Intimate Partner Violence and Health Care-Seeking Patterns Among Female Users of Urban Adolescent Clinics

To assess the prevalence of intimate partner violence (IPV) and associations with health care-seeking patterns among female patients of adolescent clinics, and to examine screening for IPV and IPV disclosure patterns within these clinics. A self-administered, anonymous, computerized survey was administered to female clients ages 14–20 years (N = 448) seeking care in five urban adolescent clinics, inquiring about IPV history, reasons for seeking care, and IPV screening by and IPV disclosure to providers. Two in five (40%) female urban adolescent clinic patients had experienced IPV, with 32% reporting physical and 21% reporting sexual victimization. Among IPV survivors, 45% reported abuse in their current or most recent relationship. IPV prevalence was equally high among those visiting clinics for reproductive health concerns as among those seeking care for other reasons. IPV victimization was associated with both poor current health status (AOR 1.57, 95% CI 1.03–2.40) and having foregone care in the past year (AOR 2.59, 95% CI 1.20–5.58). Recent IPV victimization was associated only with past 12 month foregone care (AOR 2.02, 95% CI 1.18–3.46). A minority (30%) reported ever being screened for IPV in a clinical setting. IPV victimization is pervasive among female adolescent clinic attendees regardless of visit type, yet IPV screening by providers appears low. Patients reporting poor health status and foregone care are more likely to have experienced IPV. IPV screening and interventions tailored for female patients of adolescent clinics are needed.     

Risk Factors for Intimate Partner Violence and Associated Injury Among Urban Women

The objective of this study was to identify risk factors for abuse and IPV related injury among an urban population. This study reports an additional analysis of a case-control study conducted from 1994 to 2000 in 11 USA metropolitan cities where of 4746 women, 3637 (76.6%) agreed to participate. Control group women (N = 845) were identified through random digit dialing. Significant risk factors for abuse included women’s young age (adjusted odds ratio (AOR) 2.05 p = .011), being in fair or poor mental health (AOR 2.65 p < .001), and former partner (AOR 3.33 p < .001). Risk factors for partners perpetrating IPV included not being a high school graduate (AOR 2.06 p = .014), being in fair or poor mental health (AOR 6.61 p < .001), having a problem with drug (AOR 1.94 p = .020) or alcohol use (AOR 2.77 p = .001), or pet abuse (AOR 7.59 p = .011). College completion was observed to be protective (AOR 0.60, p < .001). Significant risk factors for injury included partner’s fair or poor mental health (AOR 2.13, p = .008), suicidality (AOR 2.11, p = .020), controlling behavior (AOR 4.31, p < .001), prior domestic violence arrest (AOR 2.66, p = .004), and relationship with victim of more than 1 year (AOR 2.30, p = .026). Through integration of partner related risk factors into routine and/or targeted screening protocols, we may identify more abused women and those at greater risk of abuse and injury.     

Linkages Between Gender Equity and Intimate Partner Violence Among Urban Brazilian Youth

Purpose

Gender inequity is a risk factor for intimate partner violence (IPV), although there is little research on this relationship that focuses on youth or males. Using survey data collected from 240 male and 198 female youth aged 15–24 in Rio de Janeiro, Brazil, we explore the association between individual-level support for gender equity and IPV experiences in the past 6 months and describe responses to and motivations for IPV.

Methods

Factor analysis was used to construct gender equity scales for males and females. Logistic and multinomial logistic regression models were used to examine the relationship between gender equity and IPV.

Results

About half of female youth reported some form of recent IPV, including any victimization (32%), any perpetration (40%), and both victimization and perpetration (22%). A total of 18% of male youth reported recently perpetrating IPV. In logistic regression models, support for gender equity had a protective effect against any female IPV victimization and any male IPV perpetration and was not associated with female IPV perpetration. Female victims reported leaving the abusive partner, but later returning to him as the most frequent response to IPV. Male perpetrators said the most common response of their victims was to retaliate with violence. Jealousy was the most frequently reported motivation of females perpetrating IPV.

Conclusion

Gender equity is an important predictor of IPV among youth. Examining the gendered context of IPV will be useful in the development of targeted interventions to promote gender equity and healthy relationships and to help reduce IPV among youth.     

Intimate Partner Violence and Comorbid Mental Health Conditions Among Urban Male Patients

PURPOSE We wanted to explore the associations between intimate partner violence (IPV) and comorbid health conditions, which have received little attention in male patients.     

Intimate Partner Violence and Help-Seeking Among Ethiopian Women

Although intimate partner violence (IPV) is a widespread phenomenon in Ethiopia, the relationship between help-seeking sources and IPV is not well understood. Better understanding of this relationship could play a role in preventing IPV. We used data collected in the 2016 Ethiopia Demographic and Health Survey and limited our study to women who have ever been married, aged 15 to 49 years (n?=?4469). Overall, the proportions of women who have ever experienced emotional abuse, physical, or sexual violence were 24%, 23.1%, and 10.1%. Women who sought informal help (family) were 2.42 times more likely (OR?=?2.42; CI 1.29–4.55) to have ever experienced emotional abuse than women who did not seek family help. Neither formal nor informal help-seeking significantly associated with physical or sexual violence. The results may indicate difficulties women face in seeking help and cultural and social norms that tolerate IPV as an acceptable part of family life in Ethiopia.

     

Associations Between Perceptions and Involvement in Neighborhood Violence and Intimate Partner Violence Perpetration Among Urban,African American Men

Violence disproportionately affects African American men and their communities. Research is needed to inform programming efforts to reduce racial/ethnic disparities in violence exposure, involvement, and victimization. The current study examined involvement in and perceptions of neighborhood violence and relation to perpetration of intimate partner violence (IPV) among a sample of urban, African American men. Participants of this cross-sectional study were sexually active African American men (n = 703) between the ages of 18 and 65 years, recruited from urban community health centers. Age-adjusted logistic regression models were used to assess associations between neighborhood violence variables and perpetration of IPV. In age-adjusted logistic regression models, involvement with street violence in the previous 6 months (Odds Ratio (OR) = 3.0; 95% Confidence Interval (CI): 1.9–4.6), ever being involved with gangs (OR = 2.0; 95% CI: 1.3–3.2), and perceptions/beliefs that violence occurs in one’s neighborhood (ORs = 2.0–3.1) were found to be significantly associated with IPV perpetration. Findings demonstrate that involvement in neighborhood violence as well as perceptions/beliefs that violence occurs in one’s neighborhood are associated with increased likelihood of IPV perpetration among urban, African American men. While socioeconomics and substance use contribute to high rates of these forms of violence, the relation between these forms of violence and perpetration of IPV was significant beyond the influences of these factors. Findings suggest that future violence prevention and treatment efforts will be most successful by addressing multiple forms of violence.     

Perceived Risk of Intimate Partner Violence Among STI Clinic Patients: Implications for Partner Notification and Patient-Delivered Partner Therapy

Patient-delivered partner therapy (PDPT) is the practice of providing patients diagnosed with a bacterial sexually transmitted infection (STI) medication to give directly to their partner for treatment without requiring the partner to participate in diagnostic testing and counseling. Despite a growing body of evidence in support of PDPT, literature is limited to date on the influence of perceived risk of intimate partner violence (IPV) on PDPT use. We analyzed mixed-method data from 196 quantitative surveys (61% male, M age = 31.2, 92% Black or African-American) and 25 qualitative interviews to better understand the barriers and facilitators associated with PDPT delivery for patients attending a Midwestern, publicly funded STI clinic in the U.S. Nearly a third of surveyed patients (29; 34% of women, 26% of men) expressed worry about IPV when delivering PDPT. Patients had concerns about infidelity worry, embarrassment, and anxiety (referred to as IWEA hereafter) associated with partner notification and PDPT delivery. We found IWEA was highly correlated with IPV concerns in a fully adjusted logistic regression model. Women had 2.43 (95% CI = 1.09–5.42) times greater odds of worrying about IPV than men; other significant factors associated with IPV worry included higher condom use, no prior STI diagnosis, and being uninsured (as compared to having Medicare/Medicaid insurance). Encouraging communication between healthcare providers and their patients about the potential for IPV could facilitate patient triaging that results in the consideration of alternative partner referral mechanisms for patients or partners at risk of harm and better outcomes for patients and their partners.     

Intimate Partner Violence Among Female Service Members and Veterans: Information and Resources Available Through Military and Non-Military Websites

With the expansion of women’s roles in the military, the number of female service members and veterans has increased. Considerable knowledge about intimate partner violence (IPV) in civilian couples exists but little is known about IPV among female service members and veterans. Prevalence rates of IPV range from 17% to 39% for female service members, and 21.9% to 74% for veterans. Most service members and veterans indicated using the Internet at least occasionally and expressed willingness to seek information about services via the Internet. Informed by data, we conducted a systematic review of military (Army, Navy, Air Force, and Marine Corps) and non-military (Veterans Affairs and Google) websites to explore the availability and presentation of information and resources related to IPV. The websites search revealed a variety of resources and information available, and important differences between sites with regard to what and how information is presented. Implications for practice and further research are discussed.     

Health Indicators,Social Support,and Intimate Partner Violence Among Women Utilizing Services at a Community Organization

PurposeIntimate partner violence (IPV) against women is a significant public health concern. This study examines the physical and mental health status and relationship to social support for women seeking services to end IPV at a walk-in community organization that serves the community at large, including a shelter for abused women.MethodsOne hundred seventeen (117) English-speaking women between the ages of 18 and 61 years participated in a self-administered survey. Physical, mental, and oral health, social support, and IPV homicide lethality were measured using standardized instruments.ResultsSocial support was the most important factor related to better health. The participants who had more social support reported better physical (p < .05), mental (p < .01), and oral health (p < .05), and a lower level of psychological distress (p < .01) and depression (p < .01) compared with participants who reported less social support. The participants living in the shelter reported worse physical health (p < .05) but better mental health (p < .05) than the participants not living in a shelter. Older age and low income were related to oral health problems, whereas older age, low education level, and unemployment were related to poor mental health.ConclusionThe present study adds to the evidence that social support contributes to improving physical and mental health for women who experience IPV. The findings also suggest the importance of providing or referring women to mental health services.     

Contraception and Clean Needles: Feasibility of Combining Mobile Reproductive Health and Needle Exchange Services for Female Exotic Dancers

Young women engaged in exotic dancing have a higher need for reproductive health services than women not in this profession, and many also use drugs or exchange sex for money or drugs. Few report receiving reproductive health services. We describe a public health, academic, and community partnership that provided reproductive health services on needle exchange mobile vans in the “red light district” in downtown Baltimore, Maryland. Women made 220 visits to the vans in the first 21 months of the program''s operation, and 65% of these visits involved provision of contraception. Programmatic costs were feasible. Joint provision of needle exchange and reproductive health services targeting exotic dancers has the potential to reduce unintended pregnancies and link pregnant, substance-abusing women to reproductive care, and such programs should be implemented more widely.

KEY FINDINGS

• ▪Exotic dancers are a unique subset of sex workers and have rarely been studied.
• ▪At baseline, 75% of women using needle exchange services in the Baltimore, Maryland, “red light district” were not receiving reproductive health services. Observations indicated that several women had late pregnancy diagnoses and were unfamiliar with their health care options.
• ▪Mobile reproductive health services were feasible and affordable because they were integrated into needle exchange services and volunteers were used.
• ▪The numbers of women served exceeded expectations, but few women were connected to a clinic for full reproductive exams despite referrals, next-day appointments, telephone reminders, and incentives.
• ▪Forty-six percent of women returned for continuation of injectable contraceptives, and this rate increased over time.
• ▪Five pregnant women were identified, and all were linked to desired pregnancy services.
• ▪Joint provision of needle exchange services and reproductive health services to exotic dancers has the potential to reduce unintended pregnancies and link pregnant women to care, and such programs should be implemented more widely.

YOUNG WOMEN ENGAGED IN exotic dancing have an increased need for reproductive health services relative to women in other professions. Most exotic dancers are in their early 20s, a period in which women are at high risk for unplanned pregnancies,1 and many dancers are also engaged in high-risk activities that increase their chances of unplanned pregnancies and poor pregnancy outcomes. In a recent study, 61% of dancers in downtown Baltimore, Maryland, reported having ever sold sex and 43% reported having sold sex in the preceding three months in the club at which they were employed.2 Drug use was also common; 57% of dancers reported that they had recently used drugs, often crack cocaine or heroin.3Despite their risks, exotic dancers are a rarely studied subset of sex trade workers.4–7 Similar to other sex trade workers,4,8 there are concerns regarding overlapping sexual and injection networks among exotic dancers and their need to engage in higher risk sex work to obtain money for drugs. Rates of HIV and other sexually transmitted infections (STIs) are high among sex trade workers, as are rates of unwanted pregnancies.5 Exotic dancers differ from other sex trade workers because of the club environment, which can be an additional protective or risk factor as a result of the combination of legal and illegal sex trade work that can occur there.3 Targeted health services for women engaged in exotic dancing may be vital to reaching them.9 We assessed a public health intervention designed to provide reproductive health care for exotic dancers in downtown Baltimore.     

Alcohol and Other Drug Use,Partner Violence,and Mental Health Problems Among Female Sex Workers in Southwest China

In this study we investigated the association between mental health problems and negative experiences among female sex workers (FSWs) in China. A total of 1,022 FSWs completed a self-administered survey on their demographic characteristics, mental health status, substance use behaviors, and experiences of partner violence. We found that alcohol use was independently predictive of mental health problems when both partner violence and illicit drug use were accounted for in the multivariate logistic regression models. The findings underscore the urgent need for effective alcohol reduction interventions and mental health promotion programs among FSWs in China and other developing countries.     

Risk Factors for Severe Intimate Partner Violence and Violence-Related Injuries Among Women in India

Relying on an ecological framework, we examined risk factors for severe physical intimate partner violence (IPV) and related injuries among a nationally representative sample of women (N = 67,226) in India. Data for this cross-sectional study were derived from the 2005–2006 India National Family Health Survey, a nationally representative household-based health surveillance system. Logistic regression analyses were used to generate the study findings. We found that factors related to severe physical IPV and injuries included low or no education, low socioeconomic status, rural residence, greater number of children, and separated or divorced marital status. Husbands’ problem drinking, jealousy, suspicion, control, and emotionally and sexually abusive behaviors were also related to an increased likelihood of women experiencing severe IPV and injuries. Other factors included women’s exposure to domestic violence in childhood, perpetration of IPV, and adherence to social norms that accept husbands’ violence. Practitioners may use these findings to identify women at high risk of being victimized by severe IPV or injuries for prevention and intervention strategies. Policies and programs that focus on empowering abused women and holding perpetrators accountable may protect women at risk for severe IPV or injuries that may result in death.     

Urban Young Women’s Experiences of Discrimination and Community Violence and Intimate Partner Violence

This paper examines the interrelationships between urban young adult women’s experiences of discrimination and community violence and their reports of involvement in intimate partner violence (IPV). We explore whether such experiences are independent risk factors for IPV victimization and perpetration, even when accounting for aggressive behaviors and related risk taking, including drinking and sexual initiation, during early adolescence. We use data from the Reach for Health study, in which a sample of 550 urban African American and Latina women was followed from recruitment in economically distressed middle schools into young adulthood, over approximately 7 years. At the last wave, respondents were 19–20 years old; 28% were raising children. More than 40% reported experiencing at least one form of racial/ethnic discrimination sometimes or often over the past year. About 75% heard guns being shot, saw someone being arrested, or witnessed drug deals within this time period; 66% had seen someone beaten up, 26% had seen someone get killed, and 40% knew someone who was killed. Concurrent reports of lifetime IPV were also high: about a third reported being a victim of physical violence; a similar proportion reported perpetration. Results of multivariate regression analyses indicate that discrimination is significantly associated with physical and emotional IPV victimization and perpetration, controlling for socio-demographic characteristics, including ethnic identity formation, and early adolescent risk behaviors. Community violence is correlated with victimization, but the relationship remains significant only for emotional IPV victimization once early behaviors are controlled. Implications for violence prevention are discussed, including the importance of addressing community health, as well as individual patterns of behavior, associated with multiple forms of violence victimization and perpetration. Stueve is with the Health and Human Development Center, 96 Morton Street, 7th Floor, New York, 10014, New York NY, USA. O`Donnell is with the Health and Human Development, Education Development Center, Newton, MA, USA.     

Validity of the Brief Inpatient Screen for Intimate Partner Violence Among Adult Women

Background: Identifying intimate partner violence in healthcare settings is becoming the standard of care. The Brief Inpatient Screen was designed to assess recent emotional, physical, and sexual abuse in a general inpatient medical-surgical setting and compared to the Composite Abuse Scale. Methods: Researchers matched “cases” (inpatients screening Brief Inpatient Screen-positive) to up to four “controls” (inpatients screening Brief Inpatient Screen-negative). Forty-six female hospital inpatients ages 18–64 years completed a self-administered survey. The sensitivity and specificity of the Brief Inpatient Screen and its subscales were compared to the Composite Abuse Scale. Researchers examined the performance of the Brief Inpatient Screen when used as a verbal screen versus an anonymous written screen. Results: Twelve of 46 participants (26%) had a positive screen. Compared to the Composite Abuse Scale, the overall sensitivity and specificity of the verbal Brief Inpatient Screen were 52.6% (95% CI 28.9–75.6) and 92.6% (95% CI 75.7–99.1), respectively. The written Brief Inpatient Screen showed improved sensitivity overall (68.4%, 95% CI 43.5–87.4) for the most severe intimate partner violence. Subscale analysis revealed greater sensitivity for emotional and severe combined intimate partner violence. Conclusions: The verbal Brief Inpatient Screen, when compared to the Composite Abuse Scale, was limited in its ability to identify intimate partner violence. An anonymous written format improved sensitivity. Future research should optimize intimate partner violence screening among inpatients.     

Help-Seeking Rates for Intimate Partner Violence (IPV) Among Canadian Immigrant Women

We examined rates of help seeking for intimate partner violence (IPV) among recent (0–9 years in Canada) and nonrecent (10+ years in Canada) immigrant women. Data from a national, cross-sectional, telephone survey were used. Help-seeking variables included disclosure of IPV, reporting IPV to police, use of social services subsequent to IPV, and barriers to social service use. Recent immigrant women, compared with nonrecent immigrant women, were significantly more likely to report IPV to police and less likely to use social services. Findings have important implications for prevention and detection of IPV in immigrant communities and in future research.     

Associations Between LGBTQ-Affirming School Climate and Intimate Partner Violence Victimization Among Adolescents

Prevention Science - Intimate partner violence (IPV) impacts sexual minority adolescents at rates equal to or greater than the rate it impacts heterosexual adolescents. We investigated whether...