided ground-breaking empirical evidence on the role of rape in HIV acquisition and showed that women who were raped were 60% more likely to seroconvert over the follow-up period compared to women who were not raped. A key finding from the study is that the risk for HIV was not in the immediate period but in the long-term with the incidence rate differences most notable from 6 months post rape. This finding underscores the importance of regarding medium to long term mental health care as an essential part of post-rape care. We continue to analyse this rich data set over the next few years focusing on the multiple psychosocial and health outcomes. Additionally, we have now begun qualitative research to assist us in interpreting these results.


  1. Nguyen KA, Kengne AP, Abrahams N, Jewkes J, Mhlongo S, Peer N. Associations of childhood maltreatment with hypertension in South African women: a cross-sectional study. BMJ Open. 2022 Sep 19;(9):e057436.
    DOI: 10.1136/bmjopen-2021-057436
  2. Vuong E, Peer N, Chirwa E, Mhlongo S, Lombard C, Hemmings S, Kengne AP, Abrahams N, Seedat S. Prospective association of circulating adipokines with cardiometabolic risk profile among women: the Rape Impact Cohort Evaluation study. Women’s Health Reports. 2022 Oct 07; 3(1):820-833
    DOI: 10.1089/whr.2022.0069
  3. Vuong E, Hemmings SM, Mhlongo S, Chirwa E, Lombard C, Peer N, Abrahams N, Seedat S. Adiponectin gene polymorphisms and posttraumatic stress disorder symptoms among female rape survivors: an exploratory study. European Journal of  Psychotraumatology. 2022 Aug 15:13(2):2107820.
    DOI: 10.1080/20008066.2022.2107820
  4. Vuong E, Mhlongo S, Chirwa E, Lombard C, Peer N, Hemmings S, Abrahams N, Seedat S. Serum adiponectin-levels are predictive of probable posttraumatic stress disorder in women. Neurobiology of Stress. 2022 Aug 08;20:100477.
    DOI: 10.1016/j.ynstr.2022.100477
  5. Nöthling J, Abrahams N, Jewkes R, Mhlongo S, Lombard C, Hemmings SMJ, Seedat S. Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape. Journal of Affective Disorders. 2022 Jul 15;309:151-164. Epub 2022 Apr 13.
    DOI: 10.1016/j.jad.2022.04.032
  6. Nguyen KA, Abrahams N, Jewkes R, Mhlongo S, Seedat S, Myers B, Lombard C, Garcia-Moreno C, Chirwa E, Kengne AP, Peer N. The Associations of Intimate Partner Violence and Non-Partner Sexual Violence with Hypertension in South African Women. International Journal of Environmental Research and Public Health. 2022 Mar 29;19(7):4026.
    DOI: 10.3390/ijerph19074026
  7. Nöthling J, Abrahams N, Toikumo S, Suderman M, Mhlongo S, Lombard C, Seedat S,  Hemmings SMJ. Genome-wide differentially methylated genes associated with posttraumatic stress disorder and longitudinal change in methylation in rape survivors. Translational Psychiatry. 2021 Nov 19;11(1):594.
    DOI: 10.1038/s41398-021-01608-z
  8. Jewkes R, Mhlongo S, Chirwa E, Seedat S, Myers B, Peer N, Garcia-Moreno C, Dunkle K, Abrahams N. Pathways to and factors associated with rape stigma experienced by rape survivors in South Africa: Analysis of baseline data from a rape cohort. Clinical Psychology & Psychotherapy. 2022 Jan 31;29(1):328-338. Epub 2021 Jul 14.
    DOI: 10.1002/cpp.2637
  9. Abrahams N, Mhlongo S, Dunkle K, Chirwa E, Lombard C, Seedat S, Kengne AP, Myers B, Peer N, Garcia-Moreno C, Jewkes J. Increase in HIV incidence in women exposed to rape. AIDS. 2021 Mar 15;35(4):633-642.
    DOI: 10.1097/QAD.0000000000002779
  10. Abrahams N, Mhlongo S, Chirwa E, Lombard C, Dunkle K, Seedat S, Kengne AP, Myers B,  Peer N, García-Moreno CM, Jewkes J. Rape survivors in South Africa: analysis of the baseline socio-demographic and health characteristics of a rape cohort. Global Health Action. 2020 Dec 31;13(1):1834769.
    DOI: 10.1080/16549716.2020.1834769
  11. Peer N, Abrahams N, Kengne AP. A Systematic Review of the Associations of Adult Sexual Abuse in Women with Cardiovascular Diseases and Selected Risk Factors. Global Heart. 2020 Sep 24;15(1):65.
    DOI: 10.5334/gh.760
  12. Vuong E, , Lombard C, Jewkes R, Peer N, Abrahams N, Seedat S. Peripheral adiponectin levels in anxiety, mood, trauma- and stressor-related disorders: A systematic review and meta-analysis. Journal of Affective Disorders. 2020 Jan 01;:372-409. Epub 2019 Sep 11.
    DOI: 10.1016/j.jad.2019.09.050
  13. Nöthling J, Malan-Müller S, Abrahams N, Hemmings SMJ, Seedat S. Epigenetic alterations associated with childhood trauma and adult mental health outcomes: A systematic review. The World Journal of Biological Psychiatry. 2020 Sep 30;21(7):493-512. Epub 2019 Apr 02.
    DOI: 10.1080/15622975.2019.1583369
  14. Abrahams N, Seedat S, Lombard C, Kengne AP, Myers B, Sewnath A, Mhlongo S, Ramjee G,  Peer N, Garcia-Moreno C, Jewkes R. Study protocol for a longitudinal study evaluating the impact of rape on women’s health and their use of health services in South Africa. BMJ Open. 2017 Sep 29;7(9):e017296.
    DOI: 10.1136/bmjopen-2017-017296

Research Brief

For more information contact Dr Mercilene Machisa ( and Professor Rachel Jewkes (

Sexual and Reproductive Health and Rights and Young Women in all their Diversities under the COVID-19 Epidemic in South Africa (COVID and SRHR project) -  Young women in KwaZulu-Natal are extremely vulnerable to adverse sexual and reproductive health and rights (SRHR) outcomes and need to access SRHR services and commodities. Young women with disabilities are even more vulnerable to adverse SRHR outcomes than their peers and lack access to SRHR services and commodities. The recent worldwide coronavirus pandemic and accompanying countrywide lockdown are likely to affect the lives of young women with disabilities. Their access to SRHR is likely to be further reduced due to additional barriers to accessing SRHR services and commodities, and they may face increased risks of abuse/violence.

Investigator: Dr . Andy Gibbs (Email

Synopsis: The study is assess whether point of care viral load testing can improve adherence and retention in care through a small pilot randomized control trial. As part of this work there is ongoing qualitative research to understand this process, and the experience of care from patients and staff.


Principle Investigator: Dr Nwabisa Shai

Synopsis: The impact of Covid-19 lockdown on the help-seeking behaviour of survivors of violence and on service provision responding to violence against women in South Africa: A qualitative study to explore to understand the extent to which women survivors of violence were able to seek help during the national COVID-19 lockdown stages from 26 March 2020 to 31 July 2021, and how the provision of health and psychosocial services for Violence Against Women (VAW) were impacted. The study will recruit women who experienced violence and may or may not have sought help, and service providers and key informants working in non-governmental organisations or government departments offering Violence Against Women (VAW) health and/or psychosocial services. The study findings are envisaged to inform policy and practice related to VAW services in the province and widely.