Sexual IPV Research Articles

Examining the measurement of severity of intimate partner violence and its association to mental health outcomes: a narrative synthesis.

The aims of this synthesis were to investigate the relationship between IPV severity and mental health outcomes and shed light to gaps and limitations in existing methodologies used to assess IPV severity and its association with mental health outcomes. We conducted a two-stage narrative synthesis of 76 studies. First, we identified IPV measures used in at least five studies, focusing on their variations and severity score calculation. Then, we analyzed findings of studies correlating IPV severity with mental health outcomes, identifying features of measures and statistical methods influencing result consistency. Measures of intimate partner violence were often modified from their original, potentially impact on the reliability and validity of these measures. The operationalization of violence severity varied across studies, leading to inconsistencies in scoring whereby compromising the consistency of severity levels across studies. We found lack of consistency in applying validated methods for scoring instruments to determine abuse severity. In this review, we consistently found that the severity of IPV and its various subtypes were linked to different mental health outcomes across multiple studies. We discovered evidence suggesting that experiencing more types of IPV was associated with worse mental health outcomes. Generally, higher levels of overall IPV severity and its specific subtypes were correlated with poorer mental health outcomes. However, our analyses did not reveal consistent patterns that would allow for a definitive determination of how individual IPV subtypes differently affect mental health outcomes. Nevertheless, we observed that increasing severity of physical IPV tended to have a notable impact on post-traumatic stress disorder (PTSD). Conversely, increasing severity of psychological IPV was consistently associated with depression. While sexual IPV severity was explored in fewer studies, the evidence regarding its impact on various mental health outcomes was less conclusive. To achieve a comprehensive understanding of the mechanism by which IPV severity is related to mental health it may be time to take an alternative approach to measuring IPV severity. No IPV measures assessed the acceptability of the content to people who have experienced IPV. This is an important omission with significant consequences for the validity of the evidence base.

Understanding the Impact of Sexual Youth Intimate Partner Violence: Unmasking the Social Consequences for Young Victims

This study focuses on sexual youth intimate partner violence (YIPV), what it is like to be young and subjected to such violence and how this experience affects a young person. Drawing upon 27 interviews with victims (ages 17–24) of sexual YIPV, we ask: How does psychological aspects influence how sexual YIPV and control were experienced? How are young victims affected by the violence? From a social perspective, how can we understand the consequences? The results suggest that experiences of sexual YIPV may lead to consequences such as development of a negative body image and difficulties having sex; loss of bodily control; and using sex as a means of self-injury. Our findings also show how sexual YIPV is interconnected with other forms of violence. The findings are valuable to professionals supporting young victims of sexual IPV, as they shed light on how sexual YIPV may affect young victims.

Understanding the association between intimate partner violence and sexually transmitted infections among women in India: a propensity score matching approach

BackgroundIntimate partner violence (IPV) against women can significantly impact their overall health. While numerous studies in developing nations highlight the association between IPV and sexually transmitted infections (STIs), the evidence...

Factors associated with help-seeking by women facing intimate partner violence in India: findings from National Family Health Survey-5 (2019–2021)

BackgroundIntimate partner violence (IPV) against women has harmful effects on their psychological and physical health. However, help-seeking for IPV is significantly low among women in the Indian context. This study examines the different factors that influence help-seeking behaviour among women in India. It also studies associations of the type of IPV with the source of help.MethodsThe study analyses data from the fifth round of the National Family Health Survey that was conducted in India (2019–2021). Independent variables were categorized at individual, relationship-household and community levels. The Stata 14.2 software was used to calculate the prevalence ratios and their corresponding 95% confidence intervals. Variables with p-values less than 0.05 were considered statistically significant. Poisson regression helped identify factors associated with help-seeking.ResultsResults indicate that among 72,320 women aged 18–49 years, 17,765 women ever-faced IPV. Of them, 14.2% of women who faced either physical and/or sexual IPV sought any help. Husband’s consumption of alcohol almost doubled the likelihood of help-seeking among women (19.91%), compared to women whose husbands did not drink alcohol (10.19%). Witnessing parental IPV also increased the odds (17.26%) of help-seeking. Women who were not empowered were more likely to seek help (14.11%) compared to women who were empowered (12.56%). The police were the predominant source where women went for formal help (6.94 to 8.43%), followed by doctors (1.84 to 2.71%). Close to 1 in 4 women (22.5%) sought help for sexual IPV, while 14.4% of women sought help for physical IPV. Around 95% of all women who faced IPV sought informal help, with 3 in 5 of them approaching their own families, and 3 in 10 approaching their in-laws or marital families.ConclusionsTwo significant factors that associate positively with help-seeking by women facing IPV are husbands’ alcohol consumption and witnessing parental IPV. Most women preferred informal help from the natal family, while among formal providers, the police were the foremost choice. Programmes and initiatives to build capacities of communities, and of police to respond to women seeking help for IPV, would enable more women to reach out for help.

Exclusive breastfeeding and its association with intimate partner violence during pregnancy: analysis from Pakistan demographic and health survey

BackgroundIntimate partner violence (IPV) is a global social issue and increasingly asks for the attention of policymakers. IPV is one of the main factors that affect the health of pregnant women and their infants during pregnancy and after childbirth; it will not only cause direct harm to women themselves but also reduce women’s exclusive breastfeeding (EBF) behavior and pose a threat to newborn health. Existing facts on the association between IPV and EBF in the Pakistani context are negligible and incomplete to an enduring measure of IPV practice. To this effect, the present study aims to investigate the relationship between EBF and IPV practiced during the prenatal period and post-delivery.MethodsThe statistics study has drawn from the Pakistan Demographic and Health Survey (PDHS) 2018. A total of 1191 breastfeeding females aged 15–49 with children under 6 months were selected for the present study. T-test or chi-square test of Univariate test of hypothesis; Logistic regression model was utilized to explore the potential impact of IPV on female exclusive breastfeeding from three dimensions of physical, sexual and psychological violence, to provide data support for the Pakistani government to formulate policies to promote female EBF. All investigations have been performed in STATA software 16.0 (Stata Corp, College Station, TX, USA) at 95% confidence interval.ResultsAmong the 1191 participants, 43.6% (520 / 1191) of the females were EBF, while the rates of physical, sexual, and emotional IPV were 47.44%, 30.23%, and 51.72%, respectively. Logistic regression analysis showed that females who have experienced physical IPV were 32% less likely to be exclusively breastfed (aOR = 0.68; 95% CI; 0.490, 0.980; P < 0.05), the chances of EBF were reduced by 22% in women who experienced IPV (aOR = 0.78; 95 CI; 0.55, 1.00; P < 0.05), females who experienced emotional IPV were 31% less probable to exclusively breastfed (aOR = 0.69; 95% CI; 0.47, 0.92; P < 0.05).ConclusionsThis study determines the adverse effects of sexual and psychological violence on EBF practices in women. Policymakers in Pakistan should actively implement assistance programs to reduce IPV, emphasize monitoring women’s experiences of IPV before and after giving birth, and encourage women to break the “culture of silence” when they experience IPV to maximize their access to assistance.

Linkages between maternal experience of intimate partner violence and child nutrition outcomes: A rapid evidence assessment.

A strong evidence base indicates that maternal caregivers' experience of intimate partner violence [IPV] impacts children's health, cognitive development, and risk-taking behaviors. Our objective was to review peer-reviewed literature describing the associations between a child's indirect exposure to IPV and corresponding nutrition outcomes, with a particular focus on fragile settings in low and middle-income countries [LMICs]. We conducted a rapid evidence assessment to synthesize quantitative associations between maternal caregivers' IPV experience and children's nutrition/growth outcomes (birthweight, feeding, and growth indicators). We included peer-reviewed research, published in English or Spanish after the year 2000, conducted in fragile settings in LMICs. We identified 86 publications that fit inclusion criteria. Amongst all associations assessed, a maternal caregiver's experience of combined forms of IPV (physical, sexual and emotional) or physical IPV only, were most consistently associated with lower birthweight, especially during pregnancy. Women of child-bearing age, including adolescents, exposed to at least one type of IPV showed a decreased likelihood of following recommended breastfeeding practices. Lifetime maternal experience of combined IPV was significantly associated with stunting among children under 5 years of age in the largest study included, though findings in smaller studies were inconsistent. Maternal experience of physical or combined IPV were inconsistently associated with underweight or wasting in the first five years. Maternal experience of sexual IPV during pregnancy appeared to predict worsened lipid profiles among children. Maternal caregivers' experience of IPV is significantly associated with low birthweight and suboptimal breastfeeding practices, whereas studies showed inconsistent associations with child growth indicators or blood nutrient levels. Future research should focus on outcomes in children aged 2 years and older, investigation of feeding practices beyond breastfeeding, and examination of risk during time periods physiologically relevant to the outcomes. Programmatic implications include incorporation of GBV considerations into nutrition policies and programming and integrating GBV prevention and response into mother and child health and nutrition interventions in LMIC contexts.

Intimate partner violence and postpartum healthcare access in Kenya: a cross-sectional study

BackgroundIntimate partner violence (IPV) impacts physical health, mental health, and healthcare use. IPV during pregnancy, in particular, is associated with lower rates of antenatal care, but no studies have assessed the association between IPV and postpartum healthcare. This study aims to examine the link between IPV (emotional, physical, and sexual) and two outcomes: postpartum healthcare use and access to family planning.MethodsThis study uses data from a cross-sectional survey of 859 women in Nairobi and Kiambu counties in Kenya who gave birth during the COVID-19 pandemic in 2020.ResultsIn this sample, 36% of women reported ever experiencing IPV. Of those, 33% indicated the frequency of IPV stayed the same or increased during COVID-19. Nearly 17% of women avoided postpartum healthcare and 10% experienced issues accessing family planning. Those who experienced any form of IPV during pregnancy had approximately twice the odds of avoiding postpartum healthcare compared to those who did not experience any form of IPV. Compared to those who did not experience IPV during pregnancy, experiencing sexual IPV was associated with 2.25 times higher odds of reporting issues accessing family planning. Additionally, reporting fair or poor self-rated health was associated with both avoiding postpartum healthcare and reporting issues accessing family planning. Experiencing food insecurity was also associated with avoiding postpartum healthcare.ConclusionsTo our knowledge, this is the first study to establish the link between IPV during pregnancy and postpartum healthcare access. During COVID-19 in Kenya, postpartum women who had experienced IPV were at increased risk of disengagement with healthcare services. Women should be screened for IPV during pregnancy and postpartum in order to better support their healthcare needs. In times of crisis, such as pandemics, policymakers and healthcare providers must address barriers to healthcare for postpartum women.

Association between intimate partner violence and pregnancy intention: evidence from the Peruvian demographic and health survey

BackgroundIntimate partner violence (IPV) in Peru represents a significant public health challenge. IPV can influence women’s reproductive and social behaviors, undermining fertility control, and exacerbating unintended pregnancies. Our objective was to assess the association between IPV and pregnancy intention among Peruvian women of reproductive age.MethodsWe conducted a secondary analysis of Peru’s 2020 Demographic and Family Health Survey data. The independent variable in this study was IPV against women, which includes psychological IPV, sexual IPV, and physical IPV. If a respondent experienced any of these three forms of IPV, the IPV variable was labeled as “yes”; if none were present, it was labeled as “no”. The dependent variable was pregnancy intention (no vs. yes). We utilized a generalized linear model (GLM) from the Poisson family with a log link function to assess the relationship between IPV occurrences (total and each IPV type) and pregnancy intention. We report crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI).ResultsWe analyzed data from 8466 women aged 15 to 49. The prevalence of any IPV was 49.6% (psychological IPV: 45.8%; physical IPV: 22.2%; and sexual IPV: 4.3%). Exposure to physical IPV (aPR: 1.05; 95% CI: 1.03–1.07), psychological IPV (aPR: 1.04; 95% CI: 1.02–1.06), and sexual IPV (aPR: 1.09; 95% CI: 1.04–1.13), as well as a history of any IPV (aPR: 1.05; 95% CI: 1.02–1.07), were associated with a higher probability of not intending to become pregnant. This association persisted after adjusting for confounders like age, marital status, educational attainment, education level of the child’s father, place of residence, wealth, ethnicity, and parity.ConclusionOne in two Peruvian women reported experiencing IPV. An association was observed between IPV exposure and a higher probability of not holding an intention to become pregnant.

Underestimation of potentially traumatic events resulting from underreporting of physical and sexual violence among people entering care for HIV in Cameroon.

Measures ascertaining exposure to potentially traumatic events (PTEs) frequently ask respondents about experienced physical and sexual violence. However, little is known about the performance of physical and sexual violence questions on PTE assessments and its effect on PTE classification overall. We estimated underreporting of physical and sexual violence on a PTE assessment among individuals entering HIV care in Cameroon. We compared reports of physical and sexual violence captured via a behaviorally specific measure of intimate partner violence (IPV; Demographic and Health Survey [DHS] domestic violence module = referent) to those captured via two single-item questions that assessed exposure to physical and sexual PTEs during one's adult life to determine the degree of underreporting on the single-item PTE assessment questions. We explored correlates of underreporting on the PTE assessment using Pearson's chi-squared tests. Overall, 99 (23%) and 113 (27%) of 426 total participants reported instances of sexual and physical violence in their most recent partnership on the behaviorally specific DHS IPV module, respectively. Of those reporting sexual and physical IPV on the DHS module, just 6% (n = 6) and 52% (n = 59) reported sexual and physical violence as an adult on the single-item PTE assessment questions, respectively. Underreporting of physical violence on the PTE assessment was associated with lower educational attainment (p < .05) and reporting being punched (p < .01) or having one's hair pulled or arm twisted (p < .05) by one's most recent partner. PTE assessment tools should assess exposure to behaviorally specific acts of violence to ensure appropriate referral to services among survivors of IPV. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Men's Narratives of Sexual Intimate Partner Violence in Urban Mwanza, Northwestern Tanzania.

Engaging men has been established as central in addressing intimate partner violence. Yet few studies on intimate partner violence explored men's perspectives on what constitutes sexual violence in relationships only. To explore how men conceptualize sexual violence, we engaged a qualitative approach to unpack men's narratives of sexual IPV. The study was conducted in Mwanza, Tanzania using in-depth interviews with 30 married men. Men shared a broad spectrum of unacceptable behaviors that clearly or potentially connote sexual violence. Some of the acts were deemed to constitute sexual violence when directed to both men and women, while some were perceived as sexual violence when directed to women or men only. Threatened manhood underpinned men's conceptualization of sexual violence against them by their partners. Although a large part of men's narratives of sexual violence towards women seemed to challenge the common sexual scripts existing in patriarchal societies, some of their accounts indicated the persistence of traditional presumptions of masculine sexual entitlement. Our findings uncover additional dimensions of sexual violence that go beyond what is included in the current global frameworks, underscoring the critical need of giving people a voice in their local contexts in defining what sexual intimate partner violence entails for them. This may increase the likelihood of interventions becoming more acceptable and effective when targeting sexual violence, thereby contributing to reduced levels of sexual intimate partner violence.

The Women’s Perception on the Effects of Intimate Partner Violance on Women’s Psychological Wellbeing: A Case of Iringa Municipality

The general objective of this study is to examine the women perception on effects of Intimate Partner violence on women’s psychological wellbeing and Specific objectives was To explore the women’s perception on effect of physical Intimate Partner violence on women’s psychological wellbeing,&#x0D; To examine women’s perception on the effect of sexual Intimate Partner Violence on women’s psychological wellbeing and To determine the women’s perception on the effect of psychological Intimate Partner Violence on women’s psychological wellbeing.&#x0D; This study conducted at Kihesa ward, Makorongoni ward and Ruaha ward in Iringa Municipal. Using the mixed research design this study employed Convenience research to collect primary data from 361 women respondents in the study areas and adopted purposive sampling technique to collect data from three key informant. Questionnaires were used as research instrument to collect quantitative data. Quantitative data were presented in tables, frequencies and percentages then analyzed descriptively.&#x0D; Findings revealed that 74.2% of female agreed about the presence of violence in Iringa Municipal while 25.8% disagreed. On view of physical effects about 42.4% of women agreed that mental illness to the maximum, 44.9% of women confirmed that among the effects was chronic stress to women which affected mostly women at family level. The last physical effects were women being depressed by 12.7%. Furthermore, among the sexual effects, about 45.2% of women were affected through mental illness while 24.4% were affected through chronic stress. Likewise, 15.3% of women confirmed that among the effects were depression and 15.2% of women were affected through isolating themselves. Through psychological effect, about 37.7 % of women affected through mental illness, 29.3% of women affected through chronic stress, 27.5% of women affected through mental illness and 5.5% of women affected through isolation. This study concludes that in Iringa Municipal Council there is effects of physical, sexual and psychological IPV violence which affects women’s psychological wellbeing. The existing literature overwhelmingly confirms that intimate partner violence takes a severe toll on women's psychological wellbeing. It manifests as a range of psychological challenges, including trauma-related symptoms, depression, anxiety, and low self-esteem. Recognizing the complexity of IPV's impact and the unique experiences of survivors is essential for providing effective support and interventions.

Prevalence, correlates, and trends of intimate partner violence against women in Sierra Leone: findings from 2013 and 2019 demographic and health surveys.

Intimate partner violence (IPV) is a globally pervasive public health and medical problem in addition to being a serious violation of women's rights. The two-fold objectives of this study were to compute the lifetime prevalence and correlates of IPV perpetrated by current/former husbands/partners of ever-married women aged 15-49 years using the nationally representative Sierra Leone Demographic and Health Survey (DHS) conducted in 2019; ethnicity-based levels and trends of IPV were also computed using the data from the DHS conducted in 2013 along with the 2019 DHS. Twelve IPV correlates pertaining to socio-demographic, attitudinal, and experiential attributes were analyzed using logistic regression models for bivariate and multivariable analysis. IPV was computed as a composite variable comprising of physical, emotional, and/or sexual IPV. Lifetime prevalence of experiencing any kind of IPV was a staggering 60.81%, whereas emotional, physical, and sexual IPV prevalence were reported by 45.90%, 49.81%, and 8.14% of the respondents, respectively. No ethnicity reported a statistically significant decrease in any type of IPV during the intervening period between the two surveys. Five out of nine ethnicities reported a statistically significant increase in emotional IPV, while few ethnicities reported a statistically significant increase in one or more types of IPV. The high lifetime prevalence of IPV is alarming and points to the need for targeted health promotion campaigns to reverse the tide of IPV in Sierra Leone, including focusing on changes in cultural and ethnicity-based norms and mores to ensure women's human rights are respected and upheld.

Trajectories to Suicide Following Intimate Partner Violence Victimization: Using Structural Equation Modelling to Examine Suicide and PTSD in Female Emergency Department Users

Abstract Purpose Intimate partner violence (IPV) is known to increase the risk of suicidal thoughts and behaviors. Despite the urgent need to increase women’s safety and wellbeing, trajectories to suicide are not well understood and few studies have tested potentially important mediators, such as post-traumatic stress disorder (PTSD), that could help to improve risk stratification and clinical responses. Methods This study used baseline data from a prospective cohort study (2019–2020) to examine differential effects of psychological, physical, sexual, and multiple IPV on suicidal ideation and suicide attempt and test whether pathways are mediated by PTSD. Simple random sampling – online/in-person in Australian emergency departments (EDs) – was used to survey consenting women with a recent suicide-related ED presentation. Structural equation modelling was used to test the pathways between recent and lifetime IPV, PTSD, and suicidal ideation and attempt. Results Of the 1,715 women (M = 30.24, SD = 11.91 years) who participated, 1,012 (59%) reported lifetime IPV exposure, with 608 (35%) reporting recent victimization (&lt; 18 months). Presence of PTSD wholly mediated the effects of psychological, physical, and sexual IPV on ideation (p &lt; .05). Multiple IPV was unique in its direct effects on ideation and attempt and these pathways were most consistent for recent IPV, compared with lifetime exposure (p &lt; .05). Conclusions Pathway analysis identified two high-risk patient-populations: Women with recent multiple IPV and those with a diagnosis of PTSD following lifetime IPV exposure. Findings can be used to improve risk prediction and clinical intervention for patients living with mortality risk from partner- and self-directed violence.

Association between intimate partner violence and nutritional status among Indian women: a latent class analysis approach

BackgroundIntimate partner violence (IPV) is an unabating public health issue that has numerous negative repercussions for women’s health. Its detrimental impact on women’s nutritional outcomes has been documented in a few studies from low- and middle-income countries; however, there is a lack of granular understanding in terms of the typology of IPV experiences and their association with nutritional outcomes. This study explores the distinct classes of IPV experience among women in India and examines how these classes are associated with their nutritional outcomes.MethodsUsing data of 60,622 ever-married women aged 15–49 years from the 2019-21 National Family Health Survey (NFHS-5), latent class analysis (LCA) was performed to identify distinct groups of women based on their IPV experiences. BMI was used to assess women’s nutritional status, and it was classified as: <18.5 kg/m2 (underweight), 18.5–24.9 kg/m2 (normal) and ≥ 25.0 kg/m2 (overweight). Further, multinomial logistic regression analyses were used to estimate the odds of being underweight or overweight by latent classes of IPV experiences.ResultsLCA model identified four distinct IPV experience groups of women: Low Physical and Low Sexual IPV (LPLS-IPV) class (72%); High Physical and Low Sexual IPV (HPLS-IPV) (12.5%); High Sexual and Low Physical IPV (HSLP-IPV) (12%); and High Physical and High Sexual (HPHS-IPV) class (3.5%). The likelihood of being underweight was higher among women in the HPHS-IPV class (aOR: 1.24, 95% CI: 1.08–1.44), followed by those in the HPLS-IPV class (aOR: 1.11, 95% CI: 1.04–1.20).ConclusionThe latent class groups found that high physical IPV experiences were associated with women’s nutritional outcomes. The experiences of women having both high physical and sexual violence affect women’s nutritional outcomes to a greater extent and they are more likely to be undernourished.

Mapping the disparities in intimate partner violence prevalence and determinants across Sub-Saharan Africa.

This study aimed to map disparities in prevalence and associated factors across countries in Sub-Saharan Africa. We used National Demographic and Health Survey (DHS) data from 26 countries in the region with 114,340 participants. Women and girls in the reproductive age group of 15 to 49 years were included in the study. To map disparities across countries and their provinces, we employed the kriging interpolation technique. We used STATA for data management. The prevalence of physical, emotional and sexual IPV in Sub-Saharan Africa was 30.58, 30.22, and 12.6% respectively, and at least one form of IPV was 42.62%. Disparities were observed across the countries and provinces in each country. Younger age, secondary-level education and above, moderate participation in decision-making, not working out of home, not afraid of the spouse, rich (wealth index), not having a child, high maternal literacy, and rural residence relatively decreased the odds of IPV. The husbands' lower education, alcohol consumption, and high controlling behavior increased the probability of IPV. The prevalence of Intimate Partner Violence in Sub-Saharan Africa is the highest in the world, a signal that the global agenda to end all forms of violence against women will be difficult to achieve. There is a large gap across countries and provinces in each country. Area-specific intervention packages that focus on modifiable factors should be strengthened.

Childhood and adolescent nutrition outcomes among girls exposed to gender-based violence: A rapid evidence assessment of quantitative research.

An emerging evidence base has explored the nutritional consequences of gender-based violence (GBV) perpetrated against girls during childhood/adolescence. We conducted a rapid evidence assessment of quantitative studies describing associations between GBV and girls' nutrition. We adapted systematic review methods and included empirical, peer-reviewed studies, published after 2000 (until November, 2022), that were written in Spanish or English and reported quantitative associations between girls' exposure to GBV and nutrition outcomes. A variety of GBV forms were considered: childhood sexual abuse (CSA), child marriage, preferential feeding of boys, sexual IPV and dating violence. Nutrition outcomes included anemia, underweight, overweight, stunting, micronutrient deficiencies, meal frequency, and dietary diversity. In total, 18 studies were included, 13 of which were conducted in high-income countries. Most sources utilized longitudinal or cross-sectional data to quantify associations between CSA, sexual assault, and intimate partner/dating violence and elevated BMI/overweight/obesity/adiposity. Findings suggest that CSA perpetrated by parents/caregivers is associated with elevated BMI/overweight/obesity/adiposity via cortisol reactivity and depression; this relationship may be compounded by additional intimate partner/dating violence in adolescence. The effects of sexual violence on BMI are likely to emerge during a sensitive period of development between late adolescence and young adulthood. Emerging evidence was found regarding the relationship between child marriage (and the related exposure: age at first pregnancy) and undernutrition. The association between sexual abuse and reduced height and leg length was inconclusive. Given that only 18 studies were included, the relationship between girls' direct exposure to GBV and malnutrition has received little empirical attention, especially with respect to studies conducted in LMIC and fragile settings. Most studies focused on CSA and overweight/obesity, where significant associations were found. Future research should test the moderation and mediation effects of intermediary variables (depression, PTSD, cortisol reactivity, impulsivity, emotional eating) and consider sensitive periods of development. Research should also explore the nutritional consequences of child marriage.

Association between intimate partner violence and leukocyte telomere length: a retrospective cohort study of 144 049 UK Biobank participants

Abstract Aims Intimate partner violence (IPV) is a public health challenge negatively affecting victims’ health. Telomere length (TL), a marker for biological ageing, might be reflective of the mechanisms through which IPV leads to adverse health outcomes. The objective of the current study was to explore the association between IPV and leucocyte TL. Methods We conducted an analysis using a subset of the UK Biobank (N = 144 049). Physical, sexual and emotional IPV were reported by the participants. DNA was extracted from peripheral blood leukocytes. TL was assayed by quantitative polymerase chain reaction. We used multivariable linear regressions to test the associations between IPV and TL adjusted for age, sex, ethnicity, deprivation, education, as well as symptoms of depression and post-traumatic stress disorder in a sensitivity analysis. Results After adjusting for sociodemographic factors, any IPV was associated with 0.02-s.d. shorter TL (β = −0.02, 95% CI −0.04 to −0.01). Of the three types of IPV, physical violence had a marginally stronger association (β = −0.05, 95% CI −0.07 to −0.02) than the other two types. The associations of numbers of IPV and TL showed a dose–response pattern whereby those who experienced all three types of IPV types had the shortest TL (β = −0.07, 95% CI −0.12 to −0.03), followed by those who experienced two types (β = −0.04, 95% CI −0.07 to −0.01). Following additional adjustment for symptoms of depression and PTSD, the associations were slightly attenuated but the general trend by number of IPVs remained. Conclusions Victims of IPV, particularly those exposed to multiple types of IPVs, had shorter TL indicative of accelerated biological ageing. Given that all three types of IPV are linked to TL, clinical practitioners need to comprehensively identify all types of IPV and those who received multiple types. Further studies should explore the association of violence with changes in TL over time, as well as to which extent biological ageing is a mechanistic factor.

Quantitative evaluation of Zindagii Shoista (Living with Dignity) intervention to prevent violence against women in Tajikistan

ABSTRACT Background Violence against women and girls (VAWG) is a major problem in Tajikistan, driven by conservative gender norms, the culturally ascribed position of young women, and poverty. Objective We evaluated Zindagii Shoista (Living with Dignity), an intervention developed with the aim of reducing VAWG through a combination of gender norm change, communication skills, and income-generating activities (IGA) over a period of 30 months. Methods The evaluation used a mixed-methods approach, combining quantitative and qualitative data collection. Eighty families from four villages were enrolled in the intervention and surveyed at baseline and on three subsequent occasions. From these families, 134 women and 102 men were interviewed at baseline, 153 women and 89 men 8 months later, 153 women and 93 men 15 months later, and 143 women and 82 men, 30 months after the baseline. Generalised random effects regression models were used to assess the trend in proportions or mean score over time. Results Over the 30 months, the proportion of women and men earning in the past month rose from 17.9% to 56.6% and 44.1% to 72%, respectively. Women and men’s gender attitudes became significantly less patriarchal, and they reported less harmful gender norms in the community. Women and men reported less male controlling behaviour and greater woman involvement in decision-making. Women’s reports of experience of emotional, physical, and sexual IPV significantly reduced. Depressive symptoms and suicidal thoughts reduced significantly for men and women, and self-rated health improved. Conclusions The quantitative findings are confirmed by the findings of the qualitative research and monitoring data. They demonstrate that Zindagii Shoista is a very promising intervention for strengthening gender relations, reducing IPV, and improving mental health and socio-economic circumstances for younger married women and their families in Tajikistan.

Disability and intimate partner violence: A cross-sectional study from Mwanza, Tanzania

BackgroundWomen with disabilities are at heightened risk of experiencing intimate partner violence [IPV], although the mechanisms through which disability acts as a risk factor for IPV are not clear. ObjectiveWe analyzed cross-sectional data (n = 867) from Wave 3 of the MAISHA longitudinal study, conducted in Mwanza, Tanzania, to i) describe the levels of disability and IPV amongst women, and ii) to assess the association between level and type of disability and IPV experience. MethodsIPV was assessed using the WHO Multi-Country study instrument. Levels of disability (none, mild and severe) were categorized based on responses to the Washington Group Short Set questions. We fitted logistic regression models to determine the risk of experiencing each type of IPV according to disability level and type of disability. ResultsWe found significant associations between mild and severe disability and different types of IPV. For example, in multivariate analyses controlling for socio-demographic variables, women reporting severe disability were significantly more likely to report physical and/or sexual IPV, sexual IPV. controlling behaviors, economic IPV, and severe IPV, whereas for mild disability compared to no disability, physical and/or sexual IPV, sexual IPV, and economic IPV were significantly more likely to be reported. Cognitive disability was a significant correlate of all forms of IPV apart from physical IPV. ConclusionsOur findings that specific types of disability and not others were associated with an elevated risk of IPV exposure indicate the need for nuanced measurement and analysis of the association between disability and IPV.

Is hope associated with HIV-acquisition risk and intimate partner violence amongst young women and men? A cross-sectional study in urban informal settlements in South Africa

ABSTRACT Hope is a concept that may mediate between the structural constraints people live under and their HIV-acquisition risk behaviours/experiences. Drawing on data collected as the baseline for an intervention trial between September 2015 and September 2016, among young (18–30-year-old), out-of-school women and men in urban informal settlements in Durban, South Africa, we assess whether hope, assessed by the Snyder Hope Scale, is associated with HIV-risk behaviours/experiences. 677 women (35.5%; 33.7%; 30.9%; low, medium, and high hope scores respectively) and 668 men (40.6%; 32.8%; 26.7%; low, medium, and high hope scores respectively) were included. Among women, adjusted analyses showed high levels of hope, compared to low levels, were associated with greater modern contraceptive use (aOR1.57, 1.04–2.37). For men, medium or high levels of hope, compared to low levels, were associated with reduced physical and/or sexual IPV perpetration (med: aOR0.55, 0.38–0.81, high: 0.38, 0.25–0.57), emotional IPV perpetration (med: aOR0.54, 0.36–0.80, high: aOR0.62, 0.41–0.94) and transactional sex (med: 0.57, 0.38–0.84, high: aOR0.57, 0.39–0.86) respectively. For men, hope potentially captured a pathway between an individual’s structural context and their HIV-risk behaviour. Yet this was not the case for women. It may be the Snyder Hope Scale does not adequately capture localised meanings of hope.