Lifetime and annual incidence of intimate partner violence and resulting injuries—Georgia, 1995

Objectives. To investigate the prevalence, pattern, and socioeconomic risk factors of intimate partner violence (IPV) before and 6 months after the pandemic onset among a cohort of Iranian women. Methods. We conducted a population-based IPV survey among 2502 partnered Iranian women aged 18 to 60 years before (n = 2502) and 6 months after (n=2116) the pandemic's onset. We estimated prevalence and incidence of psychological, physical, and sexual IPV, and the odds of different forms of IPV associated with main exposure variables, adjusted for participant relationship factors. Results. Pandemic prevalence of IPV (65.4%; 95% confidence interval [CI] = 63.4%, 67.4%) was higher than prepandemic prevalence (54.2%; 95% CI = 52.2%, 56.3%). At follow-up, the incidence of IPV was 25.5% (95% CI = 22.9%, 28.4%). The highest incidence was in cases of physical and sexual IPV. Women whose partners lost their employment were at significant risk of new exposure to IPV. Highest socioeconomic status (SES) was associated with less physical IPV (odds ratio = 0.03; 95% CI = 0.01, 0.14). Conclusions. IPV prevalence has risen since the COVID-19 epidemic began with many women who had never experienced IPV now facing it. Unemployment of women or their partners and prepandemic lower socioeconomic status are risk factors of IPV. Monitoring programs should target these populations. (Am J Public Health. 2023;113(2):228-237. https://doi.org/10.2105/AJPH.2022.306839).

This study examines a hypothesis that has not received adequate scrutiny: that an important proportion of intimate partner violence (IPV) incidents, particularly those that are more serious, involve generalist offenders known to the police. Many criminological theories and empirical studies suggest that offenders are often generalists, yet few IPV studies consider this hypothesis. Based on a sample of 52,149 IPV incidents recorded by police, we found that 31% of IPV incidents involved suspects only with criminal records for non-IPV criminality, 9% involved victims only with criminal records for non-IPV criminality, and 14% involved both suspects and victims with criminal records for non-IPV criminality. Thus, 45% of IPV offenders and 23% of IPV victims had criminal records for non-IPV criminality. Multilevel regression analyses reveal that controlling for prior IPV incidents, community context, and other individual and couple variables, IPV offenders with criminal records are 16% more likely to be involved in more serious incidents, and victims of IPV with criminal records are 17% more likely to be involved in more serious incidents. In addition, IPV incidents for which both suspects and victims had criminal records were 46% more likely to be more serious incidents. These results suggest that generalist criminals known by police have an important impact on the proportion of IPV incidents, particularly the more serious ones.

There are few longitudinal estimates of intimate partner violence (IPV) incidence and continuation. This report provides estimates of IPV incidence and continuation in women receiving health care in clinics participating in an IPV assessment and services intervention study. The Women's Experience with Battering Scale was used in combination with questions addressing physical and sexual assault to annually screen women for IPV. Between April 2002 and August 2005, 657 women in rural South Carolina consented and were screened at least twice. Among those with a current partner (n = 530), the majority (86.2%) had never experienced IPV. Among prevalent victims, IPV continued over time for 37%. IPV continuation rates were higher among older women and those who considered abuse as a problem in their relationship. Of those women who were IPV negative at time 1, IPV incidence at time 2 was 4.2%. A higher score on the Women's Experience with Battering Scale at time 1, a marker of psychological abuse, was a strong predictor of physical IPV incidence (p(trend) = 0.0001). These data suggest that the incidence of IPV over a short follow-up period is relatively low and that the majority of IPV desists over this short follow-up period.

Sexual violence and intimate partner violence are exacerbated by armed conflict and other humanitarian crises. This narrative systematic review of evidence for interventions to reduce risk and incidence of sexual and intimate partner violence in conflict, post-conflict and other humanitarian crises, updates and expands our review published in 2013. A search of ten bibliographic databases for publications from January 2011 to May 2020 used database specific key words for sexual/intimate partner violence and conflict/humanitarian crisis. The 18 papers, describing 16 studies were undertaken in conflict/post-conflict settings in 12 countries. Six intervention types were reported: i) personnel; ii) community mobilisation; iii) social norms; iv) economic empowerment; v) empowerment; and vi) survivor responses, with the most common being economic empowerment (n = 7) and gendered social norms interventions (n = 6). Combined interventions were reported in nine papers. Four studies identified non-significant reductions in incidence of sexual/ intimate partner violence, showing an evident positive trend; all four evaluated gendered social norms or economic empowerment singly or in combination. Evidence for improved mental health outcomes was found for some economic empowerment, social norms and survivor interventions. Some evidence of reduced risk of sexual violence and intimate partner violence was identified for all intervention types. Qualitative studies suggest that experiences of social connection are important for women who participate in programming to address sexual and intimate partner violence. Interventions with multiple strategies appear to hold merit. Achieving and demonstrating reduced sexual and intimate partner violence remains challenging in this context. Future research should continue to explore how social norms interventions can be most effectively delivered, including the impact of including mixed and same sex groups. Work is needed with local partners to ensure programs are contextually adapted.

Intimate partner violence (IPV), defined as physical violence, psychological aggression, sexual abuse, and stalking in current or former intimate relationships, is a public health problem that impacts children and adolescents both directly and/or as collateral victims.1–4 Over 15-million children in the United States are exposed to IPV annually,5 and 6% to 10% of violent pediatric deaths are IPV related incidents.2,3 Firearm presence during IPV encounters increases risk for fatal outcomes fivefold,6 and firearms are the most common mechanism of death during childhood IPV incidents.2–4 Previous work on childhood IPV deaths used the US National Violent Death Reporting System but has not examined incident details that may differ between firearm and nonfirearm childhood IPV deaths.2–4 This work describes characteristics of childhood firearm IPV incident deaths and differences between firearm and nonfirearm childhood IPV deaths with data from an alternative reporting system, the National Fatality Review-Case Reporting System (NFR-CRS), used by child death review teams.Data are from the NFR-CRS for children ages 0 to 18 years-old who died between 2004 and 2020 as reported from 37 states. NFR-CRS development details, variables, and limitations are described elsewhere.7 Childhood IPV incident deaths were included in this sample if the mechanism of death was identified as bodily force or weapon (eg, firearm) and the mechanism intention included IPV. We report descriptive analyses for the child’s demographics, mechanism of death, incident details, and firearm characteristics, as well as unadjusted logistic regressions for bivariate comparisons (ie, odds ratios) of firearm versus nonfirearm childhood IPV deaths. Recognizing race and ethnicity as social constructs and as reported on death certificates, categories were collapsed into white and non-Hispanic versus other, given low counts within other categories. Child maltreatment history, IPV victimization history, open child protective service (CPS) cases, and number of deaths during the incident were not included in bivariate analyses because of substantial missing data (>10%) but are described below. Variables with missing data are noted when applicable and reported percentages or unadjusted logistic regressions exclude missing data. This study was exempt per University of Michigan’s Institutional Review Board.Four-hundred-and-sixty-four childhood deaths from bodily force or weapon were classified as an IPV incident in the NFR-CRS between 2004 and 2020 (Table 1). Within the sample, 43.6% (n = 337-of-464) and 37.1% (n = 170-of-464) of decedents had prior maltreatment or IPV victimization reports, respectively, and 8.0% had open CPS cases at time of death (n = 387-of-464). Firearms were the most common mechanism of death (64.7%). Other mechanisms of death included: bodily force (19.0%), knife or sharp object (17.2%), another weapon (7.1%) (eg, rope), and unknown (1.7%). For childhood firearm IPV incident deaths, handguns were used most often (72.3%), with the primary caregiver (58.3%) often cited as the firearm owner. There were higher overall number of deaths during an incident (n = 361-of-464) when a firearm was used (mean = 3.1) compared with all other mechanisms (mean = 1.8). In bivariate comparisons, children who died in an IPV incident with a firearm compared with another mechanism were more likely to be older, and the person responsible was more likely to be the parent (Table 1).NFR-CRS data demonstrate that firearms are used in most childhood deaths related to IPV incidents. Further, when IPV incidents involve a firearm, more individuals are harmed and parents are often involved relative to incidents involving a different mechanism. Although these findings are supported by previous work,2–4 they highlight that in addition to IPV interventions providing education on safe and healthy relationships, creating safe environments, and providing strategies to leave abusive relationships when safely feasible,8 that these interventions should include components of safe firearm storage counseling and/or discussions about how to limit firearm access (eg, Domestic Violence Restraining Orders). Further, with 8% of decedents in this sample known to have an open CPS case at the time of death and approximately 40% having reports of previous maltreatment and/or IPV victimization, suggests a potential for service agencies to intervene to prevent lethal escalation of family-based violence. Similar to other national reporting systems, limitations to this work largely stem from limitations inherent to the NFR-CRS, including variability in case review by examiners and data accuracy and completeness. To address these limitations, more standardized data collection practices should be implemented. Additionally, future analyses should examine case narratives to provide more context for factors contributing to childhood IPV incident deaths.The authors gratefully acknowledge the states that participate in the NFR-CRS.

Intimate partner violence (IPV) and HIV incidence rise substantially during adolescence. While surveys from African countries suggest that adult men living with HIV were more likely to be perpetrators of IPV, less is known about boys living with perinatal HIV (PHIV). To measure the prevalence and incidence of IPV perpetration between adolescents who acquired HIV perinatally and their HIV-negative peers. Adolescents 15-19 years old, in a sexual or dating relationship, were followed up for 1 year in Soweto, South Africa. We examined prevalence of IPV perpetration using a baseline survey and incidence using weekly prospective mobile phone surveys. Data were collected on emotional, physical, and sexual IPV. Associations between HIV status and IPV were estimated using logistic regression for lifetime and past-year perpetration, and generalised linear mixed models for past 24-h perpetration. Of 498 participants, 251 were living with PHIV, and 247 were HIV-negative at baseline. Lifetime and past-year IPV perpetration were reported by 52% (PHIV 50%, HIV negative 53%) and 34% (PHIV 31%, HIV negative 37%), respectively. Over 12 000 weekly mobile surveys were submitted during follow-up. Participants reported 134 incidences of physical or sexual IPV out of 5032 occasions where the mobile survey coincided with participants seeing a partner. IPV incidence was estimated as three out of every hundred person-days. There was no significant difference in the incidence of perpetration by HIV status. In 3 out of 100 encounters with a partner, physical or sexual IPV perpetration was reported. Boys living with HIV were equally likely to perpetrate violence as HIV-negative boys. Interventions targeted at boys to reduce IPV behaviour should include all adolescents. In boys living with HIV who have regular contact with healthcare providers, there is an opportunity for an intervention to potentially reduce onward HIV transmission.

Exposure to parental violence can have devastating consequences for children, including significant personal, social, and academic problems. The present study determined the situational factors that are associated with children's exposure to intimate partner violence (IPV) incidents. To examine whether these factors were unique to child witnesses' presence at IPV incidents, we also determined the factors that are associated with children's exposure to family violence (FV) and other family member witnesses' exposure to IPV incidents. Participants responded to an online panel survey investigating the role of alcohol and other drugs in family and domestic violence incidents in Australia. Nine hundred fifty-two respondents reported an IPV incident and 299 reported an FV incident; they provided details about their most recent incident. Results showed that child witnesses were more likely to be present during IPV incidents if the incident took place at home (odds ratio [OR] = 3.10), if a similar incident had occurred previously (OR = 1.66), if drugs were involved (OR = 1.60), and if a police report was made (OR = 2.61). There was some overlap with the other witness and violence combinations: The presence of a police report also predicted child witnesses' presence at FV incidents, and a home location also predicted other family member witnesses' presence at IPV incidents. These results enhance our understanding of the situations in which children might witness IPV incidents; future research is needed to determine whether these situational factors can be used to judge risk.

The COVID-19 Pandemic, Socioeconomic Effects, and Intimate Partner Violence Against Women: A Population-Based Cohort Study in Iran

Fathers who are arrested after an intimate partner violence (IPV) incident must navigate multiple systems, including child welfare, criminal justice and family court, that regulate their interactions with their family members post-arrest. Contact between fathers and their children is highly regulated in the name of safety, often creating lengthy separations and putting strain on already frayed parent-child relationships. While concerns for the safety of victims and survivors of IPV are warranted, there is increased acknowledgement of the important role that fathers, including those with a history of IPV, play in their children's lives. This exploratory study used grounded theory methodology to interrogate how fathers seeking treatment at an abusive partners' program maintained a relationship with their child(ren) and their identities as fathers. Fourteen fathers with experience in the phenomenon of interest completed in-depth qualitative interviews, focus groups, and demographic questionnaires. These data were analyzed along with observational memos to develop a four-stage theory of excision which captured the four stages of routine and effective separation of fathers from their children's lives observed: (a) extraction; (b) re-assignment of identity; (c) exclusion; and (d) what remains. The presence of a single negative case in this study allowed for a discussion of this excision appearing to operate differently along racial lines. The urgent need to redress the institutional racism within these systems that has resulted in extraordinary burden and injustice to families of color is detailed. Implications for policies and practice with families living with IPV are discussed.

OBJECTIVE To estimate the incidence and identify risk factors for intimate partner violence during postpartum.METHODS This prospective cohort study was conducted with women, aged between 18-49 years, enrolled in the Brazilian Family Health Strategy in Recife, Northeastern Brazil, between 2005 and 2006. Of the 1.057 women interviewed during pregnancy and postpartum, 539 women, who did not report violence before or during pregnancy, were evaluated. A theoretical-conceptual framework was built with three levels of factors hierarchically ordered: women’s and partners’ sociodemografic and behavioral characteristics, and relationship dynamics. Incidence and risk factors of intimate partner violence were estimated by Poisson Regression.RESULTS The incidence of violence during postpartum was 9.3% (95%CI 7.0;12.0). Isolated psychological violence was the most common (4.3%; 95%CI 2.8;6.4). The overlapping of psychological with physical violence occurred at 3.3% (95%CI 2.0;5.3) and with physical and/or sexual in almost 2.0% (95%CI 0.8;3.0) of cases. The risk of partner violence during postpartum was increased for women with a low level of education (RR = 2.6; 95%CI 1.3;5.4), without own income (RR = 1.7; 95%CI 1.0;2.9) and those who perpetrated physical violence against their partner without being assaulted first (RR = 2.0; 95%CI 1.2;3.4), had a very controlling partner (RR = 2.5; 95%CI 1.1;5.8), and had frequent fights with their partner (RR = 1.7; 95%CI 1.0;2.9).CONCLUSIONS The high incidence of intimate partner violence during postpartum and its association with aspects of the relationship’s quality between the couple, demonstrated the need for public policies that promote conflict mediation and enable forms of empowerment for women to address the cycle of violence.

There are few population-based estimates of the incidence of domestic violence. The 1995 Georgia Women's Health Survey examined the incidence of intimate partner violence (IPV), sociodemographic risk factors, and the likelihood of injury among 3,130 women aged 15 to 44. In random telephone calls, one woman per household …

This study examined whether police involvement in intimate partner violence (IPV) incidents is associated with women's trauma symptoms. Participants were 95 women recruited from domestic violence shelters. Women reported on their trauma symptoms, the frequency of IPV victimization, the use of a weapon during IPV, and police involvement over the year following shelter departure. Police involvement in IPV was associated with higher levels of reexperiencing trauma symptoms 1 year after shelter departure, even after controlling for baseline trauma symptoms, the frequency of IPV, and the use of a weapon during IPV. Women's race and ethnicity did not moderate the results. These findings suggest police involvement in IPV incidents may be associated with higher levels of trauma symptoms experienced by women. Further investigation into law enforcement practices and policies to help reduce women's distress is needed.

Identify the incidence and prevalence of intimate partner violence (IPV) in women over 55 years of age in primary care offices. Telephone survey conducted between March and June 2003 by trained female interviewers who gathered self-report information about health and abuse. A total of 3,636 women over 55 years of age had at least 1 visit in the past 12 months to primary care offices affiliated with an academic center in Southwestern Ohio were contacted by phone; 995 were deemed competent and completed the interview. INTERVENTION/INSTRUMENT: Thirty-eight page instrument that explored health, history of psychological (controlling behavior and threat of physical harm), physical, and sexual abuse since age 55 years. Interviews lasted 20 to 45 min. The mean age was 69 years (SD 8.35). Physical abuse in intimate relationships was reported by 1.52% since age 55 years (prevalence) and 0.41% in the past year (incidence). Prevalence and incidence rates for sexual abuse were 2.14% and 1.12%, threat of physical harm 2.63% and 1.62%, respectively. Less than half of the victims told someone else about the abuse. The mean number of health conditions was 3.84 for victims and 3.21 for nonvictims (P<.055) with significantly larger percentages of IPV victims reporting problems with chronic pain and depression. Physical and sexual abuse by an intimate partner does occur in women over 55 years, but rates are lower than those of younger women. Health care providers are reminded to think about IPV in older women and to ask about abuse as disclosure is rare.

Intimate partner violence (IPV) is associated with suboptimal HIV treatment outcomes, but its distribution and risk factors among certain subpopulations of people living with HIV in resource-limited settings are not well known. We examined the prevalence, incidence, and recurrence of IPV and its association with adverse childhood experiences (ACEs) among pregnant/breastfeeding women living with HIV in Malawi. This study used longitudinal data for 455 pregnant women living with HIV continuously enrolled in the VITAL Start trial. IPV was assessed at baseline and months 1, 6, and 12 using the widely validated WHO IPV survey. Forms of IPV assessed were physical IPV, emotional IPV, and sexual IPV measured as prevalence, incidence, and recurrence. ACE histories were assessed using WHO's ACE International Questionnaire (ACE-IQ) tool. Logistic and log-binomial regressions were used in multivariable analyses that controlled for factors such as depression and alcohol use. Participants' mean age was 27.6 ± 5.7 years. Forty-three percent (43%) reported IPV prevalence, 13% reported IPV incidence, and another 13% reported IPV recurrence, with emotional IPV being the most commonly reported IPV type. Over 96% reported experiencing ⩾1 ACE. In regression analysis, cumulative ACE scores were significantly associated with IPV prevalence and IPV recurrence and in both cases, the magnitude of association was greatest for sexual IPV compared with physical IPV and emotional IPV. ACE scores were not significantly associated with IPV incidence. IPV is highly prevalent among pregnant women living with HIV and continues to occur throughout the pregnancy and postpartum period; its graded relationship with ACEs is a concern in resource-limited settings where HIV/AIDS remains a public health concern. Strategies aimed to address the needs of pregnant/breastfeeding women living with HIV may benefit from the regular screening of this population for IPV and ACE, including in antenatal care clinics.

The aim of this research was to explore women's emotional and affective responses following an incident of intimate partner violence experienced during emergency department attendances. A growing body of research has explored women's experiences of emergency departments following intimate partner violence still little remains known about the experience and impact of emotional and affective responses during these attendances. A descriptive qualitative design was used, underpinned theoretically by critical realism and postmodern complexity theory to attend to multiple, intersecting mechanisms that lie behind events and experiences. Semistructured interviews with six women who had attended an emergency department directly following an incident of intimate partner violence. Interview data were transcribed and thematically analysed in nvivo9 using a coding framework. There were three interconnected key findings. First, was the commonality of acute stress experiences among women attending an emergency department following partner violence, second was that these acute stress reactions negatively impacted women's consultations, and third was the need for specialist domestic violence services at the point of first contact to assist service users navigate an effective consultation. Acute stress reactions were an important feature of women's experiences of emergency department consultations following intimate partner violence. Attending to psychological first aid; providing a safe and quiet space; and affording access to specialist violence advocacy services at the point of first contact will limit harm and improve health consultation outcomes for this population. This research provides an account of emotional and affective responses experienced by women attending emergency departments following intimate partner violence and explicates how these acute stress reactions impacted their consultation. This research has relevance for practitioners in many first contact health services, such as urgent and emergency care, general practice, community public health and mental health.