Violência intrafamiliar e comunitária contra mulheres: o impacto da pandemia de Covid-19

Abstract

The objective of this study was to determine the epidemiological profile and spatial distribution of intrafamilial and community physical violence against women across different periods of the COVID-19 pandemic, based on records of victims treated at the Núcleo de Medicina e Odontologia Legal (NUMOL) of the Instituto de Polícia Científica (IPC) in João Pessoa, Paraíba, Brazil. To this end, a cross-sectional ecological study was conducted, analyzing cases of physical violence against women attended at NUMOL in João Pessoa during different pandemic periods, alongside population data from the Brazilian Institute of Geography and Statistics (IBGE) regarding the socioeconomic, housing, and residential characteristics of the neighborhoods where the victims lived. Pearson’s chi-square tests and logistic regression with Odds Ratios (OR) were used to assess factors associated with the occurrence of facial trauma in female victims of violence, considering sociodemographic, contextual, and temporal variables. For the spatial analysis of maxillofacial trauma cases, Geographic Information Systems (GIS) were employed to map residential addresses and identify critical occurrence areas (hotspots). Digital cartographic data (shapefiles) and territorial divisions were obtained from the IBGE. Initially, descriptive analyses of the variables were conducted, followed by spatial autocorrelation using the Global Moran’s I to detect significant spatial structure. Three spatial analysis techniques were applied: (I) LISA Maps to identify high- and low-incidence clusters; (II) BoxMap, classifying neighborhoods into high-high, low-low, high-low, and low-high quadrants to represent spatial concentration and dispersion; and (III) spatial regression (Spatial Lag Model – SLM) to estimate the influence of socio-spatial vulnerability factors. Analyses were performed in R (v.4.3.2) using specialized packages, with statistical significance set at p ≤ 0.05. The study identified that the pandemic altered the profile of violence against women, with an increase in aggressions perpetrated by men, particularly partners and ex-partners, predominantly on weekends and at night. Facial trauma was present in 51.7% of cases, primarily affecting soft tissues, with higher risk among young and adult women, occurring at night, in domestic settings, involving partners, ex-partners, or acquaintances, and involving either single or multiple instruments. Spatial analysis revealed persistent concentrations of maxillofacial trauma cases in socioeconomically vulnerable areas of João Pessoa, mainly in the southern, southwestern, and southeastern zones, with expansion to the eastern zone during the critical phase of the pandemic. LISA and BoxMap analyses identified high-high and low-low clusters, indicating the persistence and spatial diffusion of violence over time. Regression models confirmed a significant association between socioeconomic indicators and case incidence (p < 0.001). In conclusion, the study identified a consistent pattern of physical violence against women across the four pandemic periods, demonstrating that the aggressor’s sex and the mechanism of aggression directly influence the occurrence of cases. Maxillofacial trauma resulting from physical violence was significantly associated with areas of higher socio-spatial vulnerability, showed relatively stable spatial patterns, and intensified during periods of crisis, highlighting the urgent need for continuous, intersectoral, and territorially targeted public policies for the prevention and management of violence against women.