Intimate Partner Violence and Safer Sex Negotiation: Effects of a Gender-Specific Intervention

This study examined the effects of a gender-specific HIV/STD prevention intervention with two dosage levels (four-session, eight-session) among women reporting physical abuse by a current or recent (past year) intimate partner. From 360 women included in the full randomized trial, we conducted subgroup analyses among 152 women who experienced partner physical abuse within the past year. Unprotected vaginal and anal sex occasions and negotiation skills were examined as outcomes. We also assessed whether the intervention increased previously abused women's subsequent risk of physical abuse. Among abused women, those in the eight-session, but not the four-session, intervention decreased their unprotected sex occasions or maintained consistent safer sex at both 1-month (OR = 3.63, 95% CI = 1.50–8.80) and 1-year (OR = 2.88, 95% CI = 1.17–7.10) postintervention. In the short-term, abused women in both the four- and eight-session groups had a greater odds of using an alternative strategy (e.g., refusal, outercourse, or mutual testing) and of having a safer sex discussion with their partners relative to their controls, and they scored higher on intention to negotiate safer sex. The intervention did not increase or decrease the incidence of subsequent abuse during the 1-year follow-up period. A gender-specific intervention that focuses on negotiation skills in the context of potentially abusive partners benefits, and does not appear to harm, recently abused women.     

Gender Attitudes,Sexual Risk,Intimate Partner Violence,and Coercive Sex Among Adolescent Gang Members

Purpose

Adolescent gang members are at greater risk of poor sexual health outcomes than nongang members. Gang members' beliefs about gender may explain variation in their sexual health outcomes. The purpose of this study was to examine how gangs' and gang members' beliefs about gender are associated with sexual health outcomes, including sexual risk-taking, intimate partner violence, and coercive sex.

Gender Norms and Age-Disparate Sexual Relationships as Predictors of Intimate Partner Violence,Sexual Violence,and Risky Sex among Adolescent Gang Members

Unequal gender norms and age-disparate sexual relationships can lead to power imbalances and are also associated with intimate partner violence (IPV), sexual coercion and violence, and sexual risk behaviors. The present study examined these variables from both victim and perpetrator perspectives among adolescent gang members. Age-disparate sexual relationships were defined as sex partners 5 or more years older among female participants and 5 or more years younger among male participants. Participants were recruited from a mid-sized Midwestern city and completed a 60–90-min audio computer-assisted self-interview in a community-based setting. Participants in this study included 107 female gang members (68 % African-American, 19 % Latina; mean age, 17.6) and 169 male gang members (62 % African-American, 28 % Latino; mean age, 17.7). As hypothesized, endorsing unequal gender norms toward women was significantly related to IPV victimization among female participants and perpetration among male participants, and engagement in group sex in the past month among both female and male participants (ps?<?0.05). Additionally, unequal gender norms were significantly related to male participants’ perpetrating rape (p?<?0.05). As hypothesized, female gang members who had been in age-disparate sexual relationships were significantly more likely to have experienced more IPV and report being raped and males gang members who had age-disparate sexual relationships were significantly more likely to perpetrate IPV in the past year and perpetrate rape (ps?<?0.05). Age-disparate sexual relationships were also significantly related to being gang raped among female gang members and participating in a gang rape among male gang members, and engaging in group sex among both female and male gang members (ps?<?0.05). Female participants who had been in age-disparate sexual relationships were more likely to have been pregnant (ps?<?0.05). It is essential for researchers and public health practitioners to create programs for female adolescents to reduce or avoid risky situations, such as inability to negotiate condom use with older sex partners. Additionally, programs must be developed for both female and male gang members to help them understand and identify unequal gender norms, and interpersonal and sexual coercion/violence. Early intervention will also be necessary as these adolescent gang members are already engaged in extremely high-risk, coercive, and violent behaviors.     

An Exploration of Maternal Intimate Partner Violence Experiences and Infant General Health and Temperament

Objectives While the women’s health consequences of intimate partner violence have received much research attention, less is known about how maternal abuse experiences affect infant health and well-being. Existing studies have also been unable to examine specific types of intimate partner violence such as psychological aggression, physical abuse, and sexual coercion. This secondary data analysis explored the prevalence, patterns, and types of intimate partner violence within a large cohort of mothers and explored the relationship between maternal intimate partner violence experiences and infant’s general health and temperament at 1 year of age. Methods Existing data were drawn from the Fragile Families and Child Wellbeing study which collected data through surveys conducted shortly after the infant’s birth (baseline) and at 1 year of age (follow-up). Records from 4,141 mothers recruited from 75 hospitals, in 20 cities, in the US were used. Bivariate and multivariate regression analyses were conducted. Results Results show high rates of intimate partner violence. Maternal reports of any intimate partner violence at baseline or follow-up were both significantly associated with increased odds of less than excellent infant general health and difficult temperament. Independent examination of psychological, physical, and sexual abuse revealed differential relationships between the types of intimate partner violence and infant health outcomes. Conclusions Results from this study contribute to our understanding of the infant health threats associated with maternal intimate partner violence experiences. Additional research addressing the complex relationship between maternal abuse experiences and infant health and specific intervention implications is warranted.     

Intimate Partner Violence Among Men Having Sex with Men,Women, or Both: Early-Life Sexual and Physical Abuse as Antecedents

Little is known about the prevalence of intimate partner violence (IPV) among men who have sex with men (MSM) or about childhood adversity as a predictor of IPV among MSM. Studies have documented high rates of childhood sexual abuse among MSM. To evaluate associations of early-life sexual and physical abuse with IPV among African American heterosexual men or MSM, prevalence of early-life (≤21 years) sexual and physical abuse was measured among 703 nonmonogamous African American men. Men were classified as (1) MSM who disclosed male sex partners; (2) MSM who initially denied male sex partners but subsequently reported oral-genital and anal-genital behaviors with men; (3) non-MSM. MSM who initially disclosed male sex partners reported significantly (P < 0.0001) higher rates of early physical abuse (36%) and lifetime abuse (49%) compared with non-MSM (15 and 22%), respectively. These MSM reported significantly higher rates of sexual abuse by age 11, age 21, and over a lifetime compared with non-MSM (P < 0.0001). Being an MSM who initially disclosed male sex partners (OR: 2.1; 95% CI: 1.2, 3.6) and early-life sexual abuse (OR: 2.8; 95% CI: 1.8, 4.3) was associated with IPV victimization in current relationships. Similarly, being an MSM with early-life physical and sexual abuse was associated (0.0004 ≤ P ≤ 0.07) with IPV perpetration. Early-life physical and sexual abuse was higher among MSM who disclosed male sex partners compared with heterosexual men; however, all MSM who experienced early-life abuse were more likely to be IPV victims or perpetrators.     

Evaluation of the Responsible,Engaged, and Loving (REAL) Fathers Initiative on Physical Child Punishment and Intimate Partner Violence in Northern Uganda

Violence against women and violence against children in Uganda are recognized as significant public health concerns. Exposure to violence at home as a child can increase the likelihood of perpetrating or experiencing violence later in life. These two forms of violence share similar risk factors and often, but not always, co-occur at the household level. Parenting programs have shown promise in reducing physical child punishment. Targeting men has also been proven effective in transforming attitudes related to gender roles and expectations and intimate partner violence (IPV) against women. The REAL Fathers Initiative is a 12-session father mentoring program implemented by volunteers that is designed to reduce child exposure to violence at home, breaking the cycle of intergenerational violence. Evaluation results comparing survey data among men exposed to the intervention and those unexposed demonstrate significant reductions in IPV at end line (aOR 0.48, CI 0.31, 0.76, p?<?0.001) and over the longer term follow-up (aOR 0.47, CI 0.31, 0.77, p?<?0.001) and significant reductions in physical child punishment at long-term follow-up (aOR 0.52, CI 0.32, 0.82, p?<?0.001).     

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 and HIV Risks: A Longitudinal Study of Men on Methadone

Whereas research has suggested that drug-involved men are at disproportionately high risk of engaging in transmission risk behaviors for HIV and of perpetrating intimate partner violence (IPV) against women, only a few cross-sectional studies have examined the relationship between IPV and HIV/sexually transmitted infection (STI) transmission risks among heterosexual, drug-involved men. This study builds on previous cross-sectional research by using a longitudinal design to examine the temporal relationships between perpetration of IPV and different HIV/STI transmission risks among a random sample of 356 men on methadone assessed at baseline (wave 1), 6 months (wave 2), and 12 months (wave 3). The findings indicate that (1) perpetration of IPV in the past 6 months at wave 1 was associated with having more than one intimate partner, buying sex, and sexual coercion at subsequent waves and that (2) noncondom use, injecting drugs, and sexual coercion at wave 1 were associated with subsequent IPV. The temporal relationships between perpetration of IPV and HIV risks found in this study underscore the need for HIV prevention interventions targeting men on methadone to consider IPV and HIV risks as cooccurring problems.     

Women's Participation in Research on Intimate Partner Violence: Findings on Recruitment,Retention, and Participants' Experiences

BackgroundResearch on intimate partner violence (IPV) faces unique challenges to recruitment and retention. Little is known about successful strategies for recruiting and retaining in research women who have experienced IPV, and their experiences of research participation.PurposeThis article presents findings on recruitment, retention, and research participation experiences from a longitudinal observational study of IPV among women receiving care through the Veterans Health Administration.MethodsAdministrative tracking data were analyzed to identify strengths, challenges, and outcomes of multiple recruitment strategies for an observational study of women patients who had experienced past-year IPV. Qualitative interviews with a purposively selected subset of the larger sample were used to identify motivations for and experiences of study participation.ResultsOf the total sample (N = 169), 92.3% were recruited via direct outreach by the research team (63.3% via letter, 29.0% in person), compared with provider or patient self-referral (3.6% and 4.1%, respectively); 88% returned for a follow-up assessment. In qualitative interviews (n = 50), participants expressed a desire to help others as a primary motivation for study participation. Although some participants experienced emotional strain during or after study visits, they also expressed perceiving value in sharing their experiences, and several participants found the experience personally beneficial. Participants expressed that disclosure was facilitated by interviewers’ empathic and neutral stance, as well as the relative anonymity and time-limited nature of the research relationship.ConclusionsDirect outreach to women Veterans Health Administration patients to participate in research interviews about IPV experience was feasible and effective, and proved more fruitful for recruitment than reliance on provider or patient self-referral. Women who have experienced IPV may welcome opportunities to contribute to improvements in care through participation in interviews.     

An Exploratory Analysis of Intimate Partner Violence and Postpartum Depression in an Impoverished Urban Population

Research on the relationship between intimate partner violence (IPV) and postpartum depression (PPD) is limited. Numerous antecedents and consequences of both IPV and PPD are noted in the literature; however, understanding the mechanisms by which intimate partner violence impacts the postpartum mood are not clearly understood. This study utilized retrospective chart reviews from a pediatric/perinatal social work outreach program to explore urban minority women experiences with IPV and depression both during pregnancy and after. Findings do not suggest a direct relationship between IPV and PPD; however, there was a high co-occurrence of prenatal depression and PPD. The severity of IPV appears to influence the occurrence and acuity of prenatal depression suggesting an indirect relationship. Implications for health and social work practitioners are discussed.     

Alcohol Outlets,Neighborhood Characteristics,and Intimate Partner Violence: Ecological Analysis of a California City

Neighborhood indicators of social disadvantage, such as poverty and unemployment, are associated with intimate partner violence (IPV). Despite the well-established link between heavy drinking and IPV, few studies have analyzed the contribution of alcohol outlet density to the occurrence of IPV. Greater numbers of alcohol outlets in a community may be a sign of loosened normative constraints against violence, promote problem drinking among at-risk couples, and provide environments where groups of persons at risk for IPV may form and mutually reinforce IPV-related attitudes, norms, and problem behaviors. This study used ecological data to determine if alcohol outlet density (number of bars, restaurants serving alcohol, and off-premise outlets per unit area) is related to rates of IPV-related police calls and IPV-related crime reports in Sacramento, California. Separate analyses for IPV calls and crime reports were conducted using Bayesian space–time models adjusted for area characteristics (poverty rate, unemployment rate, racial/ethnic composition). The results showed that each additional off-premise alcohol outlet is associated with an approximate 4% increase in IPV-related police calls and an approximate 3% increase in IPV-related crime reports. Bars and restaurants were not associated with either outcome. The findings suggest that alcohol outlet density, especially off-premise outlets, appear to be related to IPV events. Further research is needed to understand the mechanisms by which neighborhood factors, such as alcohol outlet density, affect IPV behaviors. Understanding these mechanisms is of public health importance for developing environmental IPV prevention strategies, such as changes in zoning, community action, education, and enforcement activities.     

Intimate Partner Violence and Safety Strategy Use: Frequency of Use and Perceived Effectiveness

BackgroundThere is a need for effective interventions that enable women in current or past violent relationships to reduce their risk of revictimization. One approach that can be taken is safety planning, where advocates and women talk about strategies that theoretically increase the women's safety. Although this process is common, there is little empirical research focusing on the effectiveness of the safety strategies.MethodsThis systematic review examines the frequency with which women report using safety strategies and their effectiveness at reducing risk of revictimization.ResultsNine studies reviewed confirm prior research, namely, that women in intimate partner violence situations are using a variety of safety strategies at varying frequencies to protect themselves. Results from two studies looking at whether use of safety strategies reduces a woman's risk of future violence provide modest support for a greater risk of revictimization among women who used resistance strategies. Seven studies examined the perceived helpfulness of the strategies. Women who involved other individuals reported that interaction as helpful. There are several limitations to this review, including the focus on perceived helpfulness. What is reported here is not an objective assessment of safety strategy effectiveness. We were also not able to determine whether strategies women reported using were actually discussed during safety planning.ConclusionThere is a dearth of literature focusing on the effectiveness of safety strategies. Women and advocates talk about safety strategies we know very little about. Additional research examining the consequences of using safety strategies is needed because what is known now is preliminary and limited.     

Child Abuse,Risk in Male Partner Selection,and Intimate Partner Violence Victimization of Women of the European Union

The revictimization of women during the life cycle has attracted the interest of many researchers in recent years. In this study, we examined the relationship between the experience of child abuse and the subsequent victimization by a male partner in adulthood. Specifically, we proposed that childhood abuse experiences negatively affect the development of healthy interpersonal relationships in adulthood. Thus, some female victims of child abuse are more likely to select potentially abusive intimate male partners. Data from 23,863 heterosexual women from the 28 countries of the European Union who were living with their partners at the time of the study were used. We investigated the association between child abuse, partner’s adherence to traditional gender roles, and general violence and intimate partner violence (IPV) against women. Multilevel structural equation modeling (MSEM) results indicated that child abuse is positively related to the partner’s traditional gender role and general violence, which in turn predict IPV. Countries’ level of human development was found to affect this process. We found support for the hypothesis that child abuse is related to IPV partially because it influences partner selection in adulthood. Thus, when they become adults, girls abused in childhood tend to select partners who are either traditional or generally violent. There is a persistent influence of social structural conditions (i.e., country’s human development) throughout this process.     

Disability,Gender and Intimate Partner Violence: Relationships from the Behavioral Risk Factor Surveillance System

Research on women with disabilities has found that the most common perpetrators of violence were current or former intimate partners (Young et al. Arch. Phys. Med. Rehabil. 78, S34–S38, 1997; Riddington, Beating the “odds”: Violence and Women with Disabilities (Position Paper 2). 1989). This article examines intimate partner sexual and physical abuse experienced by women with disabilities compared to women without disabilities and men with and without disabilities through chi square analysis and regression analysis using data from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). Results show that women with disabilities experienced almost twice the rate of all forms of abuse compared to the other populations. Variables increasing the likelihood of abuse include being female, disabled, not employed, uncoupled and younger age. Implications for future research, screening and intervention for rehabilitation professionals are discussed.     

Intimate Partner Violence,Parental Divorce,and Child Custody: Directions for Intervention and Future Research*

Abstract: Joint custody and cooperative coparenting are often unsafe for women who leave violent partners. Although certain legal protections are available, more work is needed to understand and address abused women's needs in this context. This study provides divorce scholars and practitioners with information on the interface between separation/divorce and intimate partner violence. We review existing research, policies, and programs and propose directions for intervention and research that center around the unique needs of these families.     

Maternal Intimate Partner Violence: Relationships with Language and Neurological Development of Infants and Toddlers

Objectives This longitudinal study examined the influence of Intimate Partner Violence (IPV) experience of pregnant women participating in the Domestic Violence Enhanced Home Visitation Program on the language and neurological development of infants and toddlers. Methods A total of 210 infants and toddlers born to women reporting low, moderate, and high levels of IPV were included in the analysis. Logistic regression analysis was used to determine the bivariate association between maternal IPV and risk of language and neurological delay of infants and toddlers and between covariates and language and neurological delay. Generalized estimating equation models with logit link was used to predict the risk of language and neurological delay of infants and toddlers as a result of maternal IPV. Results Infants and toddlers born to women exposed to moderate levels of IPV had increased odds of language delay compared to infants and toddlers of women who experienced low levels of violence (OR 5.31, 95 % CI 2.94, 9.50, p < 0.001). Infants and toddlers born to women who experienced moderate and high levels of IPV were at higher risk of neurological delay respectively, compared to infants and toddlers of women who experienced low levels of IPV (OR 5.42, 95 % CI 2.99, 9.82, p < 0.001 and OR 2.57, 95 % CI 1.11, 5.61, p = 0.026). Conclusions for Practice Maternal IPV is associated with increased risk of language and neurological delay of infants and toddlers. These findings have implications for health care for women and infants exposed to IPV. Clinicians including pediatricians working with pregnant women should screen for IPV throughout pregnancy to identify women and children at risk. Interventions to reduce maternal IPV and early intervention services for infants and toddlers exposed to IPV are necessary for optimal maternal and child health.     

Intimate Partner Violence,Maternal Stress,Nativity, and Risk for Maternal Maltreatment of Young Children

Objectives. We examined the associations of intimate partner violence (IPV) and maternal risk factors with maternal child maltreatment risk within a diverse sample of mothers.Methods. We derived the study sample (N = 2508) from the Fragile Families and Child Well-Being Study. We conducted regression analyses to examine associations between IPV, parenting stress, major depression, key covariates, and 4 proxy variables for maternal child maltreatment.Results. Mothers reported an average of 25 acts of psychological aggression and 17 acts of physical aggression against their 3-year-old children in the year before the study, 11% reported some act of neglect toward their children during the same period, and 55% had spanked their children during the previous month. About 40% of mothers had experienced IPV by their current partner. IPV and maternal parenting stress were both consistent risk factors for all 4 maltreatment proxy variables. Although foreign-born mothers reported fewer incidents of child maltreatment, the IPV relative risk for child maltreatment was greater for foreign-born than for US-born mothers.Conclusions. Further integration of IPV and child maltreatment prevention and intervention efforts is warranted; such efforts must carefully balance the needs of adult and child victims.Nearly 900 000 cases of child maltreatment were substantiated in the United States in 2005; 63% of these children were reported to be victims of neglect and 17% were reported to be victims of physical abuse.¹ Children 3 years and younger have the highest rate of victimization (16.5 per 1000).¹ Child maltreatment jeopardizes the physical, mental, social, and behavioral health of children in both the short and long terms,^2–25 and when considered cumulatively with other adverse childhood experiences, child maltreatment raises the risk of health problems such as alcoholism, drug abuse, smoking, sexually transmitted disease, obesity, and heart disease.^26–29A majority of parents in the United States report using corporal punishment, such as spanking, with their children^30–32; past-year prevalence rates seem to peak when the child is aged 3 or 4 years.³² Corporal punishment is an important risk factor for physical child maltreatment,³³ increases risk for psychiatric morbidity as an adolescent or adult,³⁴ and is banned in the home in 23 countries.³⁵ A meta-analysis found that corporal punishment was associated with decreased moral internalization and mental health for the child, decreased quality of the parent–child relationship, and increased childhood and adulthood aggressive, delinquent, criminal, and antisocial behavior.³³Most child maltreatment victims (83%) are abused by a parent.¹ In the plurality of cases, the mother is acting alone (40%). She is acting with the father 17% of the time and with someone else 6% of the time; fathers act alone in roughly 18% of cases.¹ This high prevalence of maternal child maltreatment is primarily because of exposure opportunity (i.e., mothers generally spend more time with their children than does any other person). However, fathers and father surrogates who perpetrate intimate partner violence (IPV) may play an important role in raising the risk for child maltreatment. Maternal stress,^36–38 maternal depression,^39,40 and unwanted or unintended pregnancy^41,42 are all associated with both child maltreatment and IPV victimization.⁴³ Increased child maltreatment risk among mothers who are IPV victims may be explained by increased stress, depression, or unintended pregnancy resulting from IPV.Physical and psychological IPV co-occur in homes with identified child maltreatment at a median rate of about 40%.⁴⁴ Among a nationally representative sample of investigated child maltreatment cases, the past-year prevalence of IPV was 29% and the lifetime prevalence was 45%.⁴⁰ A longitudinal study found that the presence of IPV raised the odds of subsequent child maltreatment by 2 to 3 times; however, the study examined a specialized sample of mothers who were participants in a child abuse prevention program, examined few covariates, and was unable to separate out the effects of some possible confounders such as parenting stress and depression.⁴⁵Ethnic variations in rates^1,46 and consequences of child maltreatment⁴⁷ and IPV^48,49 suggest a need to continue to assess the nature of such differences (e.g., the rate of child maltreatment victimization is nearly twice as high among Black children as it is among Hispanic or White children).¹ This variation may arise from sociocultural factors such as social norms regarding the acceptance or use of violence, socioeconomic factors such as income or educational level, or other factors related to ethnicity.⁵⁰ Examination of ethnic and nativity differences in maltreatment may help to identify those who are most vulnerable and, in time, to develop a better understanding of the roots of these patterns.Our primary aim was to assess the unique contribution of maternal IPV victimization to maternal child maltreatment risk in a diverse, population-based sample by asking (1) is maternal IPV victimization associated with risk for maternal child maltreatment even after control for potentially confounding maternal risk factors such as parenting stress, depression, and consideration of abortion; (2) are these maternal risk factors associated with maternal child maltreatment even after control for IPV; and (3) is ethnicity or nativity associated with maternal child maltreatment after control for other relevant covariates, such as income and education?