Prospective risk and protective factors for intimate partner violence victimisation among women: a systematic review and meta-analysis

Abstract

BackgroundThe lifetime prevalence of intimate partner violence (IPV), violence committed by a current or former partner, is estimated to be 30% among women worldwide. Effective prevention requires targeting conditions that increase and decrease the risk of IPV—or risk and protective factors, respectively. We aimed to systematically review and quantify the associations between prospective longitudinal risk and protective factors and IPV against women and identify evidence gaps. MethodsSystematic searches were conducted in English in 16 databases including Medline and PsycINFO from inception to June 1, 2016, using free-text terms and controlled vocabulary for violence, partner, adults, and study design. English-language studies that prospectively analysed an adjusted association between any risk or protective factor or factors and self-reported IPV victimisation among women were included. Study quality was assessed with the Cambridge Quality Checklists. Studies investigating the same risk or protective factor using similar measures, and with appropriate data available, were combined to compute odds ratios using random-effects meta-analyses. Heterogeneity was indicated by I2 and τ2. All results, including those not meta-analysed, were synthesised with harvest plots to illustrate evidence gaps and trends towards negative or positive associations. This study is registered with PROSPERO, number CRD42016039213. FindingsOf 18 608 studies identified, 60 were included, and 35 meta-analysed. The strongest evidence for modifiable risk factors for IPV against women were unplanned pregnancy (odds ratio 1·66, 95% CI 1·20–1·31) and having parents with less than a high school education (1·55, 1·10–2·17). Being older (0·96, 0·93–0·98) and married (0·93, 0·87–0·99) were protective. InterpretationStudy limitations include English-language restrictions and low statistical power. Nevertheless, to our knowledge this is the first systematic, meta-analytical review of all risk and protective factors for IPV against women without location, time, or publication restrictions. Education and sexual health interventions may be effective targets for preventing IPV against women, with young, unmarried women most at risk. More prospective evidence for perpetrator-related and context-related risk and protective factors for women's IPV experiences outside the USA is urgently needed to inform global recommendations. FundingRhodes Trust, Canadian Institutes of Health Research (DFS152265).