Domestic violence against women seeking induced abortion in China

A cross-sectional study was conducted to investigate the prevalence, type and severity of domestic violence (DV), and determine the factors related to DV among women seeking induced abortion in China. A total of 1215 women seeking induced abortion were interviewed. The results show that the prevalence of DV among participants was 22.6%. The violence included 18.1% sexual abuse, 7.8% physical abuse and 3.0% emotional abuse. Among abused women, 46 (16.8%) experienced violence frequently; 4.4% experienced three types of violence (sexual, physical and emotional violence). The number of times of having induced abortion in the abused group was significantly higher than that in the nonabused group (p<.001). There is statistically significant association between the occurrence of DV and relevant factors including fear of partner, quarreling with partner, partner's economic control, receiving the cold shoulder from partner (p<.001, OR 1.8-2.5).     

Prevalence and associations of partner abuse in women attending general practice: a cross-sectional survey

OBJECTIVE: To determine the prevalence and socio-demographic associations of physical, emotional and sexual abuse by a partner or ex-partner for women attending Australian general practices. METHOD: In 1996, women attending 20 randomly chosen Brisbane inner south region general practices were screened for a history of partner abuse using a self-report questionnaire. Multivariate analyses were conducted on the data, using presence of abuse or not adjusting for cluster effect to obtain prevalence rate ratios for socio-demographic background data and history of violence in the family of origin. RESULTS: Thirty-seven per cent (CI 31.0-42.4) of the survey participants (n = 1,836, response rate 78.5%) admitted to having ever experienced abuse in an adult intimate relationship. One in four women (23.3%) had ever experienced physical abuse, one in three (33.9%) emotional abuse and one in 10 (10.6%) sexual abuse. Abused women were 64.1 (Cl 44.4-94.1) times more likely to have ever been afraid of any partner than non-abused women. Of women in current relationships (n = 1,344), 8.0% self-reported physical or emotional or sexual abuse in the past 12 months and 1.5% all three types of abuse. Associations of abuse included being younger (< 60 years), separated or divorced, having a history of child abuse or domestic violence between their parents. CONCLUSION: Partner abuse is very common in women attending general practices and clinicians need to be alert to possible indications of partner abuse (age, marital status, past history of abuse).     

EDITORIAL

We investigated the effects of physical, psychological, and sexual violence on the health status of women attending antenatal clinics at two tertiary hospitals in rural Thailand. We asked 421 pregnant women at 32 weeks gestation or later to complete a survey questionnaire. Participants reported high rates of psychological abuse (53.7%); threats, acts of physical abuse, or both (26.6%); and sexual violence (19.2%). Women abused during pregnancy had poorer health compared with nonabused women, in role emotional functioning, vitality, bodily pain, mental health, and social functioning. Given the high prevalence of violence and poor health status, routine screenings by maternity services is urgently required.     

Domestic violence against women during pregnancy

OBJECTIVES: To determine the prevalence of domestic violence (DV) against women during pregnancy and to identify risk factors for DV and effects on women's mental health. METHODS: Pregnant women from an OB-GYN outpatient clinic at a hospital in an urban area were recruited consecutively from February to May 2003. Women who agreed to participate in the research answered three self-administered questionnaires: the GHQ30, the Rosenberg Self Esteem, and one for demographic characteristics at 14 gestational weeks. In order to determine DV prevalence rate during pregnancy, the Japanese version of the Index of Spouse Abuse (ISA) for measuring severity of DV was provided to those women over 35 gestational weeks. RESULTS: Two hundred seventy nine women answered all questionnaires. 15 of the 279 respondents (5.4%) were DV positive during pregnancy based on the Japanese version of the ISA. Nine had experienced physical violence, and twelve had non-physical violence Compared with women who had not experienced DV during pregnancy, DV positive pregnant women were more likely to be multipara (OR = 3.9) and to have experienced physical violence in the past from a different partner (OR = 9.1). Moreover, general illness (OR = 3.8), sleep disturbance (OR = 5.8), anxiety (OR = 6.3), depression (OR = 11.5) and low self-esteem (P = 0.02) were identified as effects of DV on women's mental health. CONCLUSION: Some 5.4% of women in Japan, approximately 1 in every 20, may experience DV during pregnancy. This is associated with parity and a past history of DV as demographic characteristics, and has an adverse impact on mental health, especially depression. Development of a support system for screening, intervention and referral for DV sufferers is urgently needed.     

Cumulative abuse experiences, physical health and health behaviors

PURPOSE: Our purpose was to investigate the complex relationship between a range of lifetime abuse experiences with current physical health and health behaviors. METHODS: Between October 1998 and May 1999, interviews were conducted with 557 ethnically diverse women seen at two urban primary care centers. Seven forms of abuse were measured: childhood physical and sexual abuse, past physical and sexual intimate partner violence (IPV), and recent emotional, physical, and sexual IPV. Severity was measured for six of these forms. Multiple non-specific physical symptoms were measured with a modified PRIME-MD, and four health behaviors were ascertained. RESULTS: Approximately 10% of women never experiencing abuse reported multiple non-specific physical symptoms, compared with 25.8% to 78.4% of women reporting a range of abuse experiences. Increases in recent IPV, past IPV, child abuse, and economic hardship were associated with increases in reported symptoms. Women who experienced IPV were more likely to report smoking cigarettes, binge drinking, and having poor nutritional habits. CONCLUSIONS: Recent IPV is associated with physical symptoms and risky health behaviors beyond the effects of child abuse, past IPV, and economic disadvantage. Understanding a person's IPV experiences may inform interventions for health behaviors, such as smoking cessation programs.     

Physical violence, intimate partner violence, and emotional abuse among adult American Indian men and women in Montana

BACKGROUND: Little is known about the experience of American Indian communities relative to physical violence (PV), intimate partner violence (IPV), and emotional abuse. METHODS: A random sample of adult American Indians living on or near the seven Montana reservations were interviewed through an adapted Behavioral Risk Factor Surveillance System telephone survey in 2001 (N = 1,006). Victimization from physical violence was defined as PV or sexual assault committed by any person. Respondents who reported experiencing PV and who reported that the perpetrator was a current or former spouse, boyfriend, girlfriend, or date were categorized as experiencing IPV. Emotional abuse was defined as fear for one's safety or being controlled by another individual. RESULTS: Nine, one, and twelve percent of men reported experiencing PV, IPV, and emotional abuse in the past year, respectively. Five percent of women reported PV in the past year, 3% reported IPV, and 18% reported emotional abuse. Men who reported PV in the past year were more likely to be younger and report more days of physical and mental health problems in the past month. Women reporting PV in the past year were more likely to be younger and have more days with mental health problems in the past month. Few men (7%) or women (12%) reported ever being assessed for PV or safety. CONCLUSIONS: Recent PV, IPV, and emotional abuse are prevalent for both American Indian men and women. Strategies to increase screening for PV and effective interventions for violence are needed.     

Frequency and correlates of intimate partner violence by type: physical, sexual, and psychological battering

OBJECTIVES: This study estimated the frequency and correlates of intimate partner violence by type (physical, sexual, battering, or emotional abuse) among women seeking primary health care. METHODS: Women aged 18 to 65 years who attended family practice clinics in 1997 and 1998 took part. Participation included a brief in-clinic survey assessing intimate partner violence. Multiple polytomous logistic regression was used to assess correlates of partner violence by type. RESULTS: Of 1401 eligible women surveyed, 772 (55.1%) had experienced some type of intimate partner violence in a current, most recent, or past intimate relationship with a male partner; 20.2% were currently experiencing intimate partner violence. Among those who had experienced partner violence in any relationship, 77.3% experienced physical or sexual violence, and 22.7% experienced nonphysical abuse. Alcohol and/or drug abuse by the male partner was the strongest correlate of violence. CONCLUSIONS: Partner substance abuse and intimate partner violence in the woman's family of origin were strong risk factors for experiencing violence. Efforts to universally screen for partner violence and to effectively intervene to reduce the impact of such violence on women's lives must be a public health priority.     

Prevalence of intimate partner violence and health implications for women using emergency departments and primary care clinics.

OBJECTIVES: To determine prevalence of intimate partner violence (IPV) among women accessing health care, factors that influence rates of abuse, barriers to disclosure, and associated health problems and perceptions of safety. METHODS: A convenience sample of women seeking health care completed 1268 anonymous surveys (75 in Spanish) while at 1 of 24 urban, suburban, or rural emergency departments or primary care clinics. RESULTS: Of women in this study, 50-57% had experienced physical and/or emotional abuse and 26% reported sexual abuse in their lifetime. In the past year, 28% reported emotional abuse, 12% physical abuse, 6% severe physical abuse, and 4% sexual abuse. Logistic regression models found that younger, less-educated, less-affluent women presenting to urban emergency departments reported the highest rates of physical abuse. Although 83% welcomed abuse screening, only 25% ever had been asked and 86% would disclose abuse if asked directly, respectfully, and confidentially. Abused women reported significantly lower health status ratings than nonabused women (p < 0.001). Emotional abuse was as strongly associated with health problems as physical abuse. The majority (70-93%) of women with headaches, stomach problems, chronic pain, vaginal bleeding, substance abuse, depression, and suicidal thoughts had experienced lifetime physical/emotional abuse. CONCLUSIONS: Women experience many forms of abuse and present to a wide range of health care settings. The striking prevalence of IPV and associated emotional/physical health problems challenges providers to routinely assess for abuse in ways that minimize barriers to disclosure and enhance the development of an effective plan of care based on a patient's abuse experience.     

Association Between Domestic Violence and Miscarriage: A Population-Based Cross-Sectional Study Among Women of Childbearing Ages,Sivas, Turkey

Violence against women is a global issue, with ramifications for the reproductive health of women. The current study examined the relation of domestic violence (DV) to miscarriage among women who were victimized during their last pregnancy. The study was conducted in Sivas city center, in Turkey. Associations between self-reported DV and miscarriage were analyzed using multiple regression modeling. Physical and/or sexual DV during the last pregnancy was reported by 10.0% and 6.2% of women, respectively. Women who experienced physical violence were 2.5 times as likely (Odds Ratio (OR) = 2.47, 95% confidence interval [CI]: 1.37–4.84, p = .003) to have experienced a miscarriage than women who did not report physical violence. These findings suggest that victims who experience physical violence during the last pregnancy may be more likely to experience miscarriage. Preventing DV, especially physical violence, may, therefore, be beneficial for avoiding adverse pregnancy outcomes.     

Prevalence and severity of domestic violence among pregnant women, Mexico

OBJECTIVES: To determine whether pregnancy is a risk factor for domestic violence and to compare prevalence and severity of violence reported by women before and during pregnancy. METHODS: There were interviewed 468 women in the third trimester of pregnancy who were seen during prenatal visits at public clinics in the state of Morelos, Mexico. Emotional, physical and sexual violence were investigated. A severity index was built up. Logistic regression analysis was applied in order to identify the main variables associated to domestic violence during pregnancy. RESULTS: The prevalence of domestic violence did not change significantly before and during pregnancy (32%). The prevalence of each type of violence remained the same. About 27% of women who reported violence during pregnancy did not have experience it before, and a comparable proportion had experienced violence before but not during pregnancy. The severity of emotional violence significantly increased during pregnancy (compared to the previous year) whereas the severity of physical violence decreased. Variables most clearly related to violence during pregnancy were: couple's past history of child abuse; women witnessing domestic violence during childhood; and violence in the year before pregnancy. Several risk scenarios were identified, which could be helpful for health care providers. CONCLUSIONS: The results showed that emotional violence is more prevalent than physical and sexual violence, allowing for a better understanding of this phenomenon.     

Quality of life among women living with HIV: the importance violence, social support, and self care behaviors

This paper describes the relationship between psychosocial factors and health related quality of life among 287 HIV-positive women using items from the Medical Outcomes Study HIV Health Survey to measure physical functioning, mental health and overall quality of life. Multivariate models tested the relative importance of sociodemographic characteristics, HIV-related factors and psychosocial variables in explaining these quality of life outcomes. A history of child sexual abuse and adult abuse, social support and health promoting self-care behaviors were the psychosocial factors studied. Women in the sample were on average 33 years old and had known they were HIV-positive for 41 months; 39% had been hospitalized at least once due to their HIV; 83% had children; 19% had a main sex partner who was also HIV-positive. More than one-half of the women (55%) had a history of injection drug use and 63% reported having been physically or sexually assaulted at least once as an adult. A history of childhood sexual abuse. reported by 41% of the sample, was significantly related to mental health after controlling for sociodemographic and HIV-related characteristics. Women with larger social support networks reported better mental health and overall quality of life. Women who practiced more self-care behaviors (healthy diet and vitamins, adequate sleep and exercise, and stress management) reported better physical and mental health and overall quality of life. The high prevalence of physical abuse and child sexual abuse reported by this sample underscores the importance of screening for domestic violence when providing services to HIV-positive women. That such potentially modifiable factors as social support and self care behaviors are strongly associated with health-related quality of life suggests a new opportunity to improve the lives of women living with HIV.     

Domestic violence and sexually transmitted diseases: the experience of prenatal care patients.

OBJECTIVES: The authors analyzed interview responses of patients at a prenatal care clinic to explore whether women who had been victims of sexual and physical abuse were more likely than non-victimized women to have experienced a sexually transmitted disease (STD). METHODS: A consecutive sample of 774 prenatal patients of a large health department in North Carolina were interviewed concerning a variety of health issues, including violence and STDs. Logistic regression analysis was used to model the women's STD status as a function of their experiences of sexual and physical abuse, controlling for several potentially confounding factors. RESULTS: Thirty percent of the women reported having experienced at least one STD, with the most common infections being chlamydia and gonorrhea. Twenty-eight percent of the women reported having been victims of abuse; 16% reported physical abuse only, while 12% reported both physical and sexual abuse. The majority of violence was domestic in nature, perpetrated by the victims' husbands, boyfriends, male friends, and relatives. After controlling for confounding variables, the authors found that women who reported both physical and sexual abuse were significantly more likely to have experienced STDs than non-victims (odds ratio [OR] = 2.25; 95% confidence interval [CI] 1.37, 3.69). The logistic regression analysis also showed a relationship of borderline statistical significance between non-sexual physical abuse and STDs. CONCLUSIONS: Health care providers should routinely screen patients for both abuse and STDs, and they should assist identified women in accessing appropriate health, social, and legal services.     

Child abuse and smoking among young women: the importance of severity, accumulation, and timing.

PURPOSE: We examined the association between severity, accumulation, and timing of abuse in childhood and adolescence and smoking status among young women. METHODS: Retrospective self-reported childhood abuse was ascertained with the modified Conflict Tactics Scale from 91,286 Nurses Health Study II participants in 2001 (68,505 returned; 75.0% response rate). Childhood abuse was categorized by severity (mile/moderate/severe), type (physical/sexual), and timing (childhood/adolescence). Smoking status during adolescence was reported at baseline (1989). Logistic regression was used to predict smoking initiation by age 14 and smoking status between the ages of 15 and 19. RESULTS: A graded association between severity of abuse and early initiation of smoking (by age 14 years) was demonstrated (odds ratio [OR] = 1.9, 95% confidence interval [CI] = 1.7-2.1 for severe physical violence). Young women with both physical and sexual abuse were two times more likely to start smoking by age 14 than were those reporting no abuse (OR = 2.0, 95% CI = 1.8-2.3). Although abuse during childhood increased risk for adolescent smoking (OR = 1.7, 95% CI = 1.8-2.1) for those with childhood physical and sexual abuse, inclusion of adolescent physical and sexual abuse (OR = 2.2, 95% CI 2.1-2.4) diminished the impact of childhood abuse (OR = 1.1, 95% CI 1.1-1.2). The degree of familial emotional support was protective against smoking, and reduced the impact of abuse by 40% among those with high emotional support versus those without (p < .0001). CONCLUSIONS: A strong and graded association was observed between both severity and accumulation of abuse and the risk of early initiation of smoking among girls. Smoking status during late adolescence was more strongly associated with adolescent abuse than childhood abuse. Early smoking onset is associated with both heightened risk for disease in adolescence but also increased morbidity and mortality in adulthood. Identifying and intervening in potentially modifiable risk factors for smoking onset in young women, such as early-life physical and sexual abuse, and building familial strengths, such as emotional support, may have significant public health implications.     

Childhood family violence history and women's risk for intimate partner violence and poor health

BACKGROUND: There is growing evidence for associations between generations in family violence and between family violence in both childhood and adulthood and women's health. Most studies focus on a subset of family violence (child abuse, witnessing intimate partner violence [IPV] as a child, and/or adult IPV), and few examine possible differences associated with the nature of abusive experiences, such as physical versus sexual abuse. METHODS: A population-based telephone survey, the 1999 and 2001 Washington State Behavioral Risk Factor Surveillance System, asked a representative sample of 3527 English-speaking, non-institutionalized adult women whether they had been physically or sexually assaulted or witnessed interparental violence in childhood, and whether they had experienced physical assault or emotional abuse from an intimate partner in the past year. The survey also asked about current general health and mental distress in the past month. RESULTS: The risks associated with childhood family violence experiences varied depending on the nature of those experiences. Women reporting childhood physical abuse or witnessing interparental violence were at a four- to six-fold increase in risk of physical IPV, and women reporting any of the experiences measured were at three- to four-fold increase in risk of partner emotional abuse. In contrast, women reporting childhood sexual abuse only were not at increased risk of physical IPV. Women reporting childhood physical abuse were at increased risk of poor physical health, and women reporting any type of childhood family violence were at increased risk of frequent mental distress. Approximately one third of women reporting poor general health and half of women reporting frequent mental distress also reported at least one of the childhood experiences measured. CONCLUSIONS: These findings underscore the role of childhood experiences of abuse and of witnessing family violence in women's current risk for IPV, poor physical health, and frequent mental distress.     

中国农村地区已婚妇女家庭暴力发生情况及其相关知识调查

目的 了解中国农村地区已婚妇女家庭暴力发生情况及相关知识。方法 2004年11月至2005年1月，在吉林、安徽省和重庆市的人口基金项目县，采用多阶段容量比例抽样方法随机抽取25个乡镇，对3998名18岁及以上的已婚妇女进行问卷调查。结果 调查地区家庭暴力发生非常普遍，一生中总暴力、心理暴力、躯体暴力和性暴力的发生比例分别为64．8％、58．1％、29．7％和16．7％；调查前12个月中总暴力、心理暴力、躯体暴力和性暴力的发生比例分别为42．6％、37．2％、14．0％和7．7％。不同种类家庭暴力常常同时存在，将近1／3的妇女同时遭受2种或3种家庭暴力的伤害。调查妇女对家庭暴力的认识较差，75．2％的调查妇女对家庭暴力不了解，很多遭受过家庭暴力伤害的妇女对家庭暴力也一无所知，尤其是对心理暴力的知晓情况更差。结论 中国农村地区家庭暴力发生非常普遍，尤其是心理暴力，但已婚妇女对家庭暴力的了解还比较欠缺，需要引起有关部门的重视。     

Intimate partner violence. A survey conducted in the primary care setting

OBJECTIVES: To determine the prevalence of intimate partner violence (IPV) in a sample of women attending primary care centers for any reason and to analyze the characteristics of this violence. METHODS: A cross sectional study was performed in 23 primary care centers in three regions of Spain (Andalusia, Madrid and Valencia). The sample included 1,402 randomly selected adult women aged between 18 and 65 years attending these centers. Among the variables collected through a self-administered questionnaire were the existence of physical, emotional or sexual abuse, and its timing, duration, and frequency. RESULTS: Overall, 32% had experienced some type of IPV. By type, 7% had experienced both physical and emotional IPV, 14% had experienced emotional IPV, 3% had experienced emotional and sexual IPV, and 6% had suffered all 3 types of IPV. Among the latter, 52% had experienced abuse for more than 5 years. Women who experienced abuse in a previous relationship had a greater probability of being abused by a new intimate partner (OR = 3.30; 95% CI, 2.10-5.18). CONCLUSIONS: These results show the scale of IPV in Spain. Health professionals play an important role in IPV, as they are in a privileged position to tackle this serious public health problem.     

Women behind bars: health needs of inmates in a county jail

OBJECTIVES: This study was performed to assess the prevalence of behavioral risk factors and correlates of poor self-reported health among incarcerated women in a county jail in Oregon. METHODS: The authors collected self-reported data from recently incarcerated women at a county jail, focusing on prevalence of high-risk health behaviors, history of health care use, history of physical and sexual abuse, and health care coverage. The authors assessed factors associated with poor self-reported health using logistic regression techniques. RESULTS: More than half of the participants reported a history of intravenous drug use, 67% reported a history of sexual abuse, 79% reported a history of physical abuse, and 43% stated that they had a history of trading sex for money or drugs. Two factors were associated with poor self-reported health: history of physical assault (odds ratio [OR] = 2.7; 95% confidence interval [CI] 1.4, 5.2) and use of heroin during the month prior to arrest (OR = 2.9; 95% CI 1.3, 6.6). CONCLUSIONS: The high prevalence of health risk behaviors among the inmates suggests a number of areas for intervention. These findings may also be used to guide topics addressed during intake interviews of new inmates, and to help identify inmates that require additional medical or social services.     

Violence against women and postpartum depression: the experience of Chilean women

This article is based on the findings from a cross-sectional study of women (N = 163) who were at least two weeks postpartum and attending primary care clinics in Arica, Chile. The researcher in this study examined the prevalence of history of violence and its association with postpartum depression. The Women Abuse Screen and the Postpartum Depression Screening Scale-Spanish version were used to assess interpersonal violence and postpartum depression. A history of violence was reported by 64% of the women. Of those who experienced abuse, 44% reported ongoing abuse during their pregnancy. Women who experienced violence screened positive for elevated symptoms categories of postpartum depression such as anxiety/insecurity, emotional lability, and mental confusion compared to women who had not experienced violence. Postpartum depression symptom reporting decreased with increasing number of pregnancies (OR = 0.70, 95% CI 0.54-0.97) and greater social support (OR = 0.64, 95% CI 0.46-0.88). Postpartum depression symptom reporting increased with smoking (OR = 1.71, 95% CI 1.00-2.86), and with reporting history of violence (OR = 1.79, 95% CI 1.24-2.34). Acknowledgment of the strong association between domestic violence and postpartum depression should lead to routine screening during prenatal and postpartum periods as a way to isolate risk for postpartum depression.     

Violence Against Women and Postpartum Depression: The Experience of Chilean Women

This article is based on the findings from a cross-sectional study of women (N = 163) who were at least two weeks postpartum and attending primary care clinics in Arica, Chile. The researcher in this study examined the prevalence of history of violence and its association with postpartum depression. The Women Abuse Screen and the Postpartum Depression Screening Scale–Spanish version were used to assess interpersonal violence and postpartum depression. A history of violence was reported by 64% of the women. Of those who experienced abuse, 44% reported ongoing abuse during their pregnancy. Women who experienced violence screened positive for elevated symptoms categories of postpartum depression such as anxiety/insecurity, emotional lability, and mental confusion compared to women who had not experienced violence. Postpartum depression symptom reporting decreased with increasing number of pregnancies (OR = 0.70, 95% CI 0.54–0.97) and greater social support (OR = 0.64, 95% CI 0.46–0.88). Postpartum depression symptom reporting increased with smoking (OR = 1.71, 95% CI 1.00–2.86), and with reporting history of violence (OR = 1.79, 95% CI 1.24–2.34). Acknowledgment of the strong association between domestic violence and postpartum depression should lead to routine screening during prenatal and postpartum periods as a way to isolate risk for postpartum depression.