History Of Intimate Partner Violence Research Articles

The Impact of Lifetime Intimate Partner Violence on Abortion Method Choice

Objective(s)To evaluate if the type of abortion patients prefer differs for those with a history of intimate partner violence (IPV) compared to those without a history of IPV. Study DesignWe compared choice of medication versus procedural abortion between those with a history of lifetime IPV and those without a history of IPV among patients seeking abortion at 11 weeks’ gestation or less. Secondarily, we compared preferred abortion characteristics and assessed reproductive autonomy. Individuals presenting for abortion care were recruited for an anonymous, cross-sectional survey study at Planned Parenthood League of Massachusetts, Boston Health Center from September 2021 to August 2022. We required 336 subjects to detect a 20% difference in abortion method between those with a lifetime history of IPV and those without, with 80% power. ResultsWe enrolled 342 participants and excluded 6 with missing data. A total of seventy-one individuals (21%) reported a lifetime history of IPV. A majority of individuals with a lifetime history of IPV chose procedural abortion, although their abortion method choice did not differ significantly from individuals with no history of IPV (56.3% versus 47.2%, p=.244). Individuals with a lifetime IPV history used abortion funds more frequently than those without a history of lifetime IPV (8.5% versus 1.5%, p=.047). There was no statistical difference between individuals with and without a lifetime history of IPV regarding what individuals considered important for the type of abortion they chose or reproductive autonomy. Conclusion(s)Access to procedural abortion services and abortion funds are important to meet the abortion needs of patients with a lifetime history of IPV.

Risk of death after type of intimate partner violence (IPV) involvement

Abstract Background Most studies have focused on women’s intimate partner violence (IPV) victimization but perpetration and bi-directional violence remain understudied. Methods Using linked criminal justice and population registers in Manitoba, Canada, we assessed the risk of death according to the role in IPV incidents (accused-only, victim-only, bidirectional, none). In this retrospective matched cohort study, we assembled a cohort of 212,068 adults who were followed from April 2004 to March 2023 to assess IPV incidents and subsequent death. Those involved in an IPV incident were 1:3 matched to persons with no history of IPV based on birth year, sex and marital status at the time of the incident. Results Men comprised 85% of accused-only, 21% of victim-only, and 50-51% in the other two groups. Overall, compared to those without IPV involvement, the adjusted Hazard Ratios for all-cause mortality were 1.38 [95% Confidence Intervals (CI): 1.28, 1.49] for accused-only, 1.39 (1.29, 1.50) for victim-only and 1.45 (1.19, 1.77) for bidirectional IPV. The associations were stronger among women, particularly that of bidirectional violence [1.24 (0.97, 1.60) among men and 1.92 (1.39, 2.66) among women]. Similar patterns were found for intentional mortality [0.96 (0.56, 1.64) among men and 2.43 (1.27, 4.65) among women]. Conclusions There are clear sex inequities in IPV involvement. Any type IPV involvement is associated with higher risk of death, particularly among women, who comprise most of the victims. Key messages • Any type IPV involvement is associated with higher risk of death, particularly among women, who comprise most of the victim. • Use of linked criminal justice data allows studying the consequences of IPV victimization, perpetration and bidirectional violence and monitor gender inequities over time.

Uptake of gynecological consultation following domestic or sexual violence: A case-control study in the context of induced abortion

ObjectiveThe aim of this study was to determine the prevalence of domestic and sexual violence and to characterize the association between exposure to domestic and sexual violence and low uptake of gynecological care, in the context of induced abortion.Study design.We conducted a case-control study among women seeking abortion care, in mother and child centers and sexual health centers in the Paris, France area (April 2022-March 2023). ResultsA total of 103 women were included in the study during induced abortion care. Physical, psychological or sexual domestic violence was reported by 48.5 % and sexual violence, whoever the perpetrator, was reported by 23.3 %. In the bivariate analysis, a history of physical, psychological or sexual domestic violence was not associated with the absence of a gynecological consultation in the past two years, compared with no history of intimate partner violence (p = 0.09). After adjustment for regular pelvic pain, dysmenorrhea, vulvodynia and dyspareunia, there was no association between a history of sexual violence and the absence of a gynecological consultation in the past two years (OR 1.05; CI95% 0.27–4.13, p = 0.93). ConclusionViolence was a common finding among women seeking abortion care. We did not find any association between a history of sexual violence and the absence of a gynecological consultation in the past two years. We suggest investigating multiple or frequent use of gynecological care following violence. The combination of ethical, moral, and psychological constraints associated with violence screening and abortion care is a challenge to patient recruitment in future studies.

Accessing Trauma- and Violence-Informed Breastfeeding Support from Primary Care Providers among Women with Histories of Intimate Partner Violence: An Exploratory Interpretive Description Study.

Intimate partner violence (IPV) is a wicked social problem affecting women of all social strata and geographical location, globally. Pregnancy may be a time of heightened risk of IPV and more deleterious outcomes. Breastfeeding - a protective factor for maternal and child well-being - may be jeopardized or more challenging for women experiencing IPV. This study explored the experiences of postpartum women with histories of IPV who sought trauma- and violence-informed breastfeeding support from primary care providers. Using interpretive description and philosophically underpinned by intersectionality, in-depth semi-structured interviews were completed at 12-weeks postpartum with five breastfeeding mothers with a history of IPV who sought breastfeeding support from a family physician clinic employing a trauma- and violence-informed (TVIC) model of care. Four themes and two sub-themes shed light onto the experience of accessing breastfeeding support for women with a history of IPV and the perceived barriers that they faced when attempting to accesses this support, including: 1) The (demoralizing) navigation of the perinatal system; 2) Fostering trust: i) "It's support, but it's also knowledge"; and ii) TVIC: feeling safe and feeling "I mattered"; 3) Informal support: partners, family, and friends; and 4) Baby in focus: overcoming challenges and building confidence. TVIC may aid in the development of trusting therapeutic relationships, in turn improving access to breastfeeding support, breastfeeding self-efficacy, and breastfeeding success for women who experience violence. Further research on the implementation and evaluation of TVIC for perinatal breastfeeding education and care among women is required.

The Temporal Pattern of Repeat Intimate Partner Violence Incidents Among High-Risk Survivors in Taiwan: A Survival Analysis.

Intimate partner violence (IPV) is rarely an isolated incident, with survivors often experiencing repeat violence. Few studies, however, have been conducted to investigate the temporal pattern of IPV revictimization using a validated risk assessment instrument. In Taiwan, service professionals are mandated to report any known IPV incidents using the Taiwan Intimate Partner Violence Danger Assessment (TIPVDA), a validated risk assessment designed to assess the level of lethality faced by IPV survivors. The mandatory reporting policy and the universal use of the TIPVDA provide a unique opportunity to investigate the time course of repeat IPV victimization. This study analyzes high-risk IPV incidents (n = 18,740) reported in Taiwan from 2017 to 2019 using Cox regression analysis. Analysis results suggested three main findings: (a) The time interval between IPV victimizations shortened and the severity of violence increased; (b) the TIPVDA score was consistently associated with repeat victimization, unlike self-assessed dangerousness; (c) specific TIPVDA items, such as IPV history and financial stress, predicted the rate of repeat victimization. Those who reported ever being hurt by their partner during pregnancy, an escalation in physical violence during the past year, their partner threatening to kill them, and their partner being stressed about their financial situation were likely to have a faster rate of reporting the second and third high-risk victimization reports. These findings highlight the importance of using validated risk assessments in practice, not only for predicting reassault, severe reassault, or homicide but also for estimating the timing of revictimization. This can significantly inform intervention strategies and policy decisions.

Risk for Violent and IPV Recidivism Among Incarcerated Men With a History of IPV Perpetration: An Examination of the Predictive Validity of the ODARA, DVRAG, and PCL-R

Using a hybrid prospective-retrospective study design, we examined the predictive validity of the Ontario Domestic Assault Risk Assessment (ODARA), Domestic Violence Risk Appraisal Guide (DVRAG), and the Psychopathy Checklist–Revised (PCL-R) in an incarcerated sample of 94 Canadian adult men with a history of intimate partner violence (IPV) referred for treatment. The sample was followed for an average of 3.6 years following release, yielding base rates of 23.4% and 12.8% for violent and IPV recidivism, respectively. Analyses revealed that the ODARA and DVRAG displayed high inter-rater reliability and that the two measures along with Factor 1 of the PCL-R generated the largest area under the curve (AUC) for IPV recidivism (AUC = .71, .71, and .69, respectively). Predictive validity of the three measures was maintained even after accounting for treatment exposure. Although promising, clinical implications of administering the ODARA and DVRAG to incarcerated men with a history of IPV are discussed.

HPV self-collection for cervical cancer screening among survivors of sexual trauma: a qualitative study

Intimate partner violence affects 20–30% of women in the United States. Disparities in routine cervical cancer surveillance have been demonstrated in certain populations, including victims of intimate partner violence (IPV). This study examined and assessed the acceptability of high-risk HPV (hrHPV) self-collection among individuals who have experienced IPV. We conducted an observational study using qualitative data collection and analysis. We interviewed individuals with a history of IPV and who currently reside in Oregon. This study identified key themes describing knowledge and attitudes towards cervical cancer screening for individuals who have experienced IPV. They include: guideline knowledge, prior office-based cervical cancer screening experience, barriers to cervical cancer screening, at-home hrHPV self-collection experience, and testing confidence. Participants experienced fewer barriers and expressed increased comfort and control with hrHPV self-collection process. Individuals with a history of IPV have lower rates of cervical cancer screening adherence and higher rates of cervical dysplasia and cancer than other populations. The patient-centered approach of hrHPV self-collection for cervical cancer screening can reduce barriers related to the pelvic exam and empower patients to reduce their risks of developing cervical cancer by enabling greater control of the testing process.

Extended postpartum intimate partner violence and its associated factors among Iranian women: Community-based cross-sectional study design.

The purpose of this study was to determine the prevalence of different types of intimate partner violence (IPV) and factors associated with it during the postpartum period. In this cross-sectional study, 428 women were enrolled from 10 health centers in the south of Tehran, Iran, between April 2023 and October 2023. We used a sociodemographic questionnaire, Conflict Tactics Scale (CTS2), the short form of the Connor-Davidson Resilience Scale (CD-RISC), and the Depression, Anxiety and Stress Scale (DASS-21) for data collection. Multivariate binary logistic regression was used to determine demographic and psychological predictors of IPV after childbirth. Approximately two-thirds of women (n=285, 66.6%) experienced IPV within 1 year of childbirth. Psychological aggression (n= 276, 64.5%) was the most common type of IPV, whereas injury (n=96, 22.4%) was the least common. Additionally, one in three women experienced physical assault (n= 134, 31.3%), and over one-third experienced sexual coercion (n= 152, 35.5%). Predictor factors of IPV during the postpartum period were: insufficient family income (adjusted odds ratio [aOR] 4.52, 95% confidence interval [CI] 1.24-15.28), husband's smoking (aOR 3.17, 95% CI 1.70-5.92), history of IPV in pregnancy (aOR 2.44, 95% CI 1.33-4.50), number of children (aOR 3.02, 95% CI 1.79-5.10), and depression (aOR 1.2, 95% CI 1.08-1.14). On the other hand, protective factors of IPV during the postpartum period were: longer marriage duration (aOR 0.85, 95% CI 0.77-0.93) and greater resilience (aOR 0.95, 95% CI 0.90-0.99). IPV is prevalent 1 year after childbirth. Healthcare providers should implement a thorough screening program to identify risk and protective factors related to postpartum IPV.

Risk of death after type of intimate partner violence (IPV) involvement

Objective and ApproachMost studies have focused on women’s IPV victimization but perpetration and bi-directional violence remain understudied. Using linked criminal justice and population registers in Manitoba, Canada, we assessed the risk of death according to the role in IPV incidents (accused-only, victim-only, bidirectional, none). In this retrospective matched cohort study, we assembled a cohort of 212,068 adults who were followed from April 2004 to March 2023 to assess IPV incidents and subsequent death. Those involved in an IPV incident were 1:3 matched to persons with no history of IPV based on birth year, sex and marital status at the time of the incident. ResultsMen comprised 85% of accused-only, 21% of victim-only, and 50-51% in the other two groups. Overall, compared to those without IPV involvement, the adjusted Hazard Ratios for all-cause mortality were 1.38 [95% Confidence Intervals (CI): 1.28, 1.49] for accused-only, 1.39 (1.29, 1.50) for victim-only and 1.45 (1.19, 1.77) for bidirectional IPV. The associations were stronger among women, particularly that of bidirectional violence [1.24 (0.97, 1.60) among men and 1.92 (1.39, 2.66) among women]. Similar patterns were found for intentional mortality [0.96 (0.56, 1.64) among men and 2.43 (1.27, 4.65) among women]. ConclusionsThere are clear sex inequities in IPV involvement. Any type IPV involvement is associated with higher risk of death, particularly among women, who comprise most of the victims. ImplicationsUse of linked criminal justice data allows studying the consequences of IPV victimization, perpetration and bidirectional violence and monitor gender inequities over time.

Prevalence of Perinatal Depression and Its Associated Risk Factors among Nepalese Women in Kathmandu, Nepal.

Perinatal mental health is a major public health issue that arises during pregnancy and/or after birth, with substantial implications for social, parental, and maternal functioning, as well as overall quality of life. The study aimed to determine the prevalence of perinatal depression and its associated risk factors among women who visited a maternity hospital in Kathmandu, Nepal. A cross-sectional study was conducted at the Paropakar Maternity and Women's Hospital in Kathmandu. A total of 300 women in their perinatal period were interviewed. The Edinburgh Perinatal Depression Scale (EPDS) was used to measure perinatal depression. The Poisson regression model was used to determine risk factors associated with perinatal depression. The mean age of respondents was 25.5 (SD 4.5) years; average age during their first pregnancy was 23.5 (SD 3.7) years; and 53.7% of respondents were in the antenatal period. The prevalence of depressive symptoms (EPDS ≥ 10) was 40% (95% CI 31.4% to 45.8%). Unsupportive family members (adjusted prevalence ratio [aPR] 2.23; 95% CI 1.75-2.86), postnatal period (aPR 2.64; 95% CI 1.97-3.53), complications faced during delivery (aPR 1.76; 95%CI 1.30-2.39), history of intimate partner violence (aPR 0.48; 95% CI 0.36-0.64), and first pregnancy at the age of ≤25 years (aPR 0.61; 95% CI 0.42-0.88) were identified as key risk factors of perinatal depression. Strong family support and the active involvement of partners in counselling can contribute to alleviating perinatal depression symptoms. Targeted interventions in health and well-being services should be implemented to address mental health burden during both pregnancy and postpartum periods.

Antenatal Depressive Symptoms and Its Associated Factors Among Pregnant Women in Northeast, Ethiopia

Antenatal depression is of utmost concern to public health due to its potential to negatively impact both mother and child health. Less research has been done on it, and it is not receiving enough attention in the study area. This study aimed to assess the magnitude of antenatal depressive symptoms and its associated factors among pregnant mothers in Dessie City administration, Ethiopia. From March 1 to 30, 2021, a cross-sectional study was conducted among 451 pregnant mothers in Dessie City Administration. Edinburgh Postnatal Depression Scale (EPND) was used to assess antenatal depression. A multivariable logistic regression analysis was used to assess the determinants of depressive symptoms among the women. The proportion of antenatal depressive symptoms was 18.6% with 95% CI [15.1%, 22.2%]. Age greater than 30, monthly income less than 1,500 Ethiopian Birr, history of mental illness family member, a recent intimate partner violence history, death of a close family in recent year, and insomnia were significant factors affecting antenatal depression among pregnant mothers. Depression during pregnancy are high in the study area. Age >30 years, monthly income <1,500 Ethiopian Birr, history of mental illness in the family, experiencing recent intimate partner violence, death of a close family in recent year, and insomnia were independent predictors of depressive symptoms. Considering the integration of mental health services with maternal health care and providing attention to pregnant women during follow-up are recommended actions to reduce depressive symptoms.

Factors associated with exclusive breastfeeding by maternal HIV status: a population-based survey in Kenya

BackgroundExclusive breastfeeding (EBF) in the first six months remains low globally, despite known benefits of lower morbidity and mortality among breastfed infants. It is important to understand factors associated with breastfeeding to support optimal breastfeeding practices, particularly in settings with a high burden of HIV.MethodsWe analyzed data from a population-level survey of mother-infant pairs attending 6-week or 9-month immunizations at 141 clinics across Kenya. Primary outcomes included maternal report of (1) EBF at 6-week visit, defined as currently feeding the infant breast milk only, (2) EBF for the first 6-months of life, defined as breastfeeding or feeding the infant breast milk only with no introduction of other liquids or solid foods until 6 months, and (3) continued breastfeeding with complementary feeding at 9-months. Correlates of breastfeeding practices were assessed using generalized Poisson regression models accounting for facility-level clustering.ResultsAmong 1662 mothers at 6-weeks, nearly all self-reported breastfeeding of whom 93% were EBF. Among 1180 mothers at 9-months, 99% had ever breastfed, 94% were currently breastfeeding and 73% reported 6-month EBF. At 6-weeks, younger age (< 25 years) (adjusted Prevalence Ratio (aPR) 0.96; 95% CI 0.93, 0.99), lower education (aPR 0.96; 95% CI 0.93, 0.99) and recent infant illness (aPR 0.97; 95% CI 0.94, 1.00) were associated with lower EBF prevalence while women living with HIV (WLWH) had higher EBF prevalence (aPR 1.06; 95% CI 1.02, 1.10) than women without HIV. 6-month EBF prevalence was 26% higher in WLWH (aPR 1.26; 95% CI 1.15, 1.35) than women without HIV, 14% lower in women reporting mild or above depressive symptoms (aPR 0.86; 95% CI 0.76, 0.99) than those with none or minimal depressive symptoms, and 15% lower in women with versus without history of intimate partner violence (aPR 0.85; 95% CI 0.74, 0.98). At 9-months, WLWH had a lower prevalence of continued breastfeeding with complementary feeding (aPR 0.73; 95% CI 0.64, 0.84) than women without HIV.ConclusionWLWH had higher EBF prevalence in the first 6-months, but lower prevalence of continued breastfeeding at 9-months. Strategies to support EBF and continued breastfeeding beyond 6-months postpartum, particularly among WLWH, are needed.

Difference in the mode of delivery in obstetric patients who have experienced intimate partner or sexual violence compared to those who have not: A systematic review and meta‐analysis

AbstractBackgroundA history of intimate partner violence (IPV) and/or sexual violence may impact a patient's birth experience. Limited information is available on the potential for re‐traumatisation through routine obstetrical practices and the effect on mode of delivery.ObjectivesTo identify whether there is a difference in mode of delivery between obstetrics patients who have experienced IPV/sexual violence compared to those who have not.Search StrategyMEDLINE and EMBASE were searched through inception to February 2024 for terms related to obstetric mode of delivery, IPV and sexual abuse.Selection CriteriaPeer‐reviewed, retrospective and prospective studies that contained original data.Data Collection and AnalysisTwo authors independently conducted data extraction. A random‐effects meta‐analysis was used to pool outcomes. Cochrane's chi‐squared test and the I2 statistic was used to examine the statistical heterogeneity of pooled effect estimates. All studies were evaluated using the risk of bias in a non‐randomised study‐I tool.Main ResultsThirty studies (n = 280 864) were eligible for inclusion. The likelihood of caesarean delivery was significantly higher in those who had experienced IPV/sexual violence compared to those who had not: OR = 1.16, CI = 1.05–1.27; I2 = 71. Pooled analysis of reported operative delivery rates did not reveal any significant increase in operative delivery rate for those who had experienced IPV/sexual violence versus those who had not: OR = 1.14, 95% CI = 0.89–1.45, I2 = 77%. Risk of bias for the included studies were moderate to serious.ConclusionsObstetrics patients with a history of IPV/sexual violence appear to be more likely to deliver via caesarean section as compared to those who do not.

Maternal Depression and Associated Factors Among South Sudanese Refugee Mothers in Gambella&amp;apos;s Tierkidi Refugee Camp: &amp;lt;i&amp;gt;A Cross-Sectional Study&amp;lt;/i&amp;gt;

Background: Maternal depression stands out as the prevailing psychiatric condition during pregnancy, with its detrimental impacts posing significant consequences for both the mother and the fetus. Nearly a quarter of women will encounter depression at some stage in their lives, with the majority experiencing it during their childbearing years. Refugee women face elevated susceptibility to mental health disorders, with rates surpassing those of host populations. Objective: The objective of this study is to determine the prevalence of maternal depression and the associated factors with it among South Sudanese refugee women living in the Gambella region, in the Tierkidi refugee camp in 2023. Method: A community-based cross-sectional study conducted within the Gambella region&amp;apos;s Tierkidi refugee camp in Ethiopia involved 452 randomly selected participants who were pregnant and had given birth within the past 12 months. Data collection utilized a pretested structured questionnaire administered through interviews. Data coding and entry were performed using Epi-Info version 7.2, with subsequent analysis conducted in SPSS version 23. Descriptive statistics and logistic regression were employed to identify associations between the outcome variable and explanatory variables. The strength of association was assessed using odds ratios at a 95% confidence interval, and associations were deemed significant at a p-value of less than 0.05. Results: In this study, the prevalence of maternal depression was found to be 31.5% (95% CI: 27.4-37.8). Significant associations were observed between maternal depression and unmarried marital status (AOR = 13.39, 95% CI: 3.11-57.7), unplanned pregnancy (AOR = 6.76, 95% CI: 2.13-21.4), intimate partner violence (AOR = 5.4, 95% CI: 2.32-12.4), number of pregnancies (AOR = 4.85, 95% CI: 2.56-9.17), and history of abortion (AOR = 3.97, 95% CI: 1.07-14.7). Conclusion: The study revealed a high prevalence of maternal depression among pregnant mothers with infants less than 12 months old. Factors such as being unmarried, experiencing unplanned pregnancy, having a history of abortion, a higher number of pregnancies, lack of social support, and a history of intimate partner violence were found to be significantly associated with maternal depression.

Emotional Clarity and Psychopathology in Women Who Have Experienced Physical Intimate Partner Violence.

Intimate partner violence (IPV) is a chronic, traumatic stressor related to posttraumatic stress (PTS), depression, and anxiety. As psychological symptoms are exacerbated in those with poor emotional clarity, the present study evaluates the relationship between emotional clarity and PTS, dissociation, depression, and worry in women who experienced at least one instance of physical IPV (n = 88). Hierarchical regression analyses, controlling for childhood trauma, IPV abuse severity, and IPV-related brain injury, found that lack of emotional clarity was significantly related to greater PTS, dissociative experiences, depression, and worry. Results suggest that emotional clarity may be a relevant therapeutic target for individuals with a history of IPV and psychological distress.

Antepartum Intimate Partner Violence: Development of a Risk Prediction Model.

Objectives: To explore socio-behavioral, clinical, and imaging findings associated with antepartum intimate partner violence (IPV) and aid in risk stratification of at-risk individuals. Methods: We analyzed electronic medical records during indexed pregnancies for 108 pregnant patients who self-reported antepartum IPV (cases) and 106 age-matched pregnant patients who did not self-report antepartum IPV (controls). Sociodemographic, clinical, and radiology data were analyzed via chi-squared and Fisher's exact tests with p < 0.05 as the threshold for significance. Stepwise logistic regression was applied to derive a risk prediction model. Results: The proportion of cases reporting emotional IPV (76% vs. 52%) and/or physical IPV (45% vs. 31%) during pregnancy significantly increased from prior to pregnancy. Cases were significantly more likely to report prepregnancy substance use (odds ratio [OR] = 2.60; 95% confidence interval [CI]: 1.13-5.98), sexually transmitted infections (OR = 3.48; 95%CI: 1.64-7.37), abortion (OR = 3.17; 95%CI: 1.79, 5.59), and preterm birth (OR = 5.97; 95%CI: 1.69-21.15). During pregnancy, cases were more likely to report unstable housing (OR = 5.26; 95%CI: 2.67-10.36), multigravidity (OR = 2.83; 95%CI: 1.44-5.58), multiparity (OR = 3.75; 95%CI: 1.72-8.20), anxiety (OR = 3.35; 95%CI: 1.85-6.08), depression (OR = 5.58; 95%CI: 3.07-10.16), substance use (OR = 2.92; 95%CI: 1.28-6.65), urinary tract infection (UTI) (OR = 3.26; 95%CI: 1.14-9.32), intrauterine growth restriction (OR = 10.71; 95%CI: 1.35-85.25), and cesarean delivery (OR = 2.25; 95%CI: 1.26-4.02). Cases had significantly more OBGYN abnormalities on imaging and canceled more radiological studies (OR = 5.31). Logistic regression found housing status, sexually transmitted infection history, preterm delivery history, abortion history, depression, and antepartum UTI predictive of antepartum IPV. The risk prediction model achieved good calibration with an area under the curve of 0.79. Conclusions: This study identifies significant disparities among patients experiencing antepartum IPV, and our proposed risk prediction model can inform risk assessment in this setting.

Factors Influencing Shared Decision-Making Between Healthcare Providers and Lesbian, Gay, Bisexual, Transgender, and Queer People of Color About Intimate Partner Violence.

Within the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, people of color (POC) disproportionately experience intimate partner violence (IPV). While shared decision-making (SDM)-a model of patient-provider communication-about IPV could benefit LGBTQ POC, its unique challenges merit consideration. This study identifies key factors affecting SDM between LGBTQ POC and healthcare providers surrounding IPV. LGBTQ POC participants (n = 217) in Chicago and San Francisco completed surveys about demographic information, healthcare utilization, and IPV history. Individual interviews and focus groups were then conducted with a Chicago-based subset of participants (n = 46) who identified as LGBTQ IPV survivors of color. Descriptive analyses were conducted of survey responses while focus group and interview transcripts were analyzed and thematically coded. Although 71% of survey participants experienced IPV, only 35% were asked about IPV in healthcare interactions within the previous year. Focus group and interview participants endorsed encounter-, patient-, and provider-centered factors affecting SDM around IPV. When IPV was discussed, patient-provider trust was essential while concordance of identities could either encourage or discourage IPV disclosure. Patients were hesitant to disclose IPV if they had never discussed their LGBTQ identity with their provider or thought providers would ignore their preferences for addressing IPV. Deterrents to SDM included providers denying the prevalence of IPV among LGBTQ individuals or lacking resources to support LGBTQ IPV survivors of color. This study highlights the identity-driven barriers that LGBTQ POC face in discussing IPV with providers. Utilizing SDM to discuss IPV with LGBTQ POC can better address the diverse health needs of this community. However, its success requires that providers acknowledge the diversity of experiences among this population, promote LGBTQ-inclusive practices, and identify resources welcome to LGBTQ POC.

Household crowding and income loss increases intimate partner violence during the pandemic among isolating families with young children in the United States

The COVID-19 pandemic presents significant risk for family violence. Risk for intimate partner violence (IPV) may be especially pronounced among families with young children that are isolating in crowded households and experiencing severe income loss. Because child exposure to IPV is increasingly recognized as a form and risk factor for child maltreatment, understanding factors contributing to IPV among families with young children can inform prevention and intervention efforts regarding family and child well-being during and after the pandemic. The present study examines the hypothesis that IPV during the pandemic would be more likely among families with a history of IPV that are isolating in crowded households and/or experiencing severe income loss resulting from the pandemic. Parents (n = 363) of 4- to 10-year-olds living in the United States completed an online survey with demographic, pandemic experiences, and IPV questionnaires. Family history of IPV was strongly associated with recurring IPV during the pandemic (Cramer’s V = .55). Induction rates of IPV during the pandemic were low; four families experienced IPV for the first time during the pandemic. Household isolation (r = .12), household crowding (r = .13), and severity of income loss (r = .25) were significantly and positively associated with IPV during the pandemic. Income loss was positively associated with IPV during the pandemic at low and average levels of household crowding. At high levels of household crowding, families were at high risk for IPV during the pandemic regardless of the severity of income loss. Our findings indicate that isolating families with young children are at-risk for recurring IPV during the pandemic, especially if they are also experiencing household crowding and/or severe income loss.

Partner incarceration, maternal substance use, and the mediating role of social support: A longitudinal analysis using the future of families and child wellbeing study

IntroductionThe United States is responsible for the highest incarceration rate globally. This study aimed to explore the impact of partner incarceration on maternal substance use and whether social support mediates the relationship between partner incarceration and maternal substance use. MethodsUsing data from the Future of Families and Child Wellbeing Study, a longitudinal cohort following new parents and children, this analysis quantifies the relationship between paternal incarceration and maternal substance use (N = 2823). We analyzed maternal responses in years 3 (2001–2003), 5 (2003–2006), 9 (2007–2010), and 15 (2014–2017). We explored the role of financial support and emergency social support as potential mediators. Confirmatory factor analysis (CFA) was employed to construct support-related mediators. We modeled the impact of partner incarceration and maternal substance use using generalized estimating equations (GEE) to account for repeated measures, adjusting for appropriate confounders (age of mother at child's birth, race, education, employment, and history of intimate partner violence). ResultsNearly half (44.2%, N = 1247) of participants reported partner incarceration. Among mothers who experienced partner incarceration, the odds of reporting substance use were 110% greater than those who reported no partner incarceration (adjusted Odds Ratio [aOR]: 2.10; 95% Confidence Interval (CI):1.67–2.63). Financial support at year 5 accounted for 19.5% (95% CI: 6.03–33.06%) of the association between partner incarceration at year 3 and substance use at year 9; emergency social support at year 5 accounted for 6.4% (95% CI: 0.51–12.25%) of the association between partner incarceration and substance use at year 9. Neither financial nor emergency social support at year 9 were significant mediators between partner incarceration at year 3 and substance use at year 15. ConclusionsThese findings demonstrate that partner incarceration impacts maternal substance use. Financial and emergency support may partially mediate this relationship in the short term, which has important implications for families disrupted by mass incarceration.

The Relations Among Childhood Maltreatment and Later Intimate Partner Violence Victimization With and Without a Weapon in a Sample of Pregnant Black Individuals.

Black pregnant and postpartum individuals are at risk for intimate partner violence (IPV), and those with a history of childhood maltreatment and IPV are even more likely to be re-victimized during pregnancy. However, it is unknown if specific types of child maltreatment predict later IPV with and without a weapon better than others. The current study sought to (i) document the prevalence of childhood maltreatment and IPV and (ii) examine the relations among types of childhood maltreatment and later IPV with and without a weapon within a sample of Black individuals seeking prenatal care at a large public hospital in the southeastern United States. Participants (n = 186; mean age = 27.2 years, SD = 5.3) completed measures assessing childhood maltreatment and IPV with and without a weapon. Approximately 68.5% of participants (n = 124) endorsed experiencing childhood maltreatment, while 42.6% (n = 78) endorsed experiencing IPV. The bivariate relations among five childhood maltreatment types (i.e., sexual, physical, and emotional abuse, physical and emotional neglect) and IPV with and without a weapon were assessed. All childhood maltreatment subtype scores-except childhood physical neglect-were significantly higher among participants who reported a history of IPV with or without a weapon compared to participants who denied a history of IPV with or without a weapon. Logistic regression models revealed childhood sexual abuse emerged as the only significant predictor of experiencing IPV with a weapon (B = 0.10, p = .003) and IPV without a weapon (B = 0.11, p = .001). For every point increase in childhood sexual abuse subtype score, the odds of experiencing IPV with and without a weapon increased by 10% (OR = 1.10, 95%CI [1.04, 1.18]) and 12% (OR = 1.12, [1.05, 1.20]), respectively. Findings suggest that screening for childhood sexual abuse may provide a critical opportunity for maternity care providers to identify individuals at increased risk for IPV victimization with and without a weapon.