Freedom of Movement and Adolescent Sexual Violence in India

Abstract

Background: Adolescent girls face disproportionate risk for sexual violence. Restricted movement is used as protection from sexual violence. Little research has examined whether these issues are actually associated. Methods: We analyzed data from girls aged 15-19 years (n=9,593) taken from India's nationally representative National Family Health Survey 2015-16. We defined freedom of movement using three items that assessed whether girls could go unaccompanied to specified locations; we summated responses and categorized them as fully restricted, moderately restricted or unrestricted. We used multivariable regression to assess associations between restricted movement and a) marital sexual violence among ever-married girls and b) non-marital sexual violence among all girls, adjusting for key covariates. Findings: Only 2% of girls reported non-marital sexual violence, regardless of marital status; among ever married girls, 6% reported marital sexual violence. Most girls (79%) reported some restriction in movement. Restricted movement was negatively associated with non-marital sexual violence (moderately restricted AOR: 0.55, 95% CI: 0.33-0.92; fully restricted AOR: 0.36, 95% CI: 0.12, 1.05, p=.06) but positively associated with marital sexual violence (moderately restricted movement AOR: 4.51, 95% CI: 2.09-9.70). Further analyses highlight that the association between freedom of movement and non-marital sexual violence is an issue specific to urban girls, where the association between freedom of movement and marital sexual violence is an issue for both urban and rural married girls. Interpretation: Approximately one in 30 adolescent girls in India has been a victim of sexual violence. Restricted movement is associated with lower risk for non-marital sexual violence for urban adolescent girls, due to reduced risk for sexual violence exposure or to restricted movement following non-marital sexual violence. Married girls with restricted movement have higher odds of marital sexual violence, possibly because these are both forms of control used by abusive husbands. Funding Statement: BMGF-OPP1179208; NIH-5R01HD084453. Declaration of Interests: The authors declare they have no conflicts of interest. Ethics Approval Statement: The Institutional Review Boards of IIPS and ICF provided ethical approval for NFHS-4 questionnaires, sample design and implementation. The University of California San Diego Institutional Review Board reviewed our planned secondary analysis of these publicly available, de-identified data and deemed the study exempt.