Testing evolutionary conflict theories for sexual and physical intimate partner violence in Sub-Saharan Africa

Intimate partner violence (IPV) refers to physical, sexual and psychological violence. Here an evolutionary approach is used to compare risk factors for male-to-female IPV perpetration, analysing physical and sexual IPV separately. Two hypotheses based on sexual conflict theory have been applied to IPV perpetration, but they remain largely untested using empirical data: (a) men perpetrate IPV in response to a perceived threat to their paternity certainty; and (b) IPV is caused by men pursuing a higher fertility optima than their partners, either within marriage (reproductive coercion) or outside marriage (paternal disinvestment). Demographic Health Survey data from couples in 12 sub-Saharan African countries (n = 25,577) were used to test these evolutionary hypotheses, using multilevel models and controlling for potential social and environmental confounds. The results show that evolutionary theory provides important insight into different risk factors by IPV type. Indicators of paternity concern are associated with an increased risk of both physical and sexual IPV, indicators of paternal disinvestment are associated with an increased risk of physical IPV only, while reproductive coercion is not associated with either IPV type. The risk factors identified here correspond with proximate-level explanations for IPV perpetration, but an evolutionary interpretation explains why these particular factors may motivate IPV in certain contexts.

Risk Factors Associated with Intimate Partner Violence against Chinese Women: A Systematic Review

BACKGROUND

The prevalence of intimate partner violence against women in China remains high. Understanding associated risk factors will help inform prevention. The purpose of this systematic review was to identify associated risk factors of intimate partner violence against women in mainland China.

METHODS

Nine English and Chinese databases were searched from 1 August 2008-2 August 2022. Reference lists of relevant studies supplemented the initial results. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence was used to assess article quality. Study results were combined in a narrative synthesis.

RESULTS

Nineteen eligible studies were identified. Examples of key intimate partner violence risk factors included: partner's low education or income, unhealthy habits (gambling), women's marital status, poor health or education, women's or partner's childhood abuse or witnessing thereof at home, or multiple children and husband dominance.

CONCLUSIONS

Despite the significant changes in Chinese policies and the new law, IPV continues, and this review has highlighted vulnerable women who need identification and protection. Further study is needed of individual (e.g., psychological well-being), relationship/family, and society/cultural variables.

Intimate partner violence against ever-partnered women in Europe: Prevalence and associated factors-Results from the violence against women EU-wide survey

Study questions

To describe the prevalence of physical, sexual, and psychological intimate partner violence (IPV) against women in the European Union (EU) and to search for their determinants among demographic, socioeconomic, health-related factors, and partner characteristics.

Methods

Observational study. Data from the violence against women survey, the first study conducted in the EU, which simultaneously measured all dimensions of IPV and many characteristics. The EU Agency for Fundamental Rights randomly conducted face-to-face interviews among the 28 countries with 42,002 women aged 18-74 who resided in the survey country and spoke the language. IPV is defined by a positive answer to at least one question about physical, sexual, or psychological violence perpetrated by a current or ex-partner.

Findings

Among the 40,357 women having already been in a relationship, 51.7% (51.2-52.2) reported having been victims of violence in their lifetime. The prevalence of physical, sexual, and psychological IPV was, respectively, 20.0% (19.6-20.4), 8.4% (8.2-8.7), and 48.5% (48.1-49.0). Women, who were younger, employed, had highly qualified work, had at least one immigrant parent, lived in an urban setting, were unmarried, separated, divorced, widowed, childless, cohabited with a partner, and others over the age of 18, had worse self-perceived health, or a history of violence before the age of 15 were more likely to report IPV. It was the same when their partners had a lower level of education, no work, were home staying, earned less than they did, were involved in 10 years of relationship, were frequently drunk, or were violent otherwise.

Major implication

The lifetime prevalence of reported IPV among women in Europe is high and likely underestimated. The results emphasize the importance of a comprehensive definition of IPV and partners' characteristics. They highlight socioeconomic differences and poorer health status for victims of IPV.

Understanding Formal Responses to Intimate Partner Violence and Women's Resistance Processes: A Scoping Review

Intimate partner violence (IPV) literature addresses the ways in which women oppose violent male partners through acts of "everyday resistance." There is a limited understanding, however, of the relationship between women's resistance and their formal help-seeking in the context of IPV. Our scoping review, which includes 74 articles published in English-language journals between 1994 and 2017, attempts to help fill this gap by developing systematic knowledge regarding the following research questions: (1) How are formal institutional responses discussed within the literature on resistance to IPV? (2) How does institutional help-seeking facilitate or obstruct IPV survivors' personal efforts to resist violence? We find that institutions and organizations succeed in facilitating resistance processes when they counter victim-blaming ideas and provide IPV survivors with shared community and a sense of control over their futures. However, they fall short in terms of helping survivors by expecting survivors to adhere to a rigid narrative about appropriate responses to violence, devoting insufficient attention to individual-level factors impacting survivors' vulnerability and ability to access help, and replicating abuse dynamics when interacting with survivors. Policy and practice implications are discussed.

A scoping review of the healthcare provided by nurses to people experiencing domestic violence in primary health care settings

Background

Domestic and family violence is a significant and growing public health concern in many communities around the world. Nurses are often the first and sometimes only point of contact for people seeking healthcare following DFV incidents and are therefore well placed to identify and support these vulnerable people. The aim of this scoping review is to examine the English language studies of healthcare provided by nurses in primary healthcare settings to people experiencing domestic and family violence.

Methods

A scoping review of the following databases was undertaken between March-June 2021: CINAHL, Medline, and PubMed. Primary studies were included if written in English, published from 2000 onwards, and focused on the care provided by primary healthcare nurses to people experiencing DFV. A critical appraisal of included studies was conducted using the Mixed Methods Appraisal Tool (MMAT). Results were synthesised narratively.

Results

Six studies were included, from the United States (n = 2), United Kingdom (n = 1), Sweden (n = 2), and Brazil (n = 1). Five studies were quantitative and one qualitative. A fundamental aspect of the healthcare provided by nurses, reported by all studies, was the screening of DFV. Other healthcare provided includes physical and mental health assessment and referral to other services, including sexual assault clinics, social supports, and law enforcement agencies. Findings suggest the level of DFV screening conducted by nurses is limited. Nurses' knowledge of how to support people experiencing DFV was also reportedly limited. Two studies reported that nurses were unfamiliar with DFV practice guidelines and the existence and availability of support networks for people experiencing DFV.

Conclusion

Findings suggest inconsistency in primary healthcare nurses' level of education, skill and knowledge, and detection of people experiencing DFV. As the largest healthcare professional discipline, nurses have frequent contact with people experiencing DFV. There is an urgent need for nurses to be better educationally prepared and more organisationally supported in order to adequately respond and provide healthcare to people experiencing DFV. Given that the number of people experiencing DFV has increased due to the COVID-19 pandemic, it is ever more important for nurses to be well equipped to identify and respond appropriately.

Practitioner Experiences with Domestic and Family Violence in COVID-19

The advent of COVID-19 as a global public health crisis in 2020 was quickly followed by predictions regarding likely increases in occurrences of domestic and family violence (DFV). The aim of this study was to understand the impact of the pandemic on practitioner experiences of DFV in one service organisation in New South Wales, Australia. Qualitative focus group interviews were performed with senior practitioners at Relationships Australia (NSW), and a grounded theory approach was employed in formulation of a perspective which highlighted social isolation under public health management social distancing measures as that which distinguished practitioner experiences of DFV during COVID-19. Social isolation was conceived as the overarching factor across categorisations of practitioner responses, including: (a) situations of client domestic relations; (b) client general life circumstances; (c) emerging client self-awareness; (d) organisational and social systems changes; and (e) necessary work practice changes. Organisational and workplace recommendations address the relative difference of pandemic management measures from natural disaster occurrences, with respect to supporting people experiencing DFV.

Association of Exposure to Intimate Partner Violence With Maternal Depressive Symptoms and Early Childhood Socioemotional Development Among Mothers and Children in Rural Tanzania

IMPORTANCE

Approximately 1 in 4 women experience intimate partner violence (IPV) or nonpartner sexual violence during their lifetime. Mothers exposed to IPV are more likely to experience depressive symptoms and to discipline their children harshly, which may affect their children's socioemotional development; however, there is limited evidence on these outcomes.

OBJECTIVE

To examine the association between IPV, maternal depressive symptoms, harsh child discipline, and child stimulation with child socioemotional development.

DESIGN, SETTING, AND PARTICIPANTS

This study used cross-sectional follow-up data collected from February 19 to October 10, 2014, from a birth cohort of children aged 18 to 36 months who were enrolled in a randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation in the Morogoro region of Tanzania. Data analysis occurred between September 10, 2019, and January 20, 2020.

EXPOSURES

Lifetime experience of IPV was assessed using an abbreviated module of the Tanzania Demographic and Health Survey, maternal depressive symptoms were assessed with the Patient Health Questionnaire, and data on harsh child discipline and maternal stimulation of their children were collected using modules of the United Nations Children's Fund Multiple Indicator Cluster Survey.

MAIN OUTCOMES AND MEASURES

Child socioemotional development was measured by the Caregiver-Reported Early Childhood Development Instruments.

RESULTS

A total of 981 mother-child dyads were included in the analytic sample; 388 children (39.6%) were between ages 18 and 24 (mean [SD] age, 27.06 [6.08]) months, and 515 (52.5%) were male children. A negative association was observed between maternal report of physical IPV only (mean difference, -0.022; 95% CI, -0.045 to -0.006) and physical and sexual IPV (mean difference, -0.045; 95% CI, -0.077 to -0.013) with child socioemotional scores, but neither was statistically significant after including depressive symptoms in the model, which is consistent with mediation. Furthermore, a negative association was observed between maternal mild to severe depressive symptoms and child socioemotional development, including adjustment for IPV (mean difference, -0.073; 95% CI, -0.103 to -0.043). Harsh disciplinary practices and stimulation were not associated with child socioemotional development after adjusting for IPV, maternal depressive symptoms, and other factors.

CONCLUSIONS AND RELEVANCE

The findings of this study suggest that maternal depressive symptoms may explain the negative association between IPV and child socioemotional development.

Reaching out to men in ending intimate partner violence: a qualitative study among male civil servants in Ibadan, Nigeria

PURPOSE

The aim of this study was to explore the perceptions of male civil servants in Ibadan, Nigeria about the perpetration of IPV and to document their suggested measures to prevent IPV in our communities in Nigeria.

METHODS

Four focus group discussions were conducted among 36 male civil servants selected from Oyo State Secretariat, Ibadan using purposive sampling technique. Data were transcribed and analysed using thematic approach.

RESULTS

Six major themes were identified; awareness of the forms of IPV, women and men as victims, causes, attitude, consequences as well as the suggested strategies for the prevention of IPV. Physical and psychological abuse were mentioned across the groups. The respondents pointed out that women experience IPV more than men, but that men also experience it. Some respondents stated that physical and psychological abuse against female intimate partners were acceptable in some circumstances according to the societal norms. The negative effects of IPV on physical, mental and social well-being of the individual, families and society were mentioned. Suggested ways of preventing IPV include tolerance and patience which will promote healthy, respectful and non-violent relationships among intimate partners.

CONCLUSION

Considering the perceptions and attitudes of these men to IPV, it is important to reach out to both genders for appropriate preventive and educational intervention in ending IPV among women and men.

Parents' Attitudes Toward Domestic Violence as a Risk Factor for Early Childhood Development: Testing an Actor-Partner Interdependence Model Using UNICEF MICS

Purpose: While the importance of domestic violence has been examined in relation to parenting behaviors and child development, less is known about the link between justifying attitudes toward wife beating and parenting, especially in low- and middle-income countries (LMIC). This study employs an actor-partner interdependence mediation model to examine how parents' justifying attitudes toward violence against women relate to their own (actor effects) and their partners' (partner effects) level of parental involvement, which then influence their preschool children's early development. Method: Using data from mothers, fathers, and children in 16,010 families residing in LMIC that participated in UNICEF's Multiple Indicator Cluster Survey Waves 4-5-6 and a dyadic mediation modeling approach, we have examined the associations between maternal and paternal justification of violence against women, parental involvement, and children's early development. Results: Results revealed that mothers' greater justification of violence against themselves were associated with decreased level of maternal (actor effect) and paternal (partner effect) involvement, while fathers' greater justification of violence against their wives was related to decreased paternal involvement (actor effect). Furthermore, mediation tests indicated that paternal justification of violence was negatively and indirectly associated with early childhood development through paternal involvement. Moreover, maternal justification of violence was negatively and indirectly associated with early childhood development through both maternal and paternal involvement. Conclusion: Mothers' and fathers' justifying attitudes toward domestic violence emerge as a possible risk factor for child development that can be addressed by preventive interventions.

Understanding Women's Resistance to Intimate Partner Violence: A Scoping Review

Scholars widely acknowledge that women oppose male violence and control in intimate relationships. Yet there is limited comprehensive knowledge of how resistance features in intimate partner violence (IPV) research across the social sciences. Our scoping review helps fill this gap, analyzing and synthesizing 74 research articles published in English-language scholarly journals between 1994 and 2017. Our review is guided by the following questions: (1) How is research on IPV and resistance designed and executed? (2) How do IPV researchers define the term resistance? (3) What specific types of resistance do IPV researchers discuss in their work? (4) What policy and practice implications are provided by current literature on women's resistance to IPV? We find that scholarship on resistance to IPV is varied, spanning 10 scholarly disciplines with research samples drawn from 19 countries. Studies overwhelmingly used qualitative data, gathered through a range of techniques. The 42 articles that explicitly or implicitly defined resistance either conceptualized the term in the context of power relations, defined it as a form of agency, or understood resistance as a mechanism of physical, economic, and existential survival. Articles also identify several subtypes of resistance strategies including avoidance, help-seeking, active opposition, violent action, and leaving a violent relationship. In terms of practice and policy, articles identify several ways in which institutions fail to meet women's needs, and recommend training so providers and legal personnel may better assist IPV victims.

Understanding the Body and Embodiment in the Context of Women's Resistance to Intimate Partner Violence: A Scoping Review

Scholars acknowledge that women oppose male intimate partner violence (IPV). Yet there is limited comprehensive knowledge regarding how women's bodies and embodiment, that is, their physical and emotional practices and the cultural and social systems that influence them, figure in this process. Our scoping review helps fill this gap by analyzing and synthesizing 74 research articles published in English-language scholarly journals between 1994 and 2017 to address three research questions: (1) How does existing IPV research conceptualize resistance? (2) To what extent do the body and embodiment appear in this research? and (3) What common themes emerge from investigation of the role of embodiment and the body in the context of IPV? The articles identify several subtypes of resistance strategies including avoidance, help-seeking, violent action, and leaving a violent relationship. The reviewed research also regularly describes women's physical and emotional states in the context of IPV. Only a small number of these texts, however, define or conceptualize embodiment. Our analysis of the manner in which the body figures in women's resistance to IPV yielded four themes: (1) the active body, (2) the injured/constrained body, (3) the interactive body, and (4) the transformative body. We conclude with a discussion of policy and practice implications, such as the need to increase awareness about how institutions enforce embodied norms among victims and use the body to assign blame and/or proffer assistance in the context of IPV.

Adverse adult experiences and health outcomes: Racial and ethnic differences in a low-income sample

Extending research on adverse childhood experiences (ACEs), this study aimed to investigate whether the prevalence of and outcomes associated with adverse adult experiences vary among racial and ethnic subgroups. Survey data were collected from 1566 low-income women in Wisconsin using the Adult Experiences Survey (AES). Ten major adult adversities were assessed, including items that reference an intimate partner or household member (e.g., physical or emotional abuse, substance use) along with other social and economic stressors such as homelessness and discrimination. Adverse adult experiences were highly prevalent overall, but even more so among non-Hispanic Whites than their Black and Hispanic counterparts. The results reinforce prior research on ACEs in low-income populations. Lending further credence to these findings, tests of measurement invariance indicated that the AES demonstrated acceptable configural and scalar invariance across racial and ethnic groups. As expected, greater exposure to adult adversity was significantly related to poorer physical and mental health. These associations manifested cross-sectionally and longitudinally for observed and latent measures of adult adversity-even after controlling for ACEs. Associations between adult adversity and health were not moderated by race/ethnicity. In sum, adverse adult experiences were unequally distributed across racial/ethnic groups, but the consequences associated with adversity appeared to be evenly dispersed.

The Psychosocial Impacts of Intimate Partner Violence against Women in LMIC Contexts: Toward a Holistic Approach

Work on the mental health impacts of intimate partner violence in low-and middle-income countries has focused primarily on clinical disorders such as post-traumatic stress disorder, depression, and substance abuse. This paper analyzes how non-clinical, psychosocial impacts from everyday stressors, particularly economic hardships and concern over one's children, cause extensive suffering and damage women survivors' well-being, influencing the development and expression of clinical disorders. Using a social ecological framework, the paper analyzes how psychosocial impacts arise at multiple levels, including societal levels where social norms often devalue women and privilege men, and how the stressor accumulation increases the harm caused by intimate partner violence (IPV) against women (IPVAW). Drawing on survivors' narratives and studies from diverse low and middle income country (LMIC) settings, including armed conflict and natural disaster settings, the paper underscores the importance of understanding both clinical impacts and the non-clinical, psychosocial impacts, which interact with and complement one another. Recognizing the interplay also between IPVAW and other forms of violence against girls and women, the paper calls for a more comprehensive approach to understanding and addressing the impacts of IPVAW. Recognizing the enormous variety within and across countries that are considered to be LMIC settings, the paper cautions against universalized approaches to understanding the effects of IPVAW and helping to support survivors.

A qualitative study on gender inequality and gender-based violence in Nepal

BACKGROUND

Gender inequality and violence are not mutually exclusive phenomena but complex loops affecting each other. Women in Nepal face several inequalities and violence. The causes are diverse, but most of these results are due to socially assigned lower positioning of women. The hierarchies based on power make women face subordination and violence in Nepal. The study aims to explore participants' understanding and experience to identify the status of inequality for women and how violence emerges as one of its consequences. Furthermore, it explores the causes of sex trafficking as an example of an outcome of inequality and violence.

METHOD

The study formulated separate male and female groups using a purposive sampling method. The study used a multistage focus group discussion, where the same groups met at different intervals. Six focus group discussions, three times each with male and female groups, were conducted in a year. Thirty-six individuals, including sixteen males and twenty females, were involved in the discussions. The study used constructivist grounded theory for the data analysis.

RESULTS

The study participants identify that a power play between men and women reinforce inequality and increases the likelihood of violence for women. The findings suggest that the subjugation of women occurs due to practices based on gender differences, constricted life opportunities, and internalization of constructed differences among women. The study identifies that interpersonal and socio-cultural violence can result due to established differences between men and women. Sex trafficking, as an example of the outcome of inequality and violence, occurs due to the disadvantageous position of women compounded by poverty and illiteracy. The study has developed a concept of power-play which is identified as a cause and consequence of women's subordination and violence. This power play is found operative at various levels with social approval for men to use violence and maintain/produce inequality.

CONCLUSION

The theoretical concept of power play shows that there are inequitable power relations between men and women. The male-centric socio-cultural norms and practices have endowed men with privilege, power, and an opportunity to exploit women. This lowers the status of women and the power-play help to produce and sustain inequality. The power-play exposes women to violence and manifests itself as one of the worst expressions used by men.

Posttraumatic Growth, Centrality of Event, Trauma Symptoms and Resilience: Profiles of Women Survivors of Intimate Partner Violence

The current study used a person-oriented approach to investigate (a) potential distinctive groups of women survivors of IPV based on their posttraumatic growth (PTG), centrality of event, resilience, and posttraumatic stress symptoms (PTSS) patterns, and (b) examine the role of sociodemographic (age, education, work status) and violence related (physical and emotional violence, time since last violence episode, psychological help) factors in distinguishing these groups. The study sample consisted of 421 women survivors of IPV, and latent profile analysis revealed four profiles: "negative impact" (11% of the sample), "positive growth" (46%), "low impact" (18%), and "distressed growth" (25%). Women age, education, received psychological help, frequency of physical and emotional violence, and time since last violence incident significantly distinguished some of the indicated profiles from each other. Findings of this study contribute to the existing literature by identifying different responses to IPV and investigating some of the theoretical assumptions that had not been comprehensively analyzed in the IPV literature. Limitations of the study and implications for future research are discussed.

The Effects of Workplace Support on Workplace Disruptions: Differences Between White and Black Survivors of Intimate Partner Violence

Abuser-initiated workplace disruptions are experienced by women who are in abusive intimate relationships. However, workplace disruptions may be prevented with targeted workplace supports. Using pilot data, this study examined relationships between workplace disruptions and workplace supports. Crosstabulation and Fisher's exact test results were stratified by race to understand potential racial discrimination of survivors. Findings revealed supports are associated with infrequent workplace disruptions for Black women, but White women were extended a wider variety of supports, even with frequent disruptions. Discussion of results is applied to workplaces and policy makers seeking to better support employees experiencing partner violence.

Physical abuse in childhood and intimate partner violence in Peruvian women: A population-based survey, 2019

Intimate partner violence (IPV) is a global health problem and a violation of individual rights. The objective of this study was to assess the association between physical child abuse and current IPV in women of childbearing age in Peru. An analytical cross-sectional analysis of the data from the 2019 Demographic and Family Health Survey was carried out. IPV was constituted by emotional, physical and sexual violence, while physical child abuse was constructed from variables related to physical punishment that women of childbearing age experienced during childhood. Poisson's family generalized linear models were used for the crude and adjusted analyses to determine the association between physical child abuse and IPV. Data from a total of 21,518 women of childbearing age were included. 67.1% of women experienced physical abuse in childhood, while 57.7% experienced intimate partner violence. After adjusting for the characteristics of the woman, the partner or husband, marriage or relationship and the home, it was observed that having experienced physical abuse during childhood increased the probability of experiencing emotional (adjusted prevalence ratio [aPR] 1.15; 95% confidence interval [CI]: 1.09-1.21), physical (aPR 1.33; 95% CI: 1.20-1.47), sexual (aPR 1.57; 95% CI: 1.26-1.96) and any type of violence (aPR 1.15; 95% CI: 1.09-1.21) in adulthood. In conclusion, physical abuse during childhood is a public health issue in Peru. This study shows that women aged 15 to 49 who experienced physical abuse in childhood are more likely to experience intimate partner violence.

The relationship between municipal trainees' attitudes toward violence against women and their gender perceptions

PURPOSE

This study examined the relationship between individuals' attitudes toward violence against women and their perception of gender roles.

DESIGN AND METHODS

This descriptive and cross-sectional study design (n = 635) collected data using the ISKEBE Violence against Women Attitude Scale and the Perception of Gender Scale. Data analyses included descriptive statistics, Pearson's correlation analysis, and multiple linear regression analyses.

RESULTS

About 37.5% of the participants had been exposed to violence. A moderately positive correlation was found between the participants' scores on gender perception and attitude toward violence against women (r = 0.551, p < 0.000).

PRACTICE IMPLICATIONS

Women did not approve of violence against women more than men did. Participants with higher education levels and employment had a more negative attitude toward violence against women.

Mental and Physical Health Changes Following an Abusive Intimate Relationship: A Systematic Review of Longitudinal Studies

Longitudinal studies are critical to understanding health changes following trauma. The present systematic review adopted a longitudinal perspective on intimate partner abuse (IPA) by examining characteristics and findings of studies that followed persons who recently left an abusive relationship or who were at a point where they might leave and reported on health over time. Web of Science, EBSCO, Published International Literature on Traumatic Stress, and PubMed databases were searched using combinations of terms reflecting IPA, longitudinal study design, and health outcomes. Quantitative studies that recruited adults or adolescents, had multiple time points, used a health indicator as an outcome, and where IPA was a predictor, independent variable, or inclusion criterion were included. These methods yielded 36 studies from 20 unique samples. The following domains were coded for each article: citation, demographics, risk of bias, sample setting, design, follow-up, relationship and IPA characteristics, outcomes, and analytic focus. Results showed that all samples were female, and most were help-seeking. Depression, post-traumatic stress, and physical symptoms decreased over time, while quality of life increased in most studies. Changes in anxiety symptoms over time were less consistent. Ongoing IPA and social support were the most consistent predictors of health changes over time, showing relations with indicators of poorer or better health, respectively. There was preliminary evidence that decreases in emotional and physical symptoms plateaued within 9 months of the baseline assessment. Sampling, study design, measurement, and analysis are considered, and recommendations for future research are provided.

Past intimate partner violence (IPV) predicts incident IPV during pregnancy and postpartum in pregnant women in Kisumu, Kenya

OBJECTIVE

To investigate how identifying factors associated with peripartum and postpartum intimate partner violence (IPV) may facilitate prioritizing women for psychosocial support.

METHODS

Pregnant women in Kenya were asked about IPV by their current partner at baseline (screening), during pregnancy and at 6 weeks and 6 months postpartum. IPV was defined as being physically hurt or forced to participate in sexual activities or being threatened or frightened by a partner.

RESULTS

A total of 502 women (11.8% HIV-positive) enrolled during pregnancy and were successfully followed for 6 months postpartum, 430 (85.7%) reported never experiencing IPV, 32 (6.4%) reported IPV at least once in their lifetime but not in the past 6 months, and 31 (6.2%) reported IPV in the past 6 months but not in the past month. During pregnancy and postpartum, 61 (12.2%) reported incident IPV. Women who at baseline reported IPV in the past 6 months were at 2.7-fold higher odds of experiencing IPV peripartum and postpartum (odds ratio 2.77; 95% confidence interval 1.17-6.53; P = 0.020) compared with women who had never experienced IPV. This association remained significant in multivariable analysis.

CONCLUSION

Screening for recent IPV during antenatal care visits may be an effective means to identify women at highest risk of IPV and offer targeted prevention interventions.

The Effect of Intimate Partner Violence on the Physical Health and Health-Related Behaviors of Women: A Systematic Review of the Literature

AIM

The long-term effects of intimate partner violence (IPV) on physical health outcomes and health-related behaviors are underresearched in comparison to the effects on mental health and pregnancy. This systematic review examines the recent research in this area from 2012 through 2019.

METHODS

SCOPUS, PubMed, EBSCOhost, and gray literature were searched using the key words "intimate partner violence" and "health." To meet inclusion criteria, studies needed to be original research and focus on IPV during adulthood and its effects on the physical health or health-related behaviors of women. Fifty-two studies were qualitatively analyzed, with results grouped into broad categories of effects, including cardiovascular, endocrine, infectious diseases, and health screening.

RESULTS

IPV was shown to have negative effects on physical health outcomes for women, including worsening the symptoms of menopause and increasing the risk of developing diabetes, contracting sexually transmitted infections, engaging in risk-taking behaviors including the abuse of drugs and alcohol, and developing chronic diseases and pain. It also has significant effects on human immunodeficiency virus outcomes, worsening CD4+ cell depletion. Results varied regarding the effects of IPV on cardiovascular health outcomes.

CONCLUSION

The result of this review demonstrates that women who have experienced violence and abuse are at significantly increased risk of poor health outcomes in a variety of areas and so require specialized and tailored primary care. This review highlights significant gaps in this field of research, particularly in relation to cardiovascular disease, endocrine dysfunction, and neurological symptoms and conditions. It demonstrates a need for additional long-term studies in this field to better inform the health care of women who have experienced IPV and to establish the physiological mediators of these outcomes.

Disclosure of intimate partner violence by men and women in Dar es Salaam, Tanzania

Intimate Partner Violence (IPV) has severe health consequences, though may be underreported due to stigma. In Tanzania, estimates of IPV prevalence range from 12 to >60%. List experiments, a technique of indirectly asking survey questions, may allow for more accurate prevalence estimates of sensitive topics. We examined list experiment and direct questions about experiences of physical and sexual IPV from a 2017 cross-sectional survey among 2,299 adults aged 40+ years in Dar es Salaam. List experiment prevalence estimates were determined through quantitative analysis and compared qualitatively to direct question prevalence estimates. The list experiment estimated a higher prevalence of IPV in all cases except for physical violence experienced by women. This study contributes to the estimation of IPV prevalence. If the list experiment estimates yield an unbiased estimate, findings suggest women openly report experiencing physical IPV, and IPV experienced by men is underreported and understudied.

Latent classes of men’s intimate partner violence perpetration and attitudes towards gender norms: A UN multi-country, cross-sectional study in Asia and the Pacific

Objective

To examine distinct patterns of IPV perpetration and examined gender equitable attitudes as a correlate of these patterns among men from six countries in Asia and the Pacific.

Design

2011–12 UN Multi-country Study on Men and Violence cross-sectional study.

Setting

Households in Bangladesh, Cambodia, China, Indonesia, Sri Lanka and Papua New Guinea.

Participants

10,178 men aged 18–49 years residing in Bangladesh, Cambodia, China, Indonesia, Sri Lanka and Papua New Guinea.

Primary outcomes measure

Our primary outcome was distinct patterns of IPV perpetration which were derived from multilevel latent class analyses.

Results

The odds of being assigned to the Low All Forms of IPV Perpetration class than the High All Forms of IPV Perpetration class was lower for men in the middle tertile group than men in the high tertile group for gender equitable attitudes. The odds of being assigned to the High Emotional IPV Perpetration class than the High All Forms of IPV Perpetration class was greater for men in the low tertile group than men in the high tertile group for gender equitable attitudes. The odds of being assigned to the High Physical/Emotional/Economic IPV Perpetration class than the High All Forms of IPV Perpetration class was lower for men in the low tertile group than men in the high tertile group for gender equitable attitudes.

Conclusions

Gender transformative interventions that use an adaptive, personalized approach to men’s typology of IPV perpetration may be beneficial to reduce violence against for women in the Asia-Pacific region.

Bystanders of intimate partner violence against women and their willingness to intervene: An analysis of secondary data in Spain (2005–2020)

Recent decades have seen a growing acknowledgement of violence against women (VAW) as a serious social and public health problem of epidemic proportions. The prevention of VAW and intimate partner violence against women (IPVAW) has become a priority within this context, and includes various prevention strategies such as social participation and helping behaviors. In different countries, conducting research on help-seeking behavior and bystander intervention in cases of VAW is a common practice, but addressing these issues is much less common in Spain. In this context, the objective of this study is to provide a preliminary estimation of the volume of bystanders in cases of IPVAW in Spain between 2005 and 2020 (since the entry into force of Organic Law 1/2004), their willingness to intervene and, in the case of intervention, the type of helping behavior (real or hypothetical) preferred, using the sources (secondary data) available (specifically, survey data, as the surveys of social perception of gender violence and the 2014 and 2019 macro-surveys, and also administrative data, as the database of reports filed). The data analyzed allow us to determine that, in fact, in the cases of IPVAW there are usually persons within the victim’s inner circle who are firsthand witnesses or have been informed by the victim of the existence of this type of violence, but, although the bystanders generally claim they would engage in an active and supportive response, this is in fact not always the case. These results underscore the need to develop intervention programs aimed at IPVAW bystanders to improve their reaction and contribute to the development of helpful and efficient active responses.

Police are Influenced by Anchoring and Risk When Allocating Resources for Scenario-based Intimate Partner Violence Cases

Sixty-six police officers were given four intimate partner violence (IPV) scenarios to rate for risk of future violence. At the start of the experiment, participants were provided with either a low-risk or high-risk "anchor" scenario of police attending an IPV incident. Next, participants were given three counterbalanced scenarios: high, medium, and low risk. Half the participants were given a structured professional judgment tool to guide their decisions. Participants given the low-risk anchor rated the following scenarios as being of greater risk than those given the high-risk anchor. Participants were consistent in identifying high-, medium-, and low-risk scenarios and the tool made no difference to these ratings. Participants were more confident in their higher risk judgments than their lower risk judgments. Officers distributed a disproportionately high amount of resources to the high-risk offenders and the results suggest that police officers can make decisions consistent with Risk-Need-Responsivity principles. However, anchoring effects and working in a context where violence is more severe and frequent has the potential to bias perceptions and make officers less sensitive to risk.

Wealth Inequality and Intimate Partner Violence: An Individual and Ecological Level Analysis Across 20 Countries

Intimate Partner Violence (IPV) has been linked to poor health. Economic position may be an important risk factor for IPV. We examined the association between economic position and IPV at country and individual levels. We analyzed Demographic and Health Surveys data of 187,716 ever-partnered women between ages 10 and 59 from 20 low- and middle-income countries. We calculated direct age-standardized 12-month prevalence of physical IPV and performed ecological analysis using Gini coefficients and Concentration indexes to assess correlation with 12-month prevalence of physical IPV. We conducted multivariable logistic regression for each country to assess the association between wealth status and physical IPV and a meta-analysis of the regression model to present results across countries. Compared to the Poorest quintile, odds of IPV among wealthier quintiles varied by country. In the Middle quintile, India had significantly reduced IPV (OR 0.75, 95%CI: 0.68-0.83). In the Richer and Richest quintiles, 4 and 6 countries had significant reductions in IPV, respectively. Only Mozambique was found to have significant increased IPV in the wealthiest quintile (OR 2.51, 95%CI: 1.45-4.38). Gini coefficient and physical IPV had a correlation coefficient of 0.502 (p value 0.033), while Concentration index had -0.276 (p value .253). Standardized prevalence for physical IPV ranged from 1.58% to 18.91%. Findings suggest that the relationship between wealth and IPV vary considerably in the included low- and middle-income countries, and that risk of IPV may not necessarily be higher among women in lower wealth brackets. Mozambique was the only country with increased odds of IPV among the Richest group as compared to the Poorest group. This study provides evidence IPV may transcend economic boundaries, and that studies looking at the link between inequality and IPV are paramount for designing adequate preventative policies.

A survey of coping strategies and resilience in women victims of domestic violence during the COVID-19 pandemic in Tehran, 2020

BACKGROUND

Domestic violence against women is a hidden and global epidemic that has many negative effects. The COVID-19 pandemic, quarantine, and staying at home can lead to violent and domestic violence against women. Due to the importance of the subject, the present study was conducted to investigate the coping strategies and resilience of women victims of domestic violence in the COVID-19 epidemic in Tehran, 2020.

METHODS

The present study is a descriptive-analytical study on 420 women who suffered domestic violence in Tehran, 2020. Data collection tools included a demographic information form, socioeconomic status questionnaire, WHO standardized domestic violence questionnaire, Connor-Davidson Resilience Scale, and Endler and Parker's coping strategies questionnaire. This study was based on the Internet and online. The research poster, the characteristics of the participants, the voluntary participation in the study, the confidentiality of the information, and the link to the online questionnaire were made public through Internet networks.

RESULTS

There was no correlation between resilience with general violence (p =.221), types of physical violence (p =.502), psychological violence (p =.178), and sexual violence (p =.386). The results also showed that there was a statistically significant difference between the women who were using or not using a problem-oriented style with physical violence, using or not using an emotion-oriented style with physical, psychological, sexual violence, and using or not using an avoidance style with physical violence among the samples (p < .05).

CONCLUSION

The use of coping strategies leads to a reduction in domestic violence against women during the COVID-19 pandemic. Therefore, designing and implementing training programs to improve coping styles in women can be effective in dealing with such stressful situations and help prevent injuries caused by violence.

Relationship conflict and partner violence by UK military personnel following return from deployment in Iraq and Afghanistan

PURPOSE

Risk of violence by UK military personnel, both towards non-family and family, has been found to be higher post-deployment. However, no UK research to date has attempted to examine relationship conflict and intimate partner violence (IPV) in this period. This study estimated the prevalence of and risk factors for post-deployment relationship conflict and partner violence in UK military personnel.

METHODS

We utilised data on military personnel who had deployed to Iraq and/or Afghanistan (n = 5437), drawn from a large cohort study into the health and well-being of UK military personnel.

RESULTS

34.7% reported relationship conflict (arguing with partner) and 3.4% reported perpetrating physical IPV post-deployment. Males were more likely than females to report relationship conflict. There were similar rates of self-reported physical IPV perpetration among males and females. Among our male sample, factors associated with both relationship conflict and physical IPV perpetration post-deployment included being in the Army compared with the Royal Air Force, higher levels of childhood adversity, higher levels of military trauma exposure and recent mental health and alcohol misuse problems. Being over 40 at time of deployment (vs being under 25) and having deployed in a combat role were also associated with relationship conflict, but not physical IPV perpetration.

CONCLUSIONS

Deployment-related variables and mental health and alcohol misuse problems were found to be key factors associated with post-deployment relationship conflict and IPV. Services providing health or welfare support to military personnel must collaborate with mental health services and consider history of deployment, and particularly deployment-related trauma, in their assessments to improve identification and management of intimate partner violence and abuse in military communities.

Association Between Intimate Partner Violence and Contraceptive Use in India: Exploring the Moderating Role of Husband's Controlling Behaviors

Existing studies show a mixed relationship between intimate partner violence (IPV) and contraceptive use. This study assesses the association between women's exposure to IPV and contraceptive use in India. Furthermore, we aim to determine whether husband's controlling behaviors play a moderating role in the IPV-contraception link. We used nationally representative data from the recent round of the National Family Health Survey (NFHS-4), conducted in 2015-2016. In this study, the use of contraceptives is the outcome variable, categorized into three groups: no/traditional methods, modern methods, and female sterilization. Women's exposure to IPV in the past year is the key exposure of interest. Socio-economic and demographic variables were used as covariates. Multinomial logistic regression models were performed to examine the association between women's exposure to IPV and contraceptive use. Of the total participants (N = 58,891), approximately one in every four women (24.1%) experienced any form of IPV in the past year. Slightly over half (50.8%) reported using either traditional methods of contraception or no contraceptive at all. About 14% of the respondents were using modern methods of contraception and 34.9% had undergone sterilization. After controlling for confounding factors, women who experienced IPV were 8% (95% CI [.87, .99]) less likely to report using modern contraceptives than those who did not face any IPV. Conversely, women who faced IPV were 14% (95% CI [1.09, 1.20]) more likely to undergo sterilization. Furthermore, women who experienced any form of IPV and whose husbands endorse controlling attitudes were 12% (95% CI [.81, .95]) less likely to report using modern contraceptives and 11% (95% CI [1.04, 1.17]) more likely to undergo sterilization. Interventions should be made to prevent violence against women that would increase their ability to choose appropriate contraception methods to avoid unintended pregnancies.

Men's Reflections on Romantic Jealousy and Intimate Partner Violence in Mwanza, Tanzania

Romantic jealousy is a prominent trigger for intimate partner violence. Yet, there are few studies on this relationship in sub-Saharan Africa and none captures men's perspectives. To expand the existing knowledge on romantic jealousy and its relation to intimate partner violence, our study analyzed 30 in-depth interviews with male participants. Triggers of romantic jealousy included suspicion or confirmed infidelity, reduced attention from their partners, and challenges to male supremacy. Men reported that intimate partner violence was a frequently used response to triggers of romantic jealousy. Social norms and inequitable gender norms were key underlying factors to all those triggers.

Assessing Knowledge and Acceptability of a Trauma-Informed Training Model to Strengthen Response to Conflict and Gender-Based Violence in the Democratic Republic of Congo

BACKGROUND

Conflict-related sexual and gender-based violence is common in the eastern Democratic Republic of Congo, but there are few evaluations of multisectoral training interventions in conflict settings. We conducted high-quality, trauma-informed medicolegal trainings amongst multisectoral professionals, and sought to describe changes in knowledge after training and perceived training acceptability.

METHODS

Participants were health, law enforcement, and legal professionals who completed training at one of four sites from January 2012 to December 2018. Twelve trainings were randomly selected for evaluation. We conducted pre- and post-training assessments and semi-structured interviews of participants within 12 months of index training.

FINDINGS

Forty-six trainings of 1,060 individuals were conducted during the study period. Of the randomly selected trainings, 368 questionnaires were included in the analysis (36% health, 31% legal, 12% law enforcement, 21% other). The mean knowledge scores (standard deviation) significantly improved after training: 77.9 (22.9) vs. 70.4 (20.8) (p <0.001). Four key benefits were identified: 1) improved cross-sector coordination; 2) enhanced survivor-centered care; 3) increased standardization of forensic practices; and 4) higher quality evidence collection.

CONCLUSION

Participants completing the training had improved knowledge scores and perceived several key benefits, suggesting the multisectoral training was acceptable in this under-resourced, conflict region.

Intimate Partner Violence and Its Predictors among Pregnant Women in Eastern Ethiopia: Generalized Structural Equation Modeling

Introduction

Intimate partner violence (IPV) has a negative impact on women's physical, mental, sexual, and reproductive health. Identifying the determinant factors of IPV among pregnant women is of paramount importance to overcome its negative consequences thereby increasing the performance of women in all activities. Thus, this study applied a generalized structural equation model (GSEM) to determine the prevalence of intimate partner violence among pregnant women and its predictors in Eastern Ethiopia.

Methods

A community based cross-sectional study was conducted in Kersa Health and Demographic Surveillance System (KHDSS), Eastern Ethiopia. Data were collected form a sample of 1051 pregnant women using structured questionnaires. Descript findings were presented in percentage with 95% confidence interval. The generalized structural equation model was used to determine factors associated with each domain of IPV (physical, emotional, and social violence). Adjusted odds ratio (AOR) with a 95% CI were used to declare significant factors associated with intimate partner violence.

Results

The overall prevalence of IPV in the Eastern Ethiopia was 48.57% (95% CI: 45.45, 51.69). The highest intimate partner violence was observed in the sexual domain of IPV (31.6%, 95% CI: (28.8, 34.58)). In GSEM, being a farmer (AOR = 0.42, 95% CI: 0.19, 0.91) was significantly associated with psychological domain of IPV. Age (AOR = 0.97, 95% CI: 0.95, 0.99) and educational status (neither read nor write) (AOR = 2.50, 95% CI: 1.61, 3.89) were significantly associated with physical domain of IPV. Being in medium (AOR = 0.64, 95% CI: 0.46, 0.90) and rich (AOR = 0.53, 95% CI: 0.36, 0.78), wealth quintiles were significantly associated with sexual domain of IPV, whereas husband controlling behavior was significantly associated with all domains of IPV.

Conclusions

The magnitude of IPV among pregnant women was relatively high in Eastern Ethiopia. This finding pin a light to pay special consideration to pregnant women at each point of service delivery to alleviate consequence of IPV. Being a farmer, older ages and being in higher wealth quintiles were protective factor, whereas being uneducated increase the risk of IPV. Improving socioeconomic status and promoting legal rights of women is needed to alleviate the problem, and younger women require special attention.

Sex and gender differences in mild traumatic brain injury/concussion

The high incidence of concussions/mild traumatic brain injury and the significant number of people with persisting concussion symptoms as well as the concern for delayed, neurodegenerative effects of concussions makes them a major public health concern. There is much to learn on concussions with respect to pathophysiology as well as vulnerability and resiliency factors. The heterogeneity in outcome after a concussion warrants a more personalized approach to better understand the biological and psychosocial factors that may affect outcome. In this chapter we address biological sex and gender as they impact different aspects of concussion including incidence, risk factors and outcome. As well, this chapter will provide a more fulsome overview of intimate partner violence, an often-overlooked cause of concussion in women. Applying the sex and gender lens to concussion/mild traumatic brain injury is imperative for discovery of its pathophysiology and moving closer to treatments.

Predictors of Resilience Among Adolescent Girls and Young Women Who Have Experienced Intimate Partner Violence and Sexual Violence in South Africa

South Africa has some of the highest rates of intimate partner and sexual violence globally, with prevalence ranging from 10% to 21% among adolescent girls and young women (AGYW). Yet, few studies characterize the relationship between violence and resilience. Identifying factors associated with resilience following exposure to violence can guide the development of strength-based interventions that change modifiable protective factors to bolster resilience. Data were derived from a cross-sectional survey of AGYW aged 15 to 24 years in South Africa that took place from 2017 to 2018. This survey was part of a national evaluation of a South African combination HIV intervention for AGYW funded by the Global Fund to Fight AIDS, TB, and Malaria. A sample of 4,399 observations was achieved through a systematic random sampling frame of 35% of households in districts where AGYW were at highest risk for HIV, and where the intervention was implemented. Resilience was assessed using the Connor-Davidson Resilience Scale. Intimate partner and sexual violence were assessed using: (a) an adapted version of a questionnaire from the World Health Organization's 2005 multicountry study on domestic violence against women, and (b) questions on lifetime experience of forced sex/rape. Nearly a third of AGYW (29.6%) reported intimate partner emotional and/or physical and/or sexual violence in the past year. Nearly a quarter of AGYW (23.74%) reported emotional violence, 17.48% reported physical violence, and 6.37% reported sexual violence from intimate partners. Nearly 8% (7.72%) reported forced sex/rape from intimate partners and/or nonpartners. More equitable gender norms, higher social support, and hazardous drinking were positively associated with higher resilience among those who experienced physical or sexual violence. This study addresses a gap in the resilience and violence literature. Future research should focus on the development of resilience-promoting interventions for individuals who have experienced violence.

Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial

Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. To estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams. We also aimed to determine whether improvements in knowledge, skills and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. We conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills and attitude during that follow-up period were greater in intervention teams than in control teams: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. A low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended.

Ugandan Men Exposed to Intimate Partner Violence: A Cross-Sectional Survey of Nationally Representative Data

Although women typically constitute the largest proportion of the population who experience the deleterious effects of intimate partner violence (IPV), understanding the bidirectional nature of IPV is important for developing nuanced prevention initiatives. This study examines data from the 2016 Ugandan Demographic and Health Survey. Participants were selected from households in all the 15 regions in Uganda using a two stage sampling design. A total of 2858 men who were in a heterosexual union or separated/divorced were included in the analysis. Univariate and multivariable logistic regression analyses were performed with the aim of identifying associations between selected demographic variables and male exposure to all forms of IPV combined, psychological violence, physical violence and sexual violence. The prevalence of lifetime IPV and during the 12 months preceeding the survey respectively was 43.6 and 30.5% in all forms, with 35.9 and 24.8% reporting psychological, 20.2 and 11.9% for physical and 8.2 and 5.7% sexual violence. The key factors associated with all forms of IPV were being afraid of their wife/partner most of the time (OR = 5.10, 95% CI 2.91, 8.96) controlling behaviour of the intimate partner (OR = 3.80, 95% CI 2.84, 5.07), bi-directional violence against the partner (OR = 3.20, 95% CI 2.49, 4.12), alcohol consumption by the intimate partner (OR = 1.85, 95% CI 1.40, 2.45). The factors associated with males who experience IPV appear to be modifiable and may warrant consideration for inclusion in programs supporting both males and females who experience IPV.

Social support and intimate partner violence in rural Pakistan: A longitudinal investigation of the bi-directional relationship

A large body of cross-sectional evidence finds strong and consistent associations between social support and intimate partner violence (IPV). However, the directionality of this relationship has not been firmly established due to a dearth of longitudinal evidence. Using cohort study data collected over a 3 year period from 945 women in rural Pakistan, we investigated the longitudinal relationship between IPV and social support. Friend and family social support was measured with the Multidimensional Perceived Social Support Scale, and IPV was measured with questions adopted from the World Health Organization's Violence Against Women Instrument, which was used to construct a measure of IPV severity. We estimated longitudinal associations in linear regression models that controlled for women's educational level, age at marriage, age, household composition, household assets, depressive symptoms, and Adverse Childhood Experiences. We found evidence of a bi-directional, mutually re-enforcing relationship that showed unique associations by type of social support. Specifically, we found that high social support from family, though not friends, decreased IPV severity 1 year later, and that higher IPV severity led to reductions in both friend and family social support 1 year later. Results suggest that interventions involving family members could be especially effective at reducing IPV in this context, and - given that low social support leads to many adverse health outcomes - results suggest that IPV can result in secondary harms due to diminished social support. In summary, our study confirms a bi-directional relationship between IPV and social support and suggests that IPV interventions that integrate social support may be especially effective at reducing IPV and mitigating secondary harms.

Magnitude of Child Sexual Abuse and Its Associated Factors Among Children Treated in Public Hospitals of Addis Ababa Ethiopia

Background

Methods

Results

Conclusion and Recommendations

Frequency, Types, and Manifestations of Partner Sexual Violence, Non-Partner Sexual Violence and Sexual Harassment: A Population Study in Spain

Background: This study analyzes the frequency and sociodemographic characteristics associated with sexual violence by a partner/ex-partner (PSV), someone other than a partner or ex-partner (NPSV), or sexual harassment (SH). Methods: The study is based on the 2019 Macro-survey of Violence against Women conducted by the Spanish Ministry of Equality among a sample of 9568 women age 16 or more years. Odds Ratios were calculated and multinomial logistic regression analyses were performed. Results: Forty-four women had suffered some kind of sexual violence over their lifetime, 9.2% had experienced PSV, 6.5% NPSV and 40.4% SH. More than 7% of women had been raped by a partner and 2.2% by another man. In the three groups, violence was associated with lower age and having a certified disability. NPSV and SH were significantly associated with a higher education and internet use. In NPSV, 9.2% of cases were reported to the police and 3.9% were reported to the courts. In SH, 91.7% of women told a family member or a close friend and 4.2% reported it to the police or the courts. Conclusions: A greater emphasis needs to be placed on reporting sexual violence in its various forms. Rape within intimate partnerships ought to be investigated and studied in greater depth.

Gender, Power, and Health: Measuring and Assessing Sexual Relationship Power Equity Among Young Sub-Saharan African Women and Men, a Systematic Review

Gender inequity, including low sexual relationship power (SRP), is an important determinant of intimate partner violence (IPV) and negative sexual, reproductive, and mental health. Different versions of the Sexual Relationship Power Scale (SRPS) are commonly used within youth studies to examine how gender inequities, including controlling behaviors, in heterosexual relationships impact the lives of young people in sub-Saharan Africa. This review aims to (1) describe definitions and measures of SRP within sub-Saharan African youth studies and (2) review and summarize associations between SRP equity, IPV, and sexual, reproductive, and mental health. After searching Pubmed, Ovid Med, Psych info, Web of Science, Google Scholar, and relevant research forums, 304 papers were identified, of which 29 papers based on 15 distinct studies (published 2004-2019) met our criteria for being youth-specific, conducted in sub-Saharan Africa, and including a quantitative measure of SRP. Details of each SRPS are described, including any adaptations and psychometric properties, as well as associations with IPV, sexual, reproductive, and mental health behaviors and outcomes. Results indicate that there are variations to the SRPS, and a paucity of evidence has detailed the psychometric properties of such measures within sub-Saharan African youth studies. Measures of SRP equity are associated with experiences (among women) and perpetration of (among men) IPV as numerous pathways to HIV risk; however, the evidence remains mixed. In order to address overlapping epidemics of violence against women and HIV, efforts are needed to ensure that measures, including the SRPS, are valid and reliable among highly affected populations.

Are We Asking Too Much of the Health Sector? Exploring the Readiness of Brazilian Primary Healthcare to Respond to Domestic Violence Against Women

BACKGROUND

There is growing recognition of the health sector's potential role in addressing domestic violence (DV) against women. Although Brazil has a comprehensive policy framework on violence against women (VAW), implementation has been slow and incomplete in primary healthcare (PHC), and little is known about the implementation challenges. This paper aims to assess the readiness of two PHC clinics in urban Brazil to integrate an intervention to strengthen their DV response.

METHODS

We conducted 20 semi-structured interviews with health managers and health providers; a document analysis of VAW and DV policies from São Paulo and Brazil; and 2 structured facility observations. Data were analysed using thematic analysis.

RESULTS

Findings from our readiness assessment revealed gaps in both current policy and practice needing to be addressed, particularly with regards to governance and leadership, health service organisation and health workforce. DV received less political recognition, being perceived as a lower priority compared to other health issues. Lack of clear guidance from the central and municipal levels emerged as a crucial factor that weakened DV policy implementation both by providers and managers. Furthermore, responses to DV lost visibility, as they were diluted within generic violence responses. The organizational structure of the PHC system in São Paulo, which prioritised the number of consultations and household visits as the main performance indicators, was an additional difficulty in legitimising healthcare providers' time to address DV. Individual-level challenges reported by providers included lack of time and knowledge of how to respond, as well as fears of dealing with DV.

CONCLUSION

Assessing readiness is critical because it helps to evaluate what services and infrastructure are already in place, also identifying obstacles that may hinder adaptation and integration of an intervention to strengthen the response to DV before implementation.

Factors Associated With Intimate Partner Violence Perpetration and Victimization in Asylum Seeking and Refugee Populations: A Systematic Review

Intimate partner violence (IPV) is a common and serious health and justice problem. Asylum seekers and refugees are generally vulnerable to violence and may be particularly vulnerable to IPV. The aim of this study is to identify factors associated with IPV perpetration and victimization in asylum seeking and refugee populations through a systematic review of the literature. PubMed, Web of Science, Scopus, Embase, Global Health, PsycINFO, Westlaw, and Social Science Research Network databases were searched. Quantitative studies were included according to a population, exposure, outcome framework. Studies were critically appraised with the Joanna Briggs Institute's System for the Unified Management, Assessment and Review of Information tool and quality assessed according to the Grading of Recommendations, Assessment, Development, and Evaluations approach. Meta-analysis was not possible due to heterogeneity. A complex multitude of factors associated with IPV perpetration and victimization in asylum seeking and refugee populations was found. Narrative synthesis of 23 studies showed an inverse association between both perpetrator and victim education level and IPV. Relationship factors, legal status, and age were also important factors associated with IPV. The majority of studies had a cross-sectional design. Heterogeneity in definitions of IPV, sample, methods, statistical procedures, and outcomes was reported. Low education level is a consistent modifiable factor associated with IPV in asylum seeking and refugee populations. This work points to a testable intervention that stakeholders could trial to address the unjust and unhealthy problem of IPV. More and better quality research using standardized definitions, longitudinal design, and sensitive tools is needed in this area.

Intimate Partner Abuse Among Rohingya Women and Its Relationship With Their Abilities to Reject Husbands' Advances to Unwanted Sex

Currently, around a million Rohingya refugees live in Cox's Bazar, Bangladesh. Displacement from homelands and restrictions on movement in the refugee camps may exacerbate intimate partner abuse (IPA) against refugee women and their abilities to reject husbands' advances to unwanted sex. This study examines Rohingya refugee women's attitudes toward and experience of intimate partner abuse (IPA) and their impact on the abilities to reject husbands' advances to unwanted sex. A survey was conducted among Rohingya refugee women in Cox's Bazar, Bangladesh. Women's attitudes toward IPA, and experience of IPA were the exposure variables. Women's abilities to say "no" to husbands' advances to unwanted sexual intercourse was the outcome variable. Multivariable logistic regression models were used to examine the relationships. Participants' median age was 22 years (range: 13-41). Most women perceived hitting/beatings by their husbands in certain situations as justifiable, 72% had experienced such abuse and 56.5% had to engage in unwanted sexual intercourse with their husbands. Women with increasing leniency towards hitting/beatings and those who had experienced such abuse were less likely to be able to say "no" to husbands' advances to unwanted sexual intercourse. Rohingya women's attitudes toward and experience of IPA are associated with their abilities to say "no" to husbands' advances to unwanted sex. Intervention is needed to denormalize the current practice of IPA, create awareness against IPA, and ensure formal education for girls.

Development and Validation of the Economic Coercion Scale 36 (ECS-36) in Rural Bangladesh

Assessing progress toward Sustainable Development Goal (SDG) 5, to achieve gender equality and to empower women, requires monitoring trends in intimate partner violence (IPV). Current measures of IPV may miss women's experiences of economic coercion, or interference with the acquisition, use, and maintenance of financial resources. This sequential, mixed-methods study developed and validated a scale for economic coercion in married women in rural Bangladesh, where women's expanding economic opportunities may elevate the risks of economic coercion and other IPV. Forty items capturing lifetime and prior-year economic coercion were adapted from formative qualitative research and prior scales and administered to a probability sample of 930 married women 16-49 years. An economic coercion scale (ECS) was validated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with primary data from random-split samples (N1 = 310; N2 = 620). Item response theory (IRT) methods gauged the measurement precision of items and scales over the range of the economic-coercion latent trait. Multiple-group factor analysis assessed measurement invariance of the economic-coercion construct. Two-thirds (62.26%) of women reported any lifetime economic coercion. EFA suggested a 36-item, two-factor model capturing barriers to acquire and to use or maintain economic resources. CFA, multiple group factor analysis, and multidimensional IRT methods confirmed that this model provided a reasonable fit to the data. IRT analysis showed that each dimension provided most precision over the higher range of the economic coercion trait. The Economic Coercion Scale 36 (ECS-36) should be validated elsewhere and over time. It may be added to violence-specific surveys and evaluations of violence-prevention and economic-empowerment programs that have a primary interest measuring economic coercion. Short-form versions of the ECS may be developed for multipurpose surveys and program monitoring.

Nearly Half of Women Have Experienced Intimate Partner Violence During Pregnancy in Northwest Ethiopia, 2021; The Role of Social Support and Decision-Making Power

Background

In developing countries, intimate partner violence is increasing alarmingly, though attention to this issue is rarely given. It has devastating effects on the general wellbeing of women, pregnancy outcomes, and the long-term health of children, and this needs to be addressed. Hence, this study was designed to assess intimate partner violence and associated factors in northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted from July 1^st to August 30^th, 2021, among 858 postpartum women in Gondar city. A cluster sampling technique was employed to select the study participants. EPI DATA version 4.6 and SPSS 25 were used for data entry, cleaning and analysis, respectively. A bivariable and multivariable logistic regression model was fitted to identify factors associated with intimate partner violence. The level of significant association was declared using the adjusted odds ratio (AOR) with 95 % confidence interval (CI) and a p-value of ≤ 0.05.

Results

In this study, 48.6% of women indicated having experienced intimate partner violence during pregnancy (95% CI: 45.3, 51.7). The odds of intimate partner violence during pregnancy were significantly higher among women who were not able to read and write (AOR = 4.96; 95% CI: 2.15, 11.41), were private workers (AOR = 1.78; 95% CI: 1.05, 3.02), and had low decision-making power (AOR = 1.43; 95% CI: 1.06, 1.95), a poor social support (AOR = 1.99; 95% CI: 1.32, 3.02), and unsupported pregnancy by family (AOR = 2.32; 95% CI: 1.26, 4.24). Whereas a family size of ≥ 5 (AOR = 0.73; 95% CI: 0.54, 0.98) appeared to be a protective factor for intimate partner violence.

Conclusion

The magnitude of intimate partner violence was unacceptably high in the study area and connected to poor women's empowerment and social determinants of health. Thus, it is important to focus on interventions that improve women's access to social support and allow them to participate in all aspects of household decision-making through community-based structures and networks. It is also important to encourage women to improve their educational status and arrange risk-free employment opportunities.

Creencias sexistas en hombres en situación de suspensión de condena que han ejercido violencia contra las mujeres en la pareja

La violencia contra las mujeres en la pareja es un problema que afecta a la mayoría de las sociedades. Si bien se ha descrito a los hombres que ejercen esta violencia desde el punto de vista clínico, analizar la aceptación de las actitudes sexistas permitiría incorporar la influencia de otras variables contextuales que expliquen el fenómeno desde una perspectiva más amplia. En el presente trabajo se analiza, con una muestra de 121 hombres que han ejercido violencia contra las mujeres, la relación entre la percepción de la violencia como asunto privado y las actitudes sexistas. Los resultados muestran que quienes consideran que la violencia contra la pareja es un asunto privado obtienen puntuaciones más elevadas tanto en el componente hostil como en el benévolo, y que es en la dimensión hostil del sexismo donde se hallan mayores diferencias (t = 4.03; p = .000), con un tamaño del efecto alto (d = 0.75). Identificar la violencia contra las mujeres como un problema social y no como un asunto privado parece ser un paso relevante en las intervenciones para deconstruir las actitudes discriminatorias y erradicar la violencia hacia las mujeres.

Male intake of omega-3 fatty acids and risk of intimate partner violence perpetration: a nationwide birth cohort - the Japan Environment and Children's Study

AIMS

Intake of omega-3 polyunsaturated fatty acids (PUFAs) has favourable effects on reducing aggressive and violent behaviours, but its association with perpetration of intimate partner violence (IPV) is not known. We aimed to determine the association between male intake of omega-3 PUFAs and risk of IPV perpetration.

METHODS

Participants were male-female pairs in the Japan Environment and Children's Study, in which first pregnant women and then their partners were enrolled (analytic sample: n = 48 065). Male intake of omega-3 PUFAs during the past year (preconception to mid/late pregnancy) was determined using a food frequency questionnaire. IPV (physical violence and emotional abuse) during pregnancy was measured using a self-reported questionnaire completed by pregnant women in mid/late pregnancy. Generalised additive mixed-model analysis was used to examine the non-linear association between energy-adjusted male omega-3 PUFA intake and the adjusted prevalence of male IPV perpetration.

RESULTS

A sharply decreasing regression curve was plotted for physical violence, with prevalence starting at 1.35% at the lowest intake level and decreasing to a minimum value of 0.76% at intake of 2.20 g/day (71.7th percentile). However, prevalence largely remained flat from there onward, with the upper limit of the error range not reaching the initial lower limit of the error range until intake exceeded 5.21 g/day (99.77th percentile). For emotional abuse, on the other hand, there was a distorted U- or V-shaped regression curve that rose slightly after reaching a minimum. The prevalence declined from 17.69% initially, reached a minimum at 12.44% at 2.13 g/day (68.3th percentile), and then rose slightly. The lower limit of the error range reached the minimum upper limit at 4.17 g/day (99.1th percentile), and the upper limit finally reached the maximum lower limit value at 4.56 g/day (99.5th percentile).

CONCLUSIONS

In this nationwide birth cohort study, higher male intake of omega-3 PUFAs was associated with lower risk of physical violence and emotional abuse perpetration except for extremely high intake. Our results indicate the potential applicability of omega-3 PUFAs in reducing aggressive and violent behaviours in IPV.Trial registration: UMIN000030786.

Understanding the factors associated with married women's attitudes towards wife-beating in sub-Saharan Africa

BACKGROUND

Intimate partner violence remains a major public health problem, especially in countries in sub-Saharan Africa. We examined the factors associated with married women's attitudes towards wife-beating in sub-Saharan Africa.

METHODS

We used Demographic and Health Survey data of 28 sub-Saharan African countries that had surveys conducted between 2010 and 2019. A sample of 253,782 married women was considered for the analysis. Bivariate and multivariate logistic regression analyses were carried out, and the results were presented using crude odds ratio (cOR) and adjusted odds ratio (aOR) at 95% confidence interval.

RESULTS

The pooled result showed about 71.4% of married women in the 28 countries in this study did not justify wife-beating. However, the prevalence of non-justification of wife-beating varied from 83.4% in Malawi to 17.7% in Mali. Women's age (40-44 years-aOR = 1.61, 95% CI 1.16-2.24), women's educational level (secondary school-aOR = 1.47, 95% CI 1.13-1.91), husband's educational level (higher-aOR = 0.55, 95% CI 0.31-0.95), women's occupation type (professional, technical or managerial-aOR = 1.66, 95% CI 1.06-2.62), wealth index (richest-aOR = 5.52, 95% CI 3.46-8.80) and women's decision-making power (yes-aOR = 1.39, 95% CI 1.19-1.62) were significantly associated with attitude towards wife-beating.

CONCLUSION

Overall, less than three-fourth of married women in the 28 sub-Saharan African countries disagreed with wife-beating but marked differences were observed across socio-economic, decision making and women empowerment factors. Enhancing women's socioeconomic status, decision making power, and creating employment opportunities for women should be considered to increase women's intolerance of wife-beating  practices, especially among countries with low prevalence rates such as Mali.

Intimate partner violence disclosure and associated factors among pregnant women attending a city hospital in South-Western Uganda: a cross-sectional study

Background

Intimate partner violence (IPV) during pregnancy is a public health problem in Uganda that negatively impacts maternal and newborn health outcomes. However, IPVdisclosure and associated factors among pregnant women have remained poorly documented in southwestern Uganda. Therefore, this study determined IPV disclosure and associated factors among pregnant women attending a large City hospital.

Methods

In a cross-sectional design, 283 women attending Mbarara City Hospital Antenatal care (ANC) clinic were consecutively recruited into the study. Data was collected using a semi-structured questionnaire. This was administered by the research team and the exercise took over a month. That is; from 7^th January 2019 to 7^th February 2019. The collected data was entered in STATA, and it was analyzed using chi-square, and univariate logistic regression statistics.

Results

Out of the 283 pregnant women who participated in the study, 199 of them, representing seventy-point three percent (70.3%), had reportedly experienced at least one type of IPV during their current pregnancy. However, nearly fifty percent of those that experienced IPV (49.7%, n = 99) disclosed it to a third party, while the majority disclosed it to their biological family member (66.7%), followed by their friends (55.5%), members of their husband’s family (35.3%), neighbors (12.1%), healthcare providers (9.1%), religious leaders (8.1%), and the police (3.1%). Gravidity, OR = 1.9(95% CI: 1.07–3.31, p = 0.027), parity OR = 1.9(95% CI: 1.08–3.34, p = 0.026) and witnessed IPV OR: 5.4(95% CI: 1.93–14.96; p = 0.001) were significantly associated with IPV disclosure.

Conclusion

A large proportion of the pregnant women who experienced IPV did not disclose it to any third party. In addition to the above, pregnant women's characteristics seem to have a strong influence on IPV disclosure. Therefore, it is important for healthcare providers to routinely screen for IPV during antenatal care if a high IPV disclosure rate is to be achieved.

"Two Hours on a Sunday": Fatherhood Following an Intimate Partner Violence Incident-A Theory of Excision

Fathers who are arrested after an intimate partner violence (IPV) incident must navigate multiple systems, including child welfare, criminal justice and family court, that regulate their interactions with their family members post-arrest. Contact between fathers and their children is highly regulated in the name of safety, often creating lengthy separations and putting strain on already frayed parent-child relationships. While concerns for the safety of victims and survivors of IPV are warranted, there is increased acknowledgement of the important role that fathers, including those with a history of IPV, play in their children's lives. This exploratory study used grounded theory methodology to interrogate how fathers seeking treatment at an abusive partners' program maintained a relationship with their child(ren) and their identities as fathers. Fourteen fathers with experience in the phenomenon of interest completed in-depth qualitative interviews, focus groups, and demographic questionnaires. These data were analyzed along with observational memos to develop a four-stage theory of excision which captured the four stages of routine and effective separation of fathers from their children's lives observed: (a) extraction; (b) re-assignment of identity; (c) exclusion; and (d) what remains. The presence of a single negative case in this study allowed for a discussion of this excision appearing to operate differently along racial lines. The urgent need to redress the institutional racism within these systems that has resulted in extraordinary burden and injustice to families of color is detailed. Implications for policies and practice with families living with IPV are discussed.