Abstract
Intimate partner violence (IPV) affects one in three women around the world and is the tenth leading cause of death for women in Africa aged 15 to 29 years. Partner alcohol use, access to social support, and poverty all affect women's likelihood of experiencing violence. We sought to understand how partner alcohol use differentially affected the hypothesized association between a protective role of instrumental social support (in the form of food or financial loans) against IPV for a clinic-based sample of women in the Kingdom of Eswatini (formerly known as Swaziland). We use cross-sectional data from a parent study of women recruited from urban and rural antenatal clinics in Eswatini (n = 393) to calculate the association between experiencing IPV and perception of one's ability access to large cash loans, small cash loans, and food loans-both for the full sample and stratified by partner alcohol use. In fully adjusted models, the perception that one could access loans of food or money was associated with decreased relative risk of IPV for all women. These associations were modified by partner alcohol use. Access to instrumental support (loans of food or money) is associated with decreased risk of IPV, but this association varies according to the type of loan and whether or not a woman's partner drinks alcohol. Economic empowerment interventions to reduce IPV must be carefully tailored to ensure they are appropriate for a woman's specific individual, relationship, and community context.
Highlights
More than one in three (36.6%) ever-partnered women in Africa have experienced physical and/or sexual intimate partner violence (IPV)
In bivariate analyses (Figure 1), women who reported their partner drank alcohol were at 39.7% higher risk of experiencing IPV relative to women who reported their partner did not drink alcohol
Among women whose partners drank alcohol, those who knew someone who could loan them food were at 43% less risk of experiencing IPV relative to women who did not feel they could access a food loan (RR 0.57, 95% CI: 0.41–0.78)
Summary
More than one in three (36.6%) ever-partnered women in Africa have experienced physical and/or sexual intimate partner violence (IPV). Risk for IPV is influenced by multiple social–ecological factors: characteristics of their partner, such as alcohol use (Foran & O’Leary, 2008), type and quality of social support in their communities, and structural factors such as poverty, food security, and women’s access to capital (Buller et al, 2016; Tharp et al, 2013; VanderEnde et al, 2012). Social and structural drivers influence women’s risk for IPV; one study from Eswatini (formerly Swaziland) and Botswana found women who reported food insufficiency were more likely to report past year forced sex (Tsai, Leiter et al, 2011). Other evidence from sub-Saharan Africa suggests food insecurity is associated with transactional sex, which is frequently linked with higher rates of IPV (Decoteau, 2016; Stoebenau et al, 2016)
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