Prevalence and incidence of domestic violence in an ambulatory gynecology population and associated risk factors

Abstract

Objective: To determine the prevalence and incidence of domestic violence in an ambulatory gynecology population and to describe risk factors associated with abuse. Methods: All patients presenting for initial ambulatory gynecology care at an urban private practice over 1 year were asked by a physician about the occurrence of domestic violence using a modified abuse assessment screen (AAS). The prevalence and incidence of physical, emotional, and sexual abuse were calculated. The patient’s records were abstracted for demographic and medical variables. Associations between these variables and the prevalence of abuse were analyzed. Results: Four hundred forty-three women were interviewed. No woman refused to answer the AAS. Among 424 women with completed AASs, 72 (16.2%) reported some form of domestic violence in the past. Among ever-abused women, 46 out of 72 (63.8%) reported physical abuse, 12 (16.6%) reported emotional abuse, and 4 (5.6%) reported sexual abuse. The incidence of physical abuse was 1.6%. In univariate analysis, risk factors associated with lifetime abuse included age greater than 40 ( P = 0.006), non-single status ( P = 0.003), black race ( P = 0.006), history of depression ( P = 0.0001), and sexual inactivity ( P = 0.007). A history of depression ( P = 0.001) and black race ( P = 0.01) were the only factors associated with a past history of domestic abuse in regression analysis. Conclusions: The prevalence of domestic abuse ascertained by the AAS in an ambulatory gynecology setting is high. Demographic and health factors do not accurately predict a history of domestic abuse. Screening of all patients for domestic violence should be a routine part of ambulatory gynecologic care.