Attitudinal Acceptance of Intimate Partner Violence and Mental Health Outcomes for Female Survivors in Sub-Saharan Africa.

Reine-Marcelle Ibala,Lindsay Stark,Ilana Seff

doi:10.3390/ijerph18105099

Abstract

While current literature evidences a strong association between gender-based violence exposure and adverse mental health outcomes, few studies have explored how attitudinal acceptance of intimate partner violence (IPV) might impact this relationship. This analysis employed data from 13–24-year-old females as part of the Violence Against Children Surveys in Nigeria, Uganda, and Malawi. Mental health status, defined by the Kessler Screening Scale for Psychological Distress, and suicide ideation served as outcome measures. Predictors of interest included lifetime experiences of IPV and attitudinal acceptance of IPV. Country-stratified logistic and ordinary least squares regressions were used to predict outcomes and included interactions between violence exposure and attitudinal acceptance of IPV. Violence exposure was associated with increased symptoms of mental distress and increased suicide ideation in all countries. Among those who experienced IPV, exhibiting attitudinal acceptance of IPV was associated with improved mental health in Nigeria and Malawi. IPV tolerance conferred lower odds of suicide ideation following IPV exposure in Nigeria. The findings suggest that programs aiming to reduce attitudinal acceptance of IPV must consider how these changes may interact with women’s exposure to IPV.

Highlights

Violence exposure varied across contexts, with approximately 15% of girls in Uganda and Malawi reporting ever exposure to intimate partner violence (IPV), compared to 8.9% in Nigeria
This study explores the impact of attitudinal acceptance of IPV on adverse mental health outcomes in IPV-exposed adolescent girls aged 13 to 24 in sub-Saharan Africa
Among adolescent girls exposed to IPV in Nigeria and Malawi, those who expressed attitudinal acceptance of IPV exhibited decreased symptoms of mental distress as defined by the Kessler 6 Scale, compared to survivors who did not exhibit attitudinal acceptance of IPV

Summary

Introduction

Gender-based violence (GBV) is a globally pervasive phenomenon that poses exacerbated risks of mental distress, substance use disorder, sexually transmitted infection, and death for women and girls [1]. According to the World Health Organization (WHO), one in three women globally has been a victim of physical and/or sexual violence by intimate partners and/or sexual violence by non-partners [2]. Perpetration of GBV transcends socioeconomic, educational, religious, and cultural lines, its prevalence is especially pronounced in sub-Saharan Africa, where accounts of intimate partner violence (IPV) amongst ever-married/partnered women aged 15–49 years old, for instance, supersede worldwide averages by 22% [3,4]. While low- and middle-income countries (LMICs) carry a greater burden of GBV, research on human rights violations in these settings, especially for adolescent girls, disproportionately lags behind efforts in high-income countries [3,5]

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