Intimate Partner Violence Prevention Programs Research Articles

Preventing Intimate Partner Violence Among Teen Mothers: A Pilot Study.

Despite high rates of intimate partner violence (IPV) among teens who are pregnant or parenting, the field is lacking evidence-based prevention programs designed for this population. The purpose of this study was to comprehensively adapt the evidence-based Safe Dates IPV prevention program and conduct a pilot study of the adapted program with female teens who were pregnant or parenting. We completed formative research including a literature review, focus groups, and pre-testing of adapted content to inform the revised curriculum. We then conducted a randomized controlled trial with 32 teens (average age = 17) to compare the adapted program to the original program on implementation characteristics and outcomes, including IPV perpetration and victimization. Directions of effect favored the adapted program over the original program for 18 out of 21 implementation outcomes for which models could be estimated and for 11 of 12 participant outcomes. The strongest effects, all favoring the adapted program, were found for observer-reported adherence to the curriculum, participant ratings of the relevance of characters and scenarios, participant knowledge of ways to get help for abuse, and attitudes toward IPV. These findings demonstrate the feasibility and acceptability of the adapted program for this target population and suggest that the program may be efficacious when evaluated in a larger study.

Pathways of change: qualitative evaluations of intimate partner violence prevention programmes in Ghana, Rwanda, South Africa and Tajikistan

A critical component of evaluations of the effectiveness of intimate partner violence prevention programmes involves understanding pathways of change among individuals who participate in such programmes, and the intervention or contextual elements that support or hinder these. This paper draws on qualitative evaluations of four intimate partner violence prevention programmes in Ghana, Rwanda, South Africa and Tajikistan conducted as part of the What Works to Prevent Violence against Women and Girls Programme. Using a comparative case study approach, a secondary analysis was applied to thematically analysed data to explore how and why men and women change in response to different types of programmes across diverse contexts. Similar pathways of change were identified including the value of learning and applying relationship skills to support equitable, non-violent relationships; the importance of participatory approaches to challenge harmful gender norms and allow for group rapport; and the integration of economic empowerment activities to reduce drivers of intimate partner violence and conflict, and promote participants’ self-confidence and status. These findings provide insights regarding intervention design and implementation factors pertinent to bring about changes in intimate partner violence.

Polydrug Use and Dating Violence Among Emerging Adults.

We examined sociodemographic and psychosocial risk factors that moderate the (poly) substance use and dating violence victimization and perpetration relationship among emerging adults. Using an ethnically diverse sample (N = 698), we used latent class analyses to identify mutually exclusive groups based on monthly and past-year substance use. We then examined these groups as they relate to dating violence victimization and perpetration and the moderating effect of various risk factors. Five classes were identified based on substance use patterns: (a) Regular Alcohol use, (b) Polysubstance use, (c) Heavy Alcohol and Marijuana use, (d) Mild Alcohol use, and (e) Occasional Alcohol and Marijuana use classes. Participants in the Polysubstance use class were the most likely to perpetrate dating violence followed by Heavy Alcohol and Marijuana use, Occasional Alcohol and Marijuana use, Regular Alcohol, and Mild Alcohol use classes. Similarly, participants in the Polysubstance use class were the most likely to be victims of dating violence followed by Occasional Alcohol and Marijuana, Heavy Alcohol and Marijuana, Regular Alcohol, and Mild Alcohol use classes. Depending on substance use class, gender, ethnicity, socioeconomic status, history of dating violence, and trauma symptoms differentially influenced dating violence perpetration and victimization at 1-year follow-up. Our findings support the need to comprehensively address dating violence among emerging adults. Intimate partner violence prevention and intervention programs may benefit from targeting emerging adults who misuse substances and incorporating substance use interventions into dating violence prevention efforts.

Community activism as a strategy to reduce intimate partner violence (IPV) in rural Rwanda: Results of a community randomised trial.

BackgroundThere is considerable interest in community organising and activism as a strategy to shift patriarchal gender norms, attitudes and beliefs and thus reduce intimate partner violence (IPV). Yet there is limited insight into how activism actually translates into reduced violence, including how aspects of programme implementation or cultural context may affect impact. This study evaluates the community activism/mobilisation portion of Indashyikirwa, a multi-component, IPV prevention programme implemented in rural Rwanda. The activism part of Indashyikirwa was based on SASA!, a promising program model from Uganda with demonstrated effectiveness.MethodsWe implemented two separate cross-sectional surveys as part of a larger community randomised controlled trial to assess the impact of the community portion of Indashyikirwa on preventing physical and/or sexual IPV and other secondary outcomes at a community level. The survey consisted of a random household-based sample of 1400 women and 1400 men at both waves. Surveys were conducted before community-level activities commenced and were repeated 24 months later with a new cross-sectional sample. Longitudinal, qualitative data were collected as part of an embedded process evaluation.ResultsThere was no evidence of an intervention effect at a community level on any of the trial’s primary or secondary outcomes, most notably women’s experience of physical and/or sexual IPV from a current male partner in the past 12 months (adjusted odds ratio (aOR) = 1.25; 95% confidence interval (CI) = 0.92-1.70, P = 0.16), or men’s perpetration of male-to-female physical and/or sexual IPV (aOR = 1.02; 95% CI = 0.72-1.45, P = 0.89). Process evaluation data suggest that delays due to challenges in adapting and implementing SASA!-style activites in rural Rwanda may account for the trial’s failure to measure an effect. Additionally, the intervention strategy of informal activism was not well suited to the Rwandan context and required considerable modification.ConclusionsFailure to reduce violence when implementing an adaptation of SASA! in rural Rwanda highlights the importance of allowing sufficient time for adapting evidence-based programming (EBP) to ensure cultural appropriateness and fidelity. This evaluation held little chance of demonstrating impact since the project timeline forced endline evaluation only months after certain elements of the programme became operational. Donors must anticipate longer time horizons (5 to 7 years) when contemplating evaluations of novel or newly-adapted programmess for reducing IPV at a population level. These findings also reinforce the value of including embedded process evaluations when investing in rigorous trials of complex phenomena such as community activism.Trial registrationClinicalTrials.gov, NCT03477877

Intimate Partner Violence Prevention and Intervention Group-Format Programs for Immigrant Latinas: a Systematic Review.

Immigrant Latinas (IL) experiencing intimate partner violence (IPV) often experience barriers to accessing formal support systems due to immigration-related issues (e.g., fear of deportation, language proficiency, lack of family support in the U.S.). This paper contains a systematic review of peer-reviewed published articles within the past 25 years addressing IPV prevention and intervention programming designed for this vulnerable population. We examined specific group-format programs and curricula conducted at community-based agencies with social services across the country. Qualitative analysis of the 10 articles that met search criteria (i.e., programs must be culturally specific, designed to serve IL, conducted in group-format, focused on IPV intervention or prevention) generated information regarding the nature of group interventions addressing this issue and population. Several themes emerged upon completion of the qualitative review describing key characteristics of each intervention. All reviewed articles reported generally positive outcomes using a variety of methods. Studies using quantitative methods found statistically significant outcomes for constructs including depression, self-esteem, and knowledge of wellness. Professionals from diverse practice settings working with IL would likely benefit by developing intervention and prevention group-format programming to address this problem.

Displacement-related factors influencing marital practices and associated intimate partner violence risk among Somali refugees in Dollo Ado, Ethiopia: a qualitative study

BackgroundChild and forced marriage have negative health consequences including increased risk of intimate partner violence (IPV) for women and girls. War and humanitarian crises may impact decision-making around marriage and risks of IPV for displaced populations. A qualitative study was conducted among Somali refugees in Dollo Ado, Ethiopia to understand the interplay of factors that contribute to IPV and to inform an intervention. This secondary analysis aims to explore the influence of displacement on marital practices and associated IPV risk.MethodsInterviews and focus group discussions were conducted in 2016 in Dollo Ado, Ethiopia, among Somali women and men living in Bokolmayo refugee camp, host community members, non-governmental staff and service providers, stakeholders, and community and religious leaders (N = 110). Data were transcribed, translated to English, and coded and analyzed thematically using Dedoose software and a codebook developed a priori.ResultsFindings reveal numerous displacement-related factors that led to perceived shifts in marital practices among refugees, including reductions in child and forced marriages. NGO awareness-raising programs and Ethiopian laws prohibiting child marriage as well as increased access to education for girls were reported to have contributed to these changes, despite continued economic hardship and high perceived risk of non-partner sexual violence within the camp and host community. Polygamy was also perceived to have decreased, primarily due to worsening economic conditions. Forced marriage, polygamy and dowry were reported to contribute to physical IPV, and sexual IPV was reported as common in all types of marital unions. However, there was no evidence that changes in these marital practices contributed to any perceived declines in IPV within this context.ConclusionSafe access to education for girls should be prioritized in humanitarian settings. Interventions to address child and forced marriage should address gender and social norms. Intimate partner violence prevention programming should include specialized content taking into account marital practices including child and forced marriage and polygamy. Laws recognizing sexual IPV within marital relationships are needed to reduce sexual IPV.

Willingness to use PrEP among female university students in Lesotho.

Oral pre-exposure prophylaxis (PrEP) for HIV-negative individuals at high risk was introduced in Lesotho in April 2016. To assess the feasibility and acceptability of PrEP in Lesotho and to study the attitudes and beliefs around HIV risk and prevention measures among young women, between September and December 2016 we asked 302 female university students at fourteen higher education institutions in Lesotho about their sexual behavior, experiences of sexual coercion and abuse, HIV risk perception, willingness to use PrEP, as well as their attitudes toward condom use and self-administration of daily medications. Overall, 57.3% of the sample reported perceiving themselves at risk of acquiring HIV and 32.1% reported being strongly willing to use PrEP if it were available in their community. In a multivariate mediation analysis, perceived HIV risk was associated with 11.5 percentage points increase in likelihood of using PrEP (p = 0.041). Multiple concurrent sexual partnership was associated with 16.1 percentage points increase in likelihood of self-perceived HIV risk (p = 0.007), while having sexual partners in polygamous relationships was associated with 17.8 percentage points increase in likelihood of self-perceived HIV risk (p = 0.002) and the mediated indirect effect accounted for 18.2% of its total effect. Those who reported strong adherence to antibiotics were 23.1 percentage points more likely to express willingness to use PrEP than those who did not (p = 0.004), and those who reported to dislike condoms were 19.1 percentage points more likely to be willing to use PrEP than those who did not report aversion to condom use: these effect were direct and not mediated by HIV risk perception. Intimate partner violence (IPV) in the network of peers was also directly associated with willingness to use PrEP and its effect was not significantly mediated by HIV risk perception: those who had friends who experienced intimate partner violence were 14.9 percentage points more likely to be willing to use PrEP than those who did not report IPV in their network of peers (p = 0.009). These findings support the inclusion of individuals with multiple concurrent sexual partners among the key populations for PrEP provision and confirm that willingness to use PrEP is not solely driven by HIV risk perception. They also indicate that the presence of IPV in peer networks is related to one’s willingness to use PrEP. PrEP service provision may generate synergies with IPV prevention programs when offered within this framework.

Effectiveness of a Prevention Program for Gender-Based Intimate Partner Violence at a Colombian Primary School.

Intimate partner violence, particularly against women, is widely studied owing to its high rates, based on transnational data. Colombia, where this form of violence is considerably common, is no exception, and such violence is occurring more and more often in increasingly younger couples (10−14 years old). Further, risk factors such as wide acceptance, the justification of intimate partner violence, extremely rigid traditional gender roles, and poor socio-emotional skills play a crucial role. In accordance with this reality, a gender-based intimate partner violence prevention program was designed, implemented, and evaluated for primary school children in Colombia based on a review of successful preventive programs and an identification of the main predictors of intimate partner violence. The program was evaluated using a quantitative study with a quasi-experimental design that included an experimental and a control group. In total, 344 participants were involved in the study: 195 boys (56.7%) and 149 girls (43.4%) from the second and third grades of a primary school (average age: 7.8 years) at a Colombian educational institution. The experimental group consisted of 200 participants and the control group of 144 participants. The program’s effectiveness was evaluated by measuring three groups of variables (gender stereotypes, the acceptance of violence, and socio-emotional skills) using reliable scales. To analyze the program’s effectiveness, mixed ANOVAs with a within-subjects factor (when the group was measured), two between-subjects factors (group and gender), and a covariate (age) were used. The results showed that the participants in the experimental group had lower scores in gender stereotypes, acceptance of peer aggression, and acceptance of physical violence against women compared to the control group. Conversely, they had higher scores in affective empathy after the intervention; both groups showed no significant differences before the intervention. This program is highly relevant because it has proven to have a positive impact on the participants and is innovative due to the lack of preventive programs that have been implemented in primary education and evaluated within the Colombian context.

'When you talk to someone in a bad way or always put her under pressure, it is actually worse than beating her': Conceptions and experiences of emotional intimate partner violence in Rwanda and South Africa.

Emotional intimate partner violence (IPV) is extremely common and has significant health and social consequences, yet typically receives much less attention in research and programming than physical and sexual IPV. This limits our understanding of how women experience and understand emotional IPV in different settings, which is required to inform effective prevention and response. This paper draws on qualitative data collected in mixed-methods impact evaluations of two IPV prevention programmes conducted as part of the What Works to Prevent Violence Against Women and Girls Global Programme. In doing so, we seek to develop a more nuanced understanding of the forms, causes and consequences of emotional IPV in heterosexual relationships in two distinct African settings. We draw on two rounds of in-depth interviews conducted with 15 women in South Africa and three rounds of interviews conducted with 57 women and men in Rwanda, all of whom were participants in the programmes, around their experiences of and conceptualizations of emotional IPV. Thematic analysis around emotional IPV was conducted and compared across both data sets, informed by a cross comparative analysis approach. The analysis found that the categories or types of acts perceived as emotional IPV by women experienced were similar across settings. Women in both contexts described public humiliation, control of mobility, access to housing and silencing as important categories of actions experienced emotional IPV. These types of emotional IPV were underpinned by similar patterns of gender inequalities, with the intention for men to assert control and power over women. The specific acts through which these categories of emotional IPV manifested in the two settings arose from contextual differences related to the social structure of relationships and dominant social norms. This analysis highlights commonalities in the underlying categorial understanding of IPV in two distinct African settings, and well as the differences in specific manifestations which stem from the social context of relationships. In doing so, we highlight both broad categorical areas of IPV that may be important to address in future research and prevention programming, as well as affirming the need for information on context-specific manifestations of emotional IPV to inform local intervention programmes.

The None in Three Victim Responsiveness Assessment (Ni3: VRA): a new outcome measure for intimate partner violence (IPV) prevention programs

PurposeThe purpose of this paper is to develop and validate the None in Three Victim Responsiveness Assessment (Ni3: VRA) examining affective and cognitive responsiveness toward victims of intimate partner violence.Design/methodology/approachData were collected at two time points in a sample of 359 young people from Barbados and Grenada (56.27 percent female; M age=12.73 years).FindingsConfirmatory factor analysis results indicated that the Ni3: VRA scores are best captured by a two-factor solution, including affective and cognitive dimensions. A test-retest correlation confirmed the reliability of the Ni3: VRA over time. Affective responsiveness formed a significant positive association with caring/cooperative behavior.Originality/valueThe Ni3: VRA can be used for the evaluation of preventive strategies aimed at reducing the rates of IPV.

Indashyikirwa Women’s Safe Spaces: Informal Response for Survivors of IPV within a Rwandan Prevention Programme

Within intimate partner violence (IPV) prevention programmes that raise awareness of women’s rights and the forms and consequences of IPV, there is a need to ensure response mechanisms for IPV survivors. Indashyikirwa is a Rwandan IPV prevention programme, which established 14 women’s safe spaces, whereby men and women could access support for IPV, be referred or accompanied to other services. This paper draws on qualitative interviews with safe space facilitators, attendees, staff and observations of activities at various points across the programme. Thematic analysis was conducted to assess the process and impact of the spaces. Attendees generally preferred the women’s safe spaces over formal services for IPV disclosure and support, and the spaces also enhanced the quality of and linkage to formal IPV response services. The safe spaces further supported well-being and economic empowerment of attendees. Lessons learned from implementing this model are offered, including how to ensure safe, inclusive and integrated sources of support within broader IPV prevention efforts.

Sexual coercion, consent and negotiation: processes of change amongst couples participating in the Indashyikirwa programme in Rwanda

Sexual coercion among married or cohabitating couples is a complex phenomenon with few effective strategies for prevention. This paper explores sexual coercion among couples from rural Rwanda who participated in Indashyikirwa, a 4-year intimate partner violence prevention programme that included a 5-month couples curriculum to promote equalitarian, non-violent relationships. Drawing on three rounds of longitudinal qualitative interviews with partners from 14 couples (28 individuals), this paper explores processes of change in experiences and conceptualisations of coerced sex over the course of the intervention and 1 year after. The data were analysed using thematic and dyadic analysis. Both partners of couples reported significant changes in their sexual relationship, including reduced experiences of coerced sex, greater communication about sex and increased acceptability for women to initiate sex. Men and women became more willing to disclose sexual coercion over the course of the interviews, both current and past experiences, and couples’ accounts generally became more concordant. Findings yield insights to inform programming to prevent coerced sex among spouses. These include grounding discussion of sexual coercion in an analysis of gendered power and norms, reflecting on the consequences of broader forms of sexual coercion and employing a benefits-driven, skills-based approach.

Factors associated with past year physical and sexual intimate partner violence against women in Zimbabwe: results from a national cluster-based cross-sectional survey

ABSTRACTBackground: Intimate partner violence (IPV) against women continues to be a public health burden globally.Objectives: To assess prevalence and factors associated with women’s experiences of past 12 months physical/sexual IPVMethods: A two-stage cluster-based national cross-sectional survey in which women were randomly selected for participation was conducted among 5295 women aged 15–49 years. IPV in the last 12 months was assessed using the WHO interviewer-administered questionnaire for measuring violence against women. Participants’ wife beating attitudes, partner controlling behaviours, household decision-making, STI history, HIV status and demographic characteristics were assessed. Multivariate logistic regression was conducted to assess factors associated with IPV.Results: Of the 5292 women interviewed, mean age was 31.5 years and 84.7% were married. Over one-fifth of the women (20.2: 95%CI 19.1–21.3) were physically/sexually abused in the last 12 months. IPV was associated with gender inequitable norms and practices which include lacking household decision-making power (aOR 2.05, 1.71–2.47), experiencing low (aOR 2.05; 1.71–2.47) or high (aOR 4.5; 3.62–5.60) partner controlling behaviours (vs none) and endorsing low (aOR 1.29) or high (aOR 1.36) wife beating attitudes (vs none), having sexual self-efficacy (aOR 1.19; 1.10–1.41), experiencing emotional abuse (aOR 4.50; 3.62–5.60) and having a sexually transmitted infection (STI) (aOR 1.36, 1.04–1.77). IPV was also associated with women’s empowerment factors including possessing household assets (aOR 1.26, 1.03–1.54) and reporting current media usage (aOR 1.29; 1.04–1.61). Demographic factors associated with IPV were age and number of children.Conclusions: This study provides evidence that IPV is a significant public health and societal problem as one in five women were abused in the past year. Younger women, less empowered women, women in inequitable intimate relationships and women endorsing traditional gender norms were at increased risk of abuse. IPV prevention programmes must prioritise transforming traditional gender norms and women’s economic empowerment.

Victims and Perpetrators of Intimate Partner Violence Among Sexually Active Youth in a Community With a High HIV Prevalence in Western Kenya

Physical intimate partner violence (IPV) is an important risk factor for sexually transmitted infections, including HIV. We set out to determine the prevalence and correlates of IPV among youth aged 15 to 24 years - in a community with a high HIV prevalence - with a view to recommending strategies to address IPV.We analysed data from an HIV seroprevalence survey, which included participants aged 13 years and above and was conducted between November 2012 and December 2014 in Gem Subcounty, Siaya County, Western Kenya. Participants between 15 and 24 years old (youth) were described as "perpetrators of IPV" if they had done anything to physically hurt their sexual partners in the previous year and as "victims of IPV" if they had been physically hurt by a sexual partner in the same timeframe. Logistic regression was used to determine factors associated with being either a victim or perpetrator of IPV.Of 1,957 participants included in the analysis, 142 (7%) were victims of IPV, and 77 (4%) were perpetrators of IPV. Victims were likely to be women (adjusted odds ratio [AOR] 7.9; 95% CI, 3.6 to 17.5), in a relationship or married (AOR 3.1; 95% CI, 1.8 to 5.4), and to have had multiple lifetime sexual partners. Victims of IPV were also more likely than not to have been subjected to sexual violence in the past (AOR 1.9; 95% CI, 1.0 to 3.4) or recently (AOR 3.9; 95% CI, 2.2 to 6.8). Perpetrators were likely to be men (AOR 2.1; 95% CI, 1.2 to 3.7), with 5 or more lifetime sexual partners (AOR 2.8; 95% CI, 1.3 to 6.3), and to have committed sexual violence recently (AOR 2.9; 95% CI, 1.1 to 7.7).There was a high prevalence of IPV among sexually active youth in this rural community. Study participants were recurrent victims or perpetrators and reported behaviours that put them at risk of HIV acquisition. Health programmes should screen for IPV victims and perpetrators using identified characteristics. Existing policies regarding gender-based violence should be enforced, and future research should focus on the impact of IPV prevention programmes.

A community-based qualitative study on the experience and understandings of intimate partner violence and HIV vulnerability from the perspectives of female sex workers and male intimate partners in North Karnataka state, India

BackgroundResearch has increasingly documented the important role that violence by clients and the police play in exacerbating HIV vulnerability for women in sex work. However few studies have examined violence in the intimate relationships of women in sex work, or drawn on community partnerships to explore the social dynamics involved. A community-based participatory research study was undertaken by community and academic partners leading intimate partner violence (IPV) and HIV prevention programs in Bagalkot district, Karnataka state, India. The purpose was to explore the experience and understandings of intimate partner violence and HIV/AIDS among women in sex work and their intimate partners in Bagalkot that would inform both theory and practice.MethodsA community-based, interpretive qualitative methodology was used. Data was collected between July and October 2014 through in-depth interviews with 38 participants, including 10 couples, 13 individual female sex workers, and 5 individual male intimate partners. Purposive sampling was done to maximize variation on socio-demographic characteristics. Thematic content analysis was conducted through coding and categorization for each interview question in NVivo 10.0, followed by collaborative analysis to answer the research questions.ResultsThe results showed that an array of interrelated, multi-level factors underlay the widespread acceptance and perpetuation of violence and lack of condom use in participants’ intimate relationships. These included individual expectations that justified violence and reflected societal gender norms, compounded by stigma, legal and economic constraints relating to sex work. The results demonstrate that structural vulnerability to IPV and HIV must be addressed not only on the individual and relationship levels to resolve relevant triggers of violence and lack of condom use, but also the societal-level to address gender norms and socio-economic constraints among women in sex work and their partners.ConclusionThe study contributes to a better understanding on the interplay of individual agency and structural forces at a time when researchers and program planners are increasingly pondering how best to address complex and intersecting social and health issues. Ongoing research should assess the generalizability of the results and the effectiveness of structural interventions aiming to reduce IPV and HIV vulnerability in other contexts.

Shifting Perceptions of Consequences of IPV Among Beneficiaries of Indashyikirwa: An IPV Prevention Program in Rwanda.

Indashyikirwa is a Rwandan program that seeks to prevent intimate partner violence (IPV) and support healthy, equitable relationships. A fundamental program aspect is a 5-month curriculum among heterosexual couples designed to identify the causes and consequences of economic, emotional, physical, and sexual IPV, and build skills to manage triggers of IPV. The program also trained opinion leaders to more effectively prevent and respond to IPV, and established women's safe spaces to educate women about their rights, refer or accompany women who wish to report abuse or seek services. Drawing on 30 interviews with couples and 9 interviews with opinion leaders before and after completing the Indashyikirwa trainings, this article highlights beneficiaries' perceived consequences of IPV, and how such perceptions were influenced through the Indashyikirwa program. Interviews were conducted in Kinyarwanda, recorded, translated, and transcribed into English and analyzed thematically. The data reveal a depth of understanding of consequences of various forms of IPV. Although several participants justified more minor forms of men's physical IPV, such as slapping, severe consequences of physical IPV were most readily identified and sanctioned. Various harms of emotional and economic IPV were reported, yet these forms of IPV were typically less socially sanctioned or identified as IPV. Conceptions of sexual IPV were influenced by inequitable gender norms, and not typically recognized as a violation under the law. Although the data do not yet demonstrate the long-term impact, collectively identifying the overlapping consequences and underlying power inequalities for all forms of IPV, the legal rights protecting against various forms of IPV, and the benefits of nonviolent, equitable relationships, appeared to be helpful to shift perceptions of consequences of IPV. Implications of the findings for the program and broader IPV prevention are identified.

Victims and Perpetrators of Intimate Partner Violence Among Sexually Active Youth in a Community With a High HIV Prevalence in Western Kenya

Background:Physical intimate partner violence (IPV) is an important risk factor for sexually transmitted infections, including HIV. We set out to determine the prevalence and correlates of IPV among youth aged 15 to 24 years – in a community with a high HIV prevalence – with a view to recommending strategies to address IPV.Methods:We analysed data from an HIV seroprevalence survey, which included participants aged 13 years and above and was conducted between November 2012 and December 2014 in Gem Subcounty, Siaya County, Western Kenya. Participants between 15 and 24 years old (youth) were described as “perpetrators of IPV” if they had done anything to physically hurt their sexual partners in the previous year and as “victims of IPV” if they had been physically hurt by a sexual partner in the same timeframe. Logistic regression was used to determine factors associated with being either a victim or perpetrator of IPV.Results:Of 1,957 participants included in the analysis, 142 (7%) were victims of IPV, and 77 (4%) were perpetrators of IPV. Victims were likely to be women (adjusted odds ratio [AOR] 7.9; 95% CI, 3.6 to 17.5), in a relationship or married (AOR 3.1; 95% CI, 1.8 to 5.4), and to have had multiple lifetime sexual partners. Victims of IPV were also more likely than not to have been subjected to sexual violence in the past (AOR 1.9; 95% CI, 1.0 to 3.4) or recently (AOR 3.9; 95% CI, 2.2 to 6.8). Perpetrators were likely to be men (AOR 2.1; 95% CI, 1.2 to 3.7), with 5 or more lifetime sexual partners (AOR 2.8; 95% CI, 1.3 to 6.3), and to have committed sexual violence recently (AOR 2.9; 95% CI, 1.1 to 7.7).Conclusion:There was a high prevalence of IPV among sexually active youth in this rural community. Study participants were recurrent victims or perpetrators and reported behaviours that put them at risk of HIV acquisition. Health programmes should screen for IPV victims and perpetrators using identified characteristics. Existing policies regarding gender-based violence should be enforced, and future research should focus on the impact of IPV prevention programmes.

The doing and undoing of male household decision-making and economic authority in Rwanda and its implications for gender transformative programming

This paper explores two key norms that underpin intimate partner violence in Rwanda: men’s roles as economic providers and decision-making authorities in the household. It describes the political, legal and socio-economic factors affecting these norms and how they create opportunities and barriers to ‘undoing’ restrictive gender norms. Findings are drawn from an evaluation of Inadshyikirwa, an intimate partner violence prevention programme operating in Rwanda. Across three intervention sectors, 24 focus groups were conducted with unmarried and married men and women residing in intervention communities. Thirty interviews with couples and nine interviews with opinion leaders were conducted before they completed programme training designed to shift gender norms underlying intimate partner violence. The data indicate a strong awareness of and accountability to Rwandan laws and policies supporting women’s economic empowerment and decision-making, alongside persisting traditional notions of men as household heads and primary breadwinners. Transgression of these norms could be accommodated in some circumstances, especially those involving economic necessity. The data also identified increasing recognition of the value of a more equitable partnership model. Findings highlight the importance of carefully assessing cracks in the existing gender order that can be exploited to support gender equality and non-violence.

Racial and Ethnic Differences in Homicides of Adult Women and the Role of Intimate Partner Violence - United States, 2003-2014.

Homicide is one of the leading causes of death for women aged ≤44 years.* In 2015, homicide caused the death of 3,519 girls and women in the United States. Rates of female homicide vary by race/ethnicity (1), and nearly half of victims are killed by a current or former male intimate partner (2). To inform homicide and intimate partner violence (IPV) prevention efforts, CDC analyzed homicide data from the National Violent Death Reporting System (NVDRS) among 10,018 women aged ≥18 years in 18 states during 2003-2014. The frequency of homicide by race/ethnicity and precipitating circumstances of homicides associated with and without IPV were examined. Non-Hispanic black and American Indian/Alaska Native women experienced the highest rates of homicide (4.4 and 4.3 per 100,000 population, respectively). Over half of all homicides (55.3%) were IPV-related; 11.2% of victims of IPV-related homicide experienced some form of violence in the month preceding their deaths, and argument and jealousy were common precipitating circumstances. Targeted IPV prevention programs for populations at disproportionate risk and enhanced access to intervention services for persons experiencing IPV are needed to reduce homicides among women.

Women's Work, Gender Roles, and Intimate Partner Violence in Nigeria.

The purpose of this study was to determine the contribution of women's labor force participation to the risk of intimate partner violence (IPV) victimization in the past 12months, using data for 20,635 currently married women aged 15-49years from the 2013 nationally representative Nigeria Demographic and Health Survey. Multilevel logistic regression models of sexual and physical IPV, with interactions between women's work and social norms regarding traditional gender roles, were developed. Approximately 23% of women aged 15-49years reported IPV victimization in the past 12months. Results revealed that non-cash work relative to unemployment was positively associated with both forms of IPV victimization, after controlling for other factors. Women's engagement in cash work was positively correlated with sexual IPV. The positive association between cash work and physical IPV victimization was significantly larger for women who resided in localities with greater male approval of wife beating. In localities where husband-dominated decision making was more common, a spousal education gap that favored husbands was more positively associated with sexual IPV. The findings call for integrated IPV prevention and economic empowerment programs that consider gender norms and gender-role beliefs and are adapted to the locality setting, in order to promote social environments in which women can reap the full benefits of their economic empowerment.