Narratives of intimate partner violence practiced against women

Research was conducted with women aged 15 to 49 living in an economically vulnerable area of the Brazilian state capital on the experience of victims of Intimate Partner Violence (IPV). The study adopted a qualitative technique called Collective Subject Discourse. During the interviews in their homes between February and July, 195 women reported incidents of violence throughout their lives. The discourses were grouped by similar violence using the CSD technique and organized into 7 major categories based on 395 key words; i) IPV Engineering (N = 114; 58.5%); ii) Rape of vulnerable sex (N = 77; 39.5%); iii) Silent or silenced violence (N = 43; 21%); iv) Years of Suffering (N = 43; 21%); v) New time despite the suffering (N = 39; 20%); vi) Talking about violence (N = 35; 18%); Violence is a language (N = 34; 17.4%). Three reports with the highest prevalence, entitled "IPV Engineering," are presented in full in this work. The narratives of violence revealed show the strength of vulnerability and abuse suffered by women and the existence of multiple dynamics of violence in intimate affective relationships.     

Community-level correlates of intimate partner violence against women globally: a systematic review

Intimate partner violence (IPV) against women is a problem facing women around the world, one that has implications for women's health and well-being. The relationship between communities and the occurrence of IPV is an expanding area of research. Although a large number of community characteristics have been examined in relation to IPV, the research as a whole lacks a coherent theoretical focus or perspective. In this systematic review, we provide a comprehensive synthesis of the evidence regarding the community-level correlates of IPV against women. In our review of peer-reviewed research published between January 1, 1990 and January 31, 2011, we identify key community-level correlates, detect gaps, and offer recommendations for future research. Recognizing a difference in approach between U.S. and non-U.S. based research and an over-reliance on a primarily urban, U.S.-based perspective on communities and IPV, we advocate for a global perspective that better reflects the social and economic fabric of communities around the world. Specifically, future research should focus on the most promising, but currently under-studied, community-level correlates of IPV against women, namely gender inequality, gender norms, and adapted measures of collective efficacy/social cohesion.     

Intimate partner violence against women in Maputo city,Mozambique

Background

There is limited research about IPV against women and associated factors in Sub-Saharan Africa, not least Mozambique. The objective of this study was to examine the occurrence, severity, chronicity and “predictors” of IPV against women in Maputo City (Mozambique).

Methods

Data were collected during a 12?month-period (consecutive cases, with each woman seen only once) from 1,442 women aged 15–49?years old seeking help for abuse by an intimate partner at the Forensic Services at the Maputo Central Hospital, Maputo City, Mozambique. Interviews were conducted by trained female interviewers, and data collected included demographics and lifestyle variables, violence (using the previously validated Revised Conflict Tactics Scale (CTS2), and control (using the Controlling Behaviour Scale Revised (CBS-R). The data were analysed using bivariate and multivariate methods.

Results

The overall experienced IPV during the past 12?months across severity (one or more types, minor and severe) was 70.2% (chronicity, 85.8?±?120.9).^a Severe IPV varied between 26.3-45.9% and chronicity between 3.1?±?9.1-12.8?±?26.9, depending on IPV type. Severity and chronicity figures were higher in psychological aggression than in the other IPV types. Further, 26.8% (chronicity, 55.3?±?117.6) of women experienced all IPV types across severity. The experience of other composite IPV types across severity (4 combinations of 3 types of IPV) varied between 27.1-42.6% and chronicity between 35.7?±?80.3-64.9?±?110.9, depending on the type of combination. The combination psychological aggression, physical assault and sexual coercion had the highest figures compared with the other combinations. The multiple regressions showed that controlling behaviours, own perpetration and co-occurring victimization were more important in “explaining” the experience of IPV than other variables (e.g. abuse as a child).

Conclusions

In our study, controlling behaviours over/by partner, own perpetration, co-occurring victimization and childhood abuse were more important factors in “explaining” sustained IPV. More investigation into women’s IPV exposure and its “predictors” is warranted in Sub-Saharan Africa, particularly Mozambique.

     

Different predictors of intimate partner and natal family violence against women

BackgroundViolence against women is often studied in the context of violence from intimate partners. However, women receive violence from a wider range of individuals—such as their natal kin—including their siblings, parents, uncles and cousins. Applying insights from evolutionary theory, we examine whether cousin marriage, which has been hypothesized to both reduce the risk of partner violence but increase the risk of natal family violence, associates differently with each type of violence. Second, we test whether common risk factors for partner violence, such as wealth, associate similarly with natal violence.MethodologyWe analyse over 16 000 Jordanian women from three cohorts of the Jordan Demographic Health Surveys. Predictor variables include type of cousin marriage (patrilateral or matrilateral), education, wealth, number of children, urban living and polygyny. Outcome variables include whether a woman’s husband or her natal family has ever been physically violent towards her.ResultsBeing married to a patrilateral cousin but not a matrilateral cousin is associated with a reduced risk of reporting intimate partner violence (IPV). By contrast being married to a matrilateral cousin but not a patrilateral one is associated with a reduced risk of reporting natal family violence. As expected, wealth is negatively associated with reporting partner violence, but we find no association with reports of natal family violence. Finally, individuals with more children are more likely to report IPV.Conclusions and implicationsFindings indicate the importance of distinguishing between types of cousin marriage and highlight substantial differences in risk factors for intimate partner compared to natal family violence.Lay SummarySociodemographic risk factors, such as wealth, may associate differently with intimate partner and natal family violence. Results suggest that whether cousin marriage is protective of violence may depend on the type of cousin and secondly, that violence can have fitness relevant outcomes.     

Prevalence of intimate partner violence against women in regions of Brazil

OBJECTIVE: To analyze the results from the "WHO Multi-country Study on Women's Health and Domestic Violence", on the prevalence of intimate partner violence against women found in Brazil. METHODS: This cross-sectional study was part of the "WHO Multi-country Study on Women's Health and Domestic Violence against women", which was carried out in ten countries between 2000 and 2003. All the countries used a standardized structured questionnaire, devised for this study. In order to obtain data from contrasting settings within each country, the biggest city and a rural region were investigated whenever feasible. A representative sample of women aged 15 to 49 years was selected from the city of S?o Paulo and 15 municipalities in a rural region of the northeast, the Zona da Mata de Pernambuco. The study included 940 women from S?o Paulo and 1,188 from Zona da Mata de Pernambuco who had had an intimate partner at some time in their lives. Violence was classified as psychological, physical and sexual types, and was analyzed in relation to overlapping, recurrence of episodes, severity and when it occurred. RESULTS: The women in S?o Paulo and Pernambuco respectively reported the following at least once in their lifetimes: psychological (N=383; 41.8% and N=580; 48.9%); physical (N=266; 27.2% and N=401; 33.7%); sexual (N=95; 10.1% and N=170; 14.3%) violence. There was significant overlapping among the types of violence, which seemed to be associated with the most severe types of violence. The greatest single type was psychological violence, in S?o Paulo and Pernambuco (N=164; 17.5% and N=206; 17.3%), and the smallest was sexual violence (N=2; 0.2% and N=12; 1.0%). CONCLUSIONS: The results show that violence is a very common phenomenon. The findings reiterate previous international studies results with regard to high magnitude and overlapping of types of intimate partner violence.     

Health care interventions for intimate partner violence: what women want.

OBJECTIVE: We sought to determine what women want from health care interventions for intimate partner violence (IPV) and understand why they found certain interventions useful or not useful. METHODS: We conducted interviews with 21 women who have a past or current history of intimate partner violence. Participants were given cards describing various IPV interventions and asked to perform a pile sort by placing cards into three categories ("definitely yes," "maybe," and "definitely no") indicating whether they would want that resource available. They were then asked to explain their categorizations. RESULTS: The pile sort identified that the majority of participants supported informational interventions and individual counseling. Only 9 of 17, however, felt couple's counseling was a good idea with seven reporting it was definitely not useful. Half wanted help with substance use and treatment for depression. Interventions not well regarded included "Receiving a follow-up telephone call from the doctor's office/clinic" and "Go stay at shelter" with only 7 and 5 of the 21 women placing these cards in the "definitely yes" pile. "Health provider reporting to police" was the intervention most often placed in the "definitely no" pile, with 9 of 19 women doing so. The women described several elements that affected their likelihood of using particular IPV interventions. One theme related stages of "readiness" for change. Another theme dealt with the complexity of many women's lives. Interventions that could accommodate various stages of "readiness" and helped address concomitant issues were deemed more useful. Characteristics of such interventions included: 1) not requiring disclosure or identification as IPV victims, 2) presenting multiple options, and 3) preserving respect for autonomy. CONCLUSIONS: Women who had experienced IPV described not only what they wanted from IPV interventions but how they wished to receive these services and why they would chose to use certain resources. They advised providing a variety of options to allow individualizing according to different needs and readiness to seek help. They emphasized interventions that protected safety, privacy, and autonomy.     

Intimate partner violence and women of color: a call for innovations

In this commentary, we focus on violence against women of color. Although African American women experience higher rates of intimate partner homicide than White women, the cumulative rates for nonfatal intimate partner violence are similar and do not vary between urban and rural locations (though access to services may vary by location). Much of the research about intimate partner violence is based on women with low socioeconomic status and on interventions that were developed by and for White women. Current primary prevention strategies focus on violence that is perpetrated by strangers rather than their primary perpetrators--intimate partners. We recommend the development and rigorous evaluation of prevention strategies that incorporate the views of women of color and attention to primary prevention.     

Intimate partner violence against women and healthcare in Australia: charting the scene

Intimate partner violence against women is a common problem in all countries and generates a challenging agenda for the health sector. Exchanging experiences between different countries, specifically strategies to respond to this problem, can constitute a tool for stimulating debate and promoting reflection. The scope of this article is to present and reflect on aspects of the Australian health sector response to intimate partner violence, and chart the scenario that surrounds this issue. We draw on a range of methods, combining a literature review and a dialogue with different stakeholders and site visits. We describe historical, contemporary and conceptual aspects of healthcare responses to intimate partner violence in Australia. Further we present some of the strategies, public policies and innovative projects that have been developed in this field in Australia. Some of the strategies include: screening vs. case-finding; primary care approaches for dealing with all family members; respect for diversity; and new randomized trials aiming for sustainable health system change for enhanced health professional care of people experiencing intimate partner violence. Despite the limitations of this approach to such a complex theme, we hope to stimulate thinking and discussion.     

Intimate partner violence against women: experiences from a woman-focused development programme in Matlab, Bangladesh

This paper explores the association between microcredit-based development programmes and domestic violence against women perpetrated by their husbands. A sub-set of cross-sectional data collected in 1999 from 60 BRAC-ICDDR,B study villages in Matlab, Bangladesh, was used. Data were analyzed to characterize group-level differences among study women regarding the reported occurrence of violence (physical and/or mental) and to identify its predictors. About 17.5% of women had experienced violence from their husbands in the past four months, the proportion being greater among BRAC households (p = 0.05). Results of logistic regression identified age, schooling, age of household head, and self-rated poverty status of household as important predictors of violence, but not level of BRAC membership. The study concludes that the greater level of domestic violence reported during the initial stages of BRAC membership subsided with the introduction of skill-development training among participant women over time.     

Healthcare utilization and costs for women with a history of intimate partner violence

OBJECTIVE: To determine the healthcare utilization and medical care costs of women with a history of intimate partner violence (IPV) compared to women without a history of IPV. DESIGN: Longitudinal cohort study. SETTING: Mixed-model health maintenance organization. PARTICIPANTS: Over 3000 (3333) women aged 18 to 64 years with > or = 3 year's cumulative enrollment prior to the survey, at least 1 year of which was after the 18th birthday. MAIN EXPOSURE: IPV since age 18 as determined from responses to telephone interview using questions from the Behavioral Risk Factor Surveillance System and also the Women's Experience with Battering Scale. OUTCOME MEASURES: Healthcare utilization and costs (from automated data) during the time that IPV occurred and following its cessation, compared to healthcare utilization for women who did not report IPV since age 18. RESULTS: A total of 1546 women reported IPV in their lifetime; at the time of interview, IPV had ceased in 87% of women, on average 16.0 years prior to interview. Healthcare utilization was higher for all categories of service during IPV compared to women without IPV, and decreased over time after cessation of IPV. However, healthcare utilization was still 20% higher 5 years after women's abuse ceased compared to women without IPV. Adjusted annual total healthcare costs were 19% higher in women with a history of IPV (amounting to $439 annually) compared to women without IPV. Based on prevalence for IPV of 44%, the excess costs due to IPV are approximately $19.3 million per year for every 100,000 women enrollees aged 18-64. CONCLUSIONS: Women with a history of IPV had significantly higher healthcare utilization and costs, continuing long after IPV ended. Given its high prevalence, IPV has a major impact on medical care resource utilization and efforts to prevent its occurrence and consequences are clearly indicated.     

Primary prevention of violence against women.

The best mechanisms to prevent violence against women were reviewed in a critical appraisal conducted by the University Health Network Women's Health Program. Several promising primary interventions were identified. These included: educational and policy-related interventions to change social norms, early identification of abuse by health and other professionals, programs and strategies to empower women, safety and supportive resources for victims of abuse, and improved laws and access to the criminal justice system. The policy recommendations emerging from this analysis are presented.     

Somatic consequences of violence against women.

The rapidly growing literature on the somatic, nonpsychiatric effects of violence on women's health is reviewed, including rape, battery, and the adult consequences of child sexual abuse. The sequelae of these victimizations are summarized with consideration of acute effects (genital and nongenital injuries, sexually transmitted disease, and pregnancy), late consequences (chronic pelvic pain and other forms of chronic pain, gastrointestinal symptoms, premenstrual symptoms, and negative health behaviors), and long-term increases in the use of medical services. A recurrent theme across the literature is that the medical treatment of all types of victimized women can be improved by providing attention to the underlying cause of their symptoms. Achievement of this goal requires that physicians identify victimization history and provide access to appropriate support services. Because all forms of violence against women are prevalent among primary care populations, and victimization is clearly linked to health, health care providers cannot afford to miss this relevant history. The article concludes with suggestions for fostering and responding to disclosures of victimization.