The Moderating Effects of HIV Relevant Factors on the Relationship Between Intimate Partner Violence and Intention to Start HIV Pre-exposure Prophylaxis (PrEP) Among Cisgender Women

Intimate partner violence (IPV) and HIV are serious and related public health problems that detrimentally impact women's health. Because women who experience IPV are more likely to acquire HIV, it is critical to promote HIV prevention strategies, such as HIV pre-exposure prophylaxis (PrEP), that increase autonomy. This study of cisgender women eligible for HIV PrEP took place between 2017 and 2019 in Philadelphia and New York City. This study aimed to examine the relationship between four types of IPV (control, psychological, physical, sexual) and intention to start PrEP among PrEP-eligible cisgender women and assess the extent to which HIV relevant factors moderated the association between IPV experience and intention to start PrEP. In this sample of PrEP-eligible women (n = 214), 68.7% indicated intention to start PrEP in the next 3 months. Ethnicity was strongly associated with intention to start PrEP, with Hispanic women having the highest odds of intending to start PrEP in the next 3 months. Having a controlling partner significantly predicted intention to start PrEP. Women with more than one sex partner and a controlling partner had higher odds of intending to start PrEP as compared with those who had one or no partners and had no IPV control. These findings point to a need for patient-centered interventions that address the need for safety and autonomy among cisgender, PrEP-eligible women.

Intimate partner violence: psycho-physio-pathological sequelae for defining a holistic enriched treatment

Intimate partner violence (IPV) is a health priority, which worldwide, mainly affects women. The consequences of IPV include several psychophysiological effects. These range from altered levels of hormones and neurotrophins to difficulties in emotion regulation and cognitive impairment. Mounting evidence from preclinical studies has shown that environmental enrichment, a form of sensory-motor, cognitive, and social stimulation, can induce a wide range of neuroplastic processes in the brain which consistently improve recovery from a wide variety of somatic and psychiatric diseases. To support IPV survivors, it is essential to ensure a safe housing environment, which can serve as a foundation for environmental enrichment-based interventions. However, some concerns have been raised when supportive housing interventions focus on the economic aspects of survivors’ lives instead of the emotional ones. We thus propose a holistic intervention in which supportive housing is integrated with evidenced-based psychotherapies which could constitute an enriched therapeutic approach for IPV survivors.

The Association Between Resources, Accessibility, and Female Victim Intimate Partner Homicide at the County-Level in Florida

Limited research has been conducted to understand possible relationships that exist between IPH and access to DV services. The current study adds to the literature by expanding traditional measures of DV services to capture presence, as well as access, and examines the impact on female IPH victimization across 67 Florida counties between 2005 and 2015. Using exposure reduction arguments, we shed light on factors associated with female victim IPH rates and support previous research findings showing a continuation in the disparity of IPH rates between urban and rural areas within county boundaries. We also demonstrate the importance of accessible shelter and safe homes in combating IPV and IPH rates.

COVID-19 Specific Risk Markers for Intimate Partner Violence Perpetration

Intimate partner violence (IPV) rates have grown alongside the sweeping changes, challenges, and transitions necessitated by the onset of COVID-19. The goal of this exploratory study was to examine COVID-19 related risk markers for IPV perpetration. Data were collected from a national sample of 365 U.S. individuals who were in a relationship during August 2020, in the midst of the COVID-19 epidemic. Unadjusted odds ratios were calculated for 27 unique risk markers related to lifestyle changes due to COVID-19, mental health, isolation, financial impacts, and COVID-19 diagnoses. The strongest risk markers for IPV perpetration were feelings of loneliness, followed by anxiety symptoms, perceived stress, fear, boredom, substance use and lifestyle changes. Understanding risk markers associated with an increase in IPV perpetration can aid helping professionals identify individuals who may be at risk for IPV, or target these factors to aid in IPV prevention and intervention efforts.

Rapid Review on the Associations of Social and Geographical Isolation and Intimate Partner Violence: Implications for the Ongoing COVID-19 Pandemic

While the COVID-19 pandemic forced millions of people to stay home and minimize their social contacts, newspaper reports worldwide raised concerns as they reported an increasing rate of intimate partner violence (IPV). One link of the measures enforced to control the pandemic to IPV might be a possible side effect of those measures, namely social and geographical isolation. As there was no scientific data investigating the association of IPV and social and geographical isolation in the context of epidemics or pandemics at the time of conducting this rapid review, we aimed at investigating a broader range of contexts of social as well as geographical isolation and its association with IPV to draw conclusions regarding the COVID-19 pandemic. We searched Embase, PubMed, PsycINFO, and Web of Science (core collection). A research strategy was developed and observational studies were included if they considered men and/or women, estimates of social and geographical isolation, and IPV as a primary outcome. Of the 526 identified studies, 11 were included in this review. The included studies involved 15,695 women and were conducted in the USA, Sweden, Ethiopia, Egypt, Spain, and Turkey. Indicators of social isolation such as lack of social, emotional, or informational support or the frequency and quality of social contacts were narratively assessed. Geographical isolation was primarily assessed by physical distance to the next town or support service. Both social and geographic isolation were found to be associated with an increased risk of IPV. Recommendations made by the individual studies include the following: (a) improving access to social networks outside the victims' own group, (b) improving their economic circumstances, (c) asserting the responsibility for those in contact with the victims, and (d) increasing the focus on access to preventive services and programs need to be taken into account. Therefore, considering the particular infrastructure and legislation of the countries affected by the pandemic, policies need to ensure constant access to shelters and other help services and increase awareness for IPV in the society. In addition, future studies are warranted to assess prevalence rates and risk factors of IPV during the COVID-19 pandemic.

Social Networks and Its Impact on Women's Awareness, Interest, and Uptake of HIV Pre-exposure Prophylaxis (PrEP): Implications for Women Experiencing Intimate Partner Violence

BACKGROUND

In the United States, women represent less than 5% of all pre-exposure prophylaxis (PrEP) users. Social networks may promote and/or inhibit women's PrEP awareness, which could influence PrEP intentions. Furthermore, women experiencing intimate partner violence (IPV) may have smaller, less supportive networks, which could deter or have no impact on PrEP care engagement. This study examined associations between network characteristics and women's PrEP awareness, interest, uptake, and perceived candidacy and analyzed IPV as an effect modifier.

SETTING/METHODS

From 2017 to 2018, data were collected from a prospective cohort study of 218 PrEP-eligible women with (n = 94) and without (n = 124) IPV experiences in Connecticut. Women completed surveys on demographics, IPV, social networks, and PrEP care continuum outcomes.

RESULTS

Adjusted analyses showed that PrEP awareness related to having more PrEP-aware alters. PrEP intentions related to having more alters with favorable opinions of women's potential PrEP use and a smaller network size. Viewing oneself as an appropriate PrEP candidate related to having more PrEP-aware alters and more alters with favorable opinions of women's potential PrEP use. IPV modified associations between network characteristics and PrEP care. Having members who were aware of and/or used PrEP was positively associated with PrEP care engagement for women without IPV experiences but had either no effect or the opposite effect for women experiencing IPV.

CONCLUSION

Improving PrEP attitudes might improve its utilization among women. Social network interventions might be one way to increase PrEP uptake among many US women but may not be as effective for women experiencing IPV.

Possibilities for maintaining a strong self - a grounded theory study of relational experiences among Thai women in Sweden

Background: Due to increasing globalization and Internet communication, the number of international marriages has increased. In Sweden, 75% of the Thai population are women, among whom 80% are partnered with Swedish or other Scandinavian men. Previous studies have indicated that lack of autonomy, social isolation, and stigma are important risk factors for poor mental health for foreign-born women as well as for women in international marriages.

Objectives: To explore what characterizes the processes, choices, challenges and relational conditions that Thai women, partnered with Swedish or Danish men, experience during their first years in Sweden.

Method: A qualitative study using a Constructivist Grounded Theory approach based on fourteen individual interviews with Thai women partnered with Swedish or Danish men and residing in Sweden.

Results: The core category ‘possibilities to maintain a strong self in Sweden’ is linked to five categories characterizing the process that the women go through over time. The subcategories illustrate different paths taken even if there were possibilities to change paths along the way. The women had, for different reasons, reached a turning point that made them leave Thailand. In Sweden, they started in dependency and struggled in different ways to adjust to relational norms and handle prejudice. Toward the end of the timeline, differing ways of recognizing life choices depended on access to social networks and partners’ attitudes.

Conclusion: Our study showed the crucial role of economical, emotional and social support from partners and networks for Thai women’s possibilities to maintain a strong self and good health after migration. This implies a need for supporting Thai women to be more independent by providing access to language education, employment and community involvement. The current requirement for becoming a permanent resident should also be reviewed not to jeopardize women international marriages possibilities’ to leave unhealthy relationships.

Intimate partner violence and psychotic experiences in four U.S. cities

BACKGROUND

A large body of research has established a relationship between trauma exposure, particularly during childhood, and psychotic experiences. Yet, there remains a general lack of research on adult trauma exposure, including intimate partner violence (IPV), as a risk factor for psychotic experiences. The purpose of this study is to investigate the association between IPV and psychotic experiences in U.S. cities.

METHODS

Data were collected from 1615 participants in four U.S. cities. Psychotic experiences were assessed through the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) psychosis screen along with adapted IPV measures.

RESULTS

Findings revealed that experiencing at least one form of IPV was significantly associated with each of the four psychotic experiences assessed for both men and women. The strongest associations were found for threatening and sexual IPV; physical IPV was not significantly associated with psychotic experiences. Exposure to IPV was associated with more than a tripling of the odds of reporting at least one psychotic experience as opposed to none. Among those exposed to IPV there was between three- to five times the odds of reporting specific subtypes of psychotic experiences.

CONCLUSION

The results expand on prior findings linking psychotic experiences and childhood trauma exposure to include intimate adult exposures. Emotional and sexual IPV appear to be associated with elevated risk for psychotic experiences in adulthood. Even though IPV is more commonly reported by women in the U.S., such victimization appears to have similar associations with psychotic experiences regardless of gender.

Mothers' Reentry into Family Life Following Incarceration

The experiences of a group of mothers reentering the community after a period of incarceration are explored. The authors are particularly interested in how incarceration and subsequent reentry influence mothers' family relationships and primary risk and protective factors. Eighty-min interviews are conducted with 28 women probationers who had at least one minor child and had undergone incarceration at least 2 months prior to release. Descriptive analyses reveal that mental health risks characterize many mothers in this study, resource adequacy and parenting stress are significantly related, and family support is an important factor in successful reentry. It also appears that incarceration, even for short periods, is associated with shifts in family configuration on mothers' release by increasing the likelihood of divorce and decreasing the likelihood that mothers will reside with the father of at least one of their biological children. Implications for intervention and directions for future research are discussed.

Within the Bounds: The Role of Relocation on Intimate Partner Violence Help-Seeking for Immigrant and Native Women With Histories of Homelessness

Our study examines the effects of abused women's relocation and recentness to an area on informal and formal help-seeking, and how access to personal and social resources affect these relationships. Secondary data analysis was conducted using a sample of 572 women with histories of abuse and homelessness who were interviewed at shelters in the state of Florida. Findings from nested linear regressions demonstrate that relocation affects formal help-seeking while recentness to an area affects informal help-seeking. Access to personal resources also predicts women's use of both informal and formal resources. Implications for intimate partner violence help-seeking are discussed.

Risk and resiliency factors influencing onset and adolescence-limited commercial sexual exploitation of disadvantaged girls

BACKGROUND

Previous research into age-related variables relevant to girls and young women being involved in commercial sexual exploitation (including prostitution) has not distinguished between its onset and limitation to adolescence and its early onset and persistence into adult life.

AIMS

The aims of this study were to examine variables associated with adolescent versus adult onset of commercial sexual exploitation and identify potential risk and resiliency factors differentiating adolescence-limited sexual exploitation and early-onset-adult persistent exploitation.

METHOD

Interviews with 174 vulnerable mostly African-American women, 23% of whom reported commercial sexual exploitation in adolescence and/or adulthood, yielded data, which were analysed using multinomial logistic regressions.

RESULTS

Adolescent sexual victimisation, younger age at first alcohol/drug use, being a victim of intimate partner violence and sense of stigmatisation of sexual self/others were all variables associated with adolescent onset of commercial sexual exploitation. Educational attainment differentiated adolescence limited from adolescent-adult persistent exploitation; exploitation had ceased by adulthood among over two-thirds of those who completed at least high school education, but only 13% of those exploited into adult life had finished high school.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

As level of education was linked to cessation of exploitation by adulthood, support for vulnerable girls to complete education at least to high school level may be protective.The link between early onset of substance misuse and persistent exploitation suggests that education and support specifically targeted within this field could reduce likelihood of persistent abuse.Work directed at improvement of self-image may also reduce risk of persistent exploitation.

Intimate partner violence and poor mental health among Thai women residing in Sweden

Objectives

The current aim is to examine the prevalence of intimate partner violence (IPV) among Thai women residing in Sweden and its association with mental health. We also investigate the potential influence of social isolation and social capital regarding the association between IPV and mental health outcome.

Design

A public health questionnaire in Thai was distributed by post to the entire population of Thai women, aged 18–64, residing in two regions in Sweden since 2006. Items included aspects related to IPV (physical/sexual/emotional), sociodemographic background, physical health, mental health (GHQ-12), social isolation, and social capital (i.e. social trust/participation).

Results

The response rate was 62.3% (n=804). Prevalence of lifetime reported IPV was 22.1%, with 20.5% by a previous partner and 6.7% by a current partner. Previous IPV exposure was significantly related to current IPV exposure, and all IPV exposure measures were significantly related to poor mental health. However, Thai women experiencing IPV by a current partner were more at risk for poor mental health than Thai women with previous or without any experience of IPV. Also, among all women exposed to IPV, those with trust in others and without exposure to social isolation seemed to have partial protection against the adverse mental health consequences associated with IPV.

Conclusions

Most Thai women had never been exposed to IPV, and after migrating to Sweden, women had lower IPV exposure than in Thailand. However, the increased risk for poor mental health among those Thai women exposed to IPV suggests the need for supportive measures and targeted interventions to prevent further injuries and adverse health consequences. Although poor mental health in Thai women represents an obstacle for integration, the potential resilience indicated in the group with high social trust and without exposure to social isolation suggests that such aspects be included in the program designed to facilitate integration.

Intimate partner violence and drug-addicted women: from explicative models to gender-oriented treatments

Thanks to studies conducted over the past decades, it has been underlined how harmful consumption of alcohol or other substances and intimate partner violence are intertwined. What has been recognized is, in particular, how the relation between these two factors may be represented as a vicious cycle in which each of them influences the other, reciprocally. The aim of this paper is to offer an overview, firstly, about the global and European scenario of the spread of these constructs, delineating, then, the main explanation models that theorize their connection and those risk factors associated with the environmental settings which may play a significant role. The last part, finally, offers some starting points in order to provide efficient multidisciplinary approaches both to prevent and support victims, increasing their mental, physical, and emotional health.

Recent violence in a community-based sample of homeless and unstably housed women with high levels of psychiatric comorbidity

OBJECTIVES

We determined associations between co-occurring psychiatric conditions and violence against homeless and unstably housed women.

METHODS

Between 2008 and 2010, we interviewed homeless and unstably housed women recruited from community venues about violence, socioeconomic factors, and psychiatric conditions. We used multivariable logistic regression to determine independent correlates of violence.

RESULTS

Among 291 women, 97% screened positive for 1 or more psychiatric conditions. Types of violence perpetrated by primary partners and persons who were not primary partners (non-primary partners) included emotional violence (24% vs 50%; P < .01), physical violence (11% vs 19%; P < .01), and sexual violence (7% vs 22%; P < .01). The odds of primary partner and non-primary partner violence increased with each additional psychiatric diagnosis and decreasing levels of social isolation.

CONCLUSIONS

All types of violence were more commonly perpetrated by non-primary partners, suggesting that an exclusive focus on domestic violence screening in health care or social service settings will miss most of the violence in this population. Contrary to some previous studies, the odds of violence decreased as social isolation increased, suggesting that social isolation may be protective in homeless and unstably housed communities with high levels of comorbidity and limited options.

Correlates of victim-blaming attitudes regarding partner violence against women among the Spanish general population

This article analyzes correlates of victim-blaming attitudes regarding partner violence against women (PVAW) among the Spanish general population (N = 1,006). Results showed that victim-blaming attitudes were more common among respondents who were older, less educated, and who placed themselves at the bottom of the social scale. Furthermore, the odds of expressing victim-blaming attitudes were higher among respondents who thought that PVAW was common in society, considered it more acceptable, and knew women victims of partner violence in their circle of friends and family. Implications for public education are discussed.

Revisiting the role of the urban environment in substance use: the case of analgesic overdose fatalities

OBJECTIVES

We examined whether neighborhood social characteristics (income distribution and family fragmentation) and physical characteristics (clean sidewalks and dilapidated housing) were associated with the risk of fatalities caused by analgesic overdose.

METHODS

In a case-control study, we compared 447 unintentional analgesic opioid overdose fatalities (cases) with 3436 unintentional nonoverdose fatalities and 2530 heroin overdose fatalities (controls) occurring in 59 New York City neighborhoods between 2000 and 2006.

RESULTS

Analgesic overdose fatalities were less likely than nonoverdose unintentional fatalities to have occurred in higher-income neighborhoods (odds ratio [OR] = 0.82; 95% confidence interval [CI] = 0.70, 0.96) and more likely to have occurred in fragmented neighborhoods (OR = 1.35; 95% CI = 1.05, 1.72). They were more likely than heroin overdose fatalities to have occurred in higher-income (OR = 1.31; 95% CI = 1.12, 1.54) and less fragmented (OR = 0.71; 95% CI = 0.55, 0.92) neighborhoods.

CONCLUSIONS

Analgesic overdose fatalities exhibit spatial patterns that are distinct from those of heroin and nonoverdose unintentional fatalities. Whereas analgesic fatalities typically occur in lower-income, more fragmented neighborhoods than nonoverdose fatalities, they tend to occur in higher-income, less unequal, and less fragmented neighborhoods than heroin fatalities.

Public Responses to Intimate Partner Violence Against Women: The Influence of Perceived Severity and Personal Responsibility

This paper explored public willingness to act when exposed to cases of intimate partner violence against women, by analyzing the influence of perceived severity and personal responsibility on two types of responses: mediating and reporting to the police. Results (N = 419) yielded main effects of personal responsibility for both types of responses. No main effects of perceived severity were found. A significant interaction between perceived severity and personal responsibility was found only for reporting responses. Results are discussed in light of the helping behavior research tradition. Implications for public education and advocacy programs are also considered.

Experiencing violence as a predictor of drug use relapse among former drug users in Baltimore, Maryland

The purpose of this study was to examine experiencing violence as a predictor of subsequent drug relapse among a sample of former crack, cocaine, and heroin users in Baltimore, MD, USA. The sample consists of 228 former drug users in Baltimore who were recruited through street outreach. Mixed-effects models were used to examine experiencing violence as a predictor of drug relapse at follow-up after adjusting for clustering of responses among participants living in the same census block. Using longitudinal data, we found that experiencing violence in the past year predicted drug relapse at 2-year follow-up among former drug users. Results indicate experiencing violence is a determinant of drug use relapse and highlight the importance of addressing the fundamental issues of violence experienced in inner-city communities. Addressing the extent of recent violence among drug treatment participants, providing coping skills, and reducing community violence are strategies that may address the link between violence and drug relapse.

Violence, drug markets and racial composition: challenging stereotypes through spatial analysis

Places in which there is a strong spatial connection between violence and drug activity can often evoke particular stereotypes. They are believed to be places marked by high levels of social disorganisation, unemployment, disorder and racial heterogeneity. Yet scholars have argued that the spatial relationship between drug market activity and violence is more complicated and that other factors may explain this geographical connection. In the first article of this two-part series, different types of spatial analysis were employed to describe crime concentrations of drugs and violence. Evidence was found that challenges the notion that places with drug activity are inevitably more violent. This second paper examines what factors predict these variations in drug–violence spatial patterns in Seattle when derived using different spatial methods. The findings indicate that racial composition, disorder and unemployment may not be as salient as once believed in predicting places that are violent drug markets.

Intimate Partner Violence and Social Isolation Across the Rural/Urban Divide

Intimate partner violence (IPV) is a pervasive social problem that affects victims, families, and communities. Beginning with the acknowledgment of this phenomenon as a social problem, investigations have attempted to answer questions regarding the extent, prevalence, and the possible contributing social and psychological factors that influence this behavior. This study proposes an approach to the problem of IPV based on a unifying concept: social isolation. The authors argue that the utility of the concept of social isolation lies in its ability to encapsulate critical social-structural and social-psychological correlates of IPV. The main objective of the study is to examine the extent to which the role of social isolation in predicting IPV varies by urban/rural context. Measures of key variables were obtained from Waves 1 and 2 of the National Survey of Families and Households and the 1990 census. Results of multivariate analyses indicate that only some measures of social support (isolation) are statistically significant and only for families within rural (nonmetropolitan) counties.

Nowhere to go: how stigma limits the options of female drug users after release from jail

BACKGROUND

Drug and alcohol using women leaving prison or jail face many challenges to successful re-integration in the community and are severely hampered in their efforts by the stigma of drug or alcohol use compounded by the stigma of incarceration.

METHODS

This qualitative study is based on individual semi-structured interviews and focus groups with 17 women who had recently left jail about the challenges they faced on reentry.

RESULTS

Our analysis identified three major themes, which are related by the overarching influence of stigma: survival (jobs and housing), access to treatment services, and family and community reintegration.

CONCLUSION

Stigma based on drug use and incarceration works to increase the needs of women for health and social services and at the same time, restricts their access to these services. These specific forms of stigma may amplify gender and race-based stigma. Punitive drug and social policies related to employment, housing, education, welfare, and mental health and substance abuse treatment make it extremely difficult for women to succeed.