Intimate Partner Violence and Sexual Agency in a Nationally Representative Sample of Women and Girls in the Philippines

Investigating the Impact of Reproductive Coercion and Intimate Partner Violence on Psychological and Sexual Wellbeing

Emerging research suggests that reproductive coercion and abuse (RCA), like intimate partner violence (IPV), is associated with poorer mental and sexual health outcomes, including greater symptoms of post-traumatic stress disorder (PTSD) and depression and poorer markers of physical and sexual health such as sexually transmitted infections, unplanned pregnancies and lowered sexual agency. Although victims/survivors of RCA report long-lasting impacts on future relationships, including fear and anxiety, little is known about impacts of RCA on anxiety and general wellbeing, nor emotional and mental components of sexual health that comprise a person's sexual self-concept. With community samples of participants in Australia, we conducted two studies to explore the impact of RCA and IPV on psychological (study 1) and sexual (study 2) health outcomes. Study 1 (n = 368) found that experiencing IPV and RCA both significantly and uniquely contributed to poorer mental health outcomes. After controlling for age and IPV, RCA significantly predicted symptoms of depression, anxiety, stress, PTSD, and reduced satisfaction with life. Study 2 (n = 329) found that IPV and RCA differentially predicted various components of sexual health. IPV predicted decreased sexual satisfaction and increased sexual anxiety, depression, and fear of sexual encounters. After controlling for age and IPV, RCA significantly and uniquely predicted lower levels of sexual assertiveness and increased sexual depression and fear of sexual encounters, but not sexual satisfaction or anxiety. We conclude that RCA is associated with significant psychological distress and a negative sexual self-concept that may impact future relationships. Screening for both IPV and RCA across settings is warranted.

Society's Attitude Toward Spousal Physical Abuse: Findings from the Philippines National Demographic and Health Survey, 2022

Background

Societal attitude toward spousal physical abuse plays a crucial role in preventing violence against women. Yet, this public health issue has been insufficiently addressed. This study examines the relationship between the societal attitude toward spousal physical abuse and various social determinants.

Methods

We used data from the 2022 Philippines' National Demographic and Health Survey. The outcome variable was attitude toward spousal physical abuse. Covariates included women's sociodemographic characteristics, experiences of witnessing their father's abusive behavior, intimate partner violence (IPV), and controlling behavior. Partner-related variables (age, educational level, employment status, and alcohol consumption behavior) were also considered. Descriptive and logistic regression analyses were performed to examine the associated factors of spousal physical abuse by using Stata 18.0.

Results

Overall, 1,920 (9%) of 19,228 women reported that spousal physical abuse is justifiable in at least one of the presented scenarios. Women IPV survivors (adjusted Odds Ratio [aOR] = 1.35, 95% confidence interval [95% CI] = 1.06-1.73) and those who experienced controlling behavior by their partners (aOR = 1.77, 95% CI = 1.45-2.15) were more likely to accept spousal physical abuse than their counterparts. Conversely, women with a higher decision-making score were less likely to accept spousal physical abuse than those who had a lower score (aOR = 0.74, 95% CI = 0.56-0.98).

Conclusions

Finding suggests that women's attitudes toward spousal physical abuse are significantly influenced by their experience of IPV. Future health research, programs, and policies should address individual, interpersonal, and systemic-level risk factors that profoundly impact women's health.

Internet use, exposure to digital family planning messages, and sexual agency among partnered women in Northern Nigeria: implications for digital family planning intervention

Digital health interventions are gaining ground in conflict-affected countries, but studies on their reproductive health benefits for women are scanty. Focusing on conflict-affected northern Nigeria, this study examined the relationships between Internet use, exposure to digital family planning messages via text messages or social media, and sexual agency - measured as the ability to refuse sex and ask a male partner to use a condom - among partnered women including the rural-urban differentials. Partnered women's data (n= 18,205) from the 2018 Nigeria Demographic and Health Survey were analysed using descriptive and multinomial logistic regression analyses. 44.6% of women are able to refuse sex, and 31.4% to ask a male partner to use a condom. Internet use was positively associated with women's ability to refuse sex in the northern region and urban areas, and across the region to ask a male partner to use a condom. It was also positively associated with women's uncertainty about asking a male partner to use a condom. Exposure to digital family planning messages was positively associated with women's ability to ask a male partner to use a condom across the region, in both urban and rural areas. However, exposure to digital family planning messages was negatively associated with women's uncertainty in urban areas about their ability to refuse sex. Implications of these findings for digital family planning interventions are discussed.

Men's Involvement in Sexual and Reproductive Health Care and Decision Making in the Philippines: A Systematic Review of the Literature

Sexual and reproductive health care (SRH) and family planning (FP) services have been primarily female centered. In recent decades, international groups have advocated for men’s involvement in SRH and FP, yet related research remains limited and implementation not fully realized in many countries. This systematic review of literature seeks to summarize the barriers and facilitators to men’s involvement in SRH/FP services in the Philippines. It is limited to publications in English from 1994 to 2021 regarding studies conducted in the Philippines whose research questions focused on men’s involvement in SRH/FP. Eligible studies were assessed for methodological quality using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Evidence Rating Scale. The Ecological Model for Health Promotion was used as the guiding theoretical framework for analysis and to report findings. Barriers and facilitators were identified at every ecological level except that of policy. The most common barrier identified was men’s deficit in knowledge about SRH/FP; the most common facilitator was the positive influence of their social network on men’s attitudes, beliefs, and practices pertaining to SRH/FP. A range of factors from the individual to the community level influenced men’s involvement, including religious beliefs, economic means, and cultural gender roles. More studies are needed to provide a fuller understanding of the multilevel ecological factors influencing men’s involvement in SRH/FP and inform interventions with men that can positively affect their behavior related to SRH/FP decision making.