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.

     

Health, Access to Health Care, and Health Care use Among Homeless Women with a History of Intimate Partner Violence

Among a sample of sheltered homeless women, we examined health, access to health care, and health care use overall and among the subgroup of participants with and without intimate partner violence (IPV). We recruited homeless women from a random sampling of shelters in New York City, and queried them on health, access to health care and health care use. Using multivariable logistic regression, we determined whether IPV was associated with past-year use of emergency, primary care and outpatient mental health services. Of the 329 participants, 31.6% reported one or more cardiovascular risk factors, 32.2% one or more sexually transmitted infections, and 32.2% any psychiatric condition. Three-fourths (73.5%) had health insurance. Health care use varied: 55.4% used emergency, 48.9% primary care, and 75.9% outpatient mental health services in the past year. Across all participants, 44.7% reported IPV. Participants with IPV compared to those without were more likely to report medical and psychiatric conditions, and be insured. Participants with IPV reported using emergency (64.4%) more than primary care (55.5%) services. History of IPV was independently associated with use of emergency (Adjusted odds ratio (AOR) 1.7, 95% CI 1.0-2.7), but not primary care (AOR 1.5, 95% CI 0.9-2.6) or outpatient mental health services (AOR 1.9, 95% CI 0.9-4.1). Across the whole sample and among the subgroup with IPV, participants used emergency more than primary care services despite being relatively highly insured. Identifying and eliminating non-financial barriers to primary care may increase reliance on primary care among this high-risk group.     

Intimate Partner Violence Affects Skilled Attendance at Most Recent Delivery Among Women in Kenya

Delivery assistance by skilled health personnel is a key progress indicator for Millennium Development Goal 5, which aims to reduce the worldwide maternal mortality ratio by 75% between 1990 and 2015. The role of socio-demographic factors in determining skilled attendance at delivery has been widely explored, but relatively little attention has been paid to the effect of gender power relations on delivery care. This analysis investigated whether women's status in the household, as measured by their experience of intimate partner violence (IPV), affected skilled attendance at most recent delivery among women in Kenya. Cross-sectional data were obtained from the 2003 Kenya Demographic and Health Surveys (KDHS). 975 ever-married women who had given birth in the past year and completed the KDHS domestic violence module were included in the analysis. Logistic regression was used to assess the association between skilled attendance and IPV. In this sample, 46% reported having experienced any type of IPV, with 39% reporting physical violence, 21% emotional violence, and 13% sexual violence. After adjusting for demographic characteristics and number of antenatal visits, lifetime experience of emotional violence was found to decrease the odds of skilled attendance at most recent delivery by 40%, while lifetime experience of physical violence reduced the odds by 29%. Women's experience of IPV may influence receipt of skilled attendance during parturition, and should be addressed as national programs and their international partners align efforts to contribute to the achievement of Millennium Development Goal 5.     

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.     

Intersections Between Childhood Abuse and Adult Intimate Partner Violence Among Ecuadorian Women

Objectives Strong linkages exist between childhood abuse and adult intimate partner violence (IPV) among women in developed countries. Few studies examine this pattern in developing nations. This study explores the effect of childhood physical and/or psychological abuse on the likelihood of IPV among a national sample of Ecuadorian women of reproductive age. Methods Secondary data analysis was conducted on a subsample of 9,077 Ecuadorian women, utilizing the 2004 Encuesta Demografía y de Salud Materna e Infantil survey. Cross-tabulations and multivariate logistic regression models were utilized to assess whether women who report childhood abuse had a higher likelihood of reporting sexual, physical or psychological IPV during their lifetimes or within the past year. Results Levels of abuse were high. More than 30% of women reported childhood psychological or physical abuse, and 21% experienced both types of abuse. Forty percent of women reported sexual, physical or psychological IPV during their lifetimes, while 15% reported any form of IPV in the past year. The co-occurrence of childhood psychological and physical abuse was highly predictive of all forms of IPV, with less consistent associations for women who reported only physical or only psychological childhood abuse. Conclusions This study suggests that childhood abuse is an important risk factor for IPV victimization among Ecuadorian women. While this analysis supports findings from developed countries, more cross-cultural research about patterns of violence throughout the life course is needed to develop relevant prevention programs.     

Intimate Partner Violence,Depression, PTSD,and Use of Mental Health Resources Among Ethnically Diverse Black Women

This study examined exposure to violence and risk for lethality in intimate partner relationships as factors related to co-occurring MH problems and use of mental health (MH) resources among women of African descent. Black women with intimate partner violence (IPV) experiences (n?=?431) were recruited from primary care, prenatal or family planning clinics in the United States and the U.S. Virgin Islands. Severity of IPV was significantly associated with co-occurring MH problems, but was not associated with the use of MH resources among African-American women. Risk for lethality and co-occurring problems were also not significantly related to the use of resources. African Caribbean women with severe physical abuse experiences were significantly less likely to use resources. In contrast, severity of physical abuse was positively associated with the use of resources among Black women with mixed ethnicity. Severe IPV experiences are risk factors for co-occurring MH problems, which in turn, increases the need for MH services. However, Black women may not seek help for MH problems. Thus, social work practitioners in health care settings must thoroughly assess women for their IPV experiences and develop tailored treatment plans that address their abuse histories and MH needs.     

Actions Taken by Women in Response to Intimate Partner Violence and Intimate Partner Violence Status at 1-Year Follow-Up

BackgroundIntimate partner violence (IPV) is a pervasive public health issue with significant physical and mental health sequelae. A longer duration and greater severity of abuse are associated with adverse health outcomes and increased risk of revictimization. Current research has identified a variety of strategies used by women in response to abuse, but has not established whether the use of these strategies is associated with decreased IPV over time. For this study, we analyzed the associations between the use of specific actions in response to abuse—placating, resistance, informal or formal network help-seeking, safety planning, and substance use—and IPV victimization at the 1-year follow-up.MethodsNinety-five women with past-year IPV at baseline participated in a 1-year follow-up survey measuring their use of specific actions in response to IPV and subsequent IPV status. IPV victimization at the 1-year follow-up was analyzed as a function of types of actions taken and sociodemographic variables.ResultsAmong women with past-year IPV at baseline (N = 95), 53% reported no further IPV victimization at the 1-year follow-up. In bivariate analysis, social support was associated with decreased risk of IPV victimization (odds ratio, 0.43; 95% confidence interval [CI], 0.18–0.99). In multivariable analyses, high use of placating (adjusted odds ratio, 9.40; 95% CI, 2.53–34.9), formal network help-seeking (adjusted odds ratio, 7.26; 95% CI, 1.97–26.74), and safety planning (adjusted odds ratio, 2.98; 95% CI, 1.02–8.69) strategies were associated with an increased risk of IPV victimization at the 1-year follow-up.ConclusionsOur data demonstrate that IPV exposure can change over time and that the use of specific actions in response to IPV can be indicators of risk of subsequent victimization. Abuse severity is an important potential confounder of action efficacy.     

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.     

Prevalence and Risk Factors of Intimate Partner Violence Among Pregnant Women in Japan

Intimate partner violence (IPV) during pregnancy can result in adverse outcomes for both mothers and their infants. This cross-sectional study examined the prevalence and risk factors of IPV associated with abuse during pregnancy via a self-administered questionnaire completed by 302 healthy pregnant women. Demographic information was also collected from medical records to analyze risk factors for abuse. Of the 302 women, 48 (15.9%) were identified as experiencing IPV. The identified risk factors were age over 30, multipara, previous abortion experience, and male partner aged under 30.     

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.     

Community Health Worker Knowledge,Attitudes, Practices and Readiness to Manage Intimate Partner Violence

Journal of Community Health - Intimate partner violence (IPV) is an important public health concern with higher prevalence among women. Community health workers (CHWs) are trusted frontline public...     

The Anatomy of a Community Health Center System-Level Intervention for Intimate Partner Violence

The US Preventive Services Task Force (USPSTF) now recommends screening for intimate partner violence (IPV) as part of routine preventive services for women. However, there is a lack of clarity as to the most effective methods of screening and referral. We conducted a 3-year community-based mixed-method participatory research project involving four community health centers that serve as safety net medical providers for a predominately indigent urban population. The project involved preparatory work, a multifaceted systems-level demonstration project, and a sustainability period with provider/staff debriefing. The goal was to determine if a low-tech system-level intervention would result in an increase in IPV detection and response in an urban community health center. Results highlight the challenges, but also the opportunities, for implementing the new USPSTF guidelines to screen all women of childbearing years for intimate partner violence in resource-limited primary care settings.     

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.     

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.     

Prevalence of Intimate Partner Violence Among Women Visiting Health Care Centers in Palestine Refugee Camps in Jordan

This study was conducted to investigate the prevalence of intimate partner violence (IPV) among a sample of women visiting health care centers in Palestine refugee camps in Jordan. We found that different types of IPV, including physical, emotional, sexual, economic, and control behaviors by the partners were experienced by the participants. This study was among a number of studies that investigated this phenomenon in residents of Palestinian camps. It adds to existing studies in this field, however, as it focuses on the prevalence of the top five types of IPV in these women. Cooccurrence of IPV, that is, experiencing two or more types of partner violence at the same time, was noticed in these women. Experiencing control by one's partner and the presence of different attitudes between men and women toward the use of violence were factors contributing to the occurrence of this phenomenon in these women. National efforts aiming at breaking the cycle of violence should be fostered through media and public awareness campaigns. Changing people's attitudes concerning men's use and women's acceptance of violence should be the aim of these efforts.     

Intimate Partner Violence and the Utilization of Maternal Health Care Services in Nigeria

Our aim in this study is to examine the association between women's lifetime experiences of physical, sexual, and emotional intimate partner violence (IPV) and the use of maternal health care services. We used data from the 2008 Nigeria Demographic and Health Survey. Analysis was based on responses from 17,476 women (for antenatal care [ANC]) and 17,412 (for delivery assisted by a skilled health provider) who had had deliveries in the 5 years preceding the survey. We found an overall IPV prevalence rate of 33.4%. Physical IPV was associated with low use of ANC. Emotionally abused women were less likely to use delivery assistance from skilled health care providers. Based on our findings, we suggest the importance of designing interventions to address the health care needs of women who have experienced violence from their partners.