Focusing on the Positive: How Resilience Shapes Risk for Sexual Intimate Partner Violence in 30 Resource-Constrained Countries

Abstract

Combating sexual intimate partner violence (IPV) is one of nine key elements to the World Health Organization’s (WHO) strategy for achieving sexual health for all. To achieve this, the WHO recommends looking beyond the individual to how the socio-economic and demographic norms of the community shape sexual health. Positive deviance analyses do this by studying how an individual’s departure from community norms is associated with improved health outcomes. Sometimes called ‘resilience’, positive deviance analyses have studied sexual health outcomes such as delayed sexarche and increased condom use. However, positive deviance has never been applied to sexual IPV. This study examined how the extent to which a woman differs from her community shapes her risk. Demographic and Health Surveys published since 2010 that included a domestic violence module (n=30 countries, n=350,794 women) The association between positive deviance to 13 community norms and lifetime experiences of sexual IPV was examined using multilevel logistic regression modelling. Subsequent analyses stratified countries by sexual IPV prevalence and Gender Inequality Index score.