Exploring risk factors associated with intimate partner violence in Vietnam: results from a cross-sectional national survey

Development of the Vietnamese Rape Myths Acceptance Scales: A Web-Based Survey of Young Adults

Rape myths-false but widely held beliefs that serve to deny and justify sexual aggression-present a major barrier to reporting and prevention of sexual violence in Vietnam and globally. Based on a parent study aimed at reducing sexual violence at two universities in Hanoi, we developed and assessed a contextualized measure of rape myths among young people in Vietnam. Items from previously validated rape myth acceptance (RMA) scales and data from qualitative research informed the development of 50 items, which were administered to Vietnamese 18-24-year-olds (n = 2,756 total, n = 1,798 cisgender women) via an anonymous link in February 2021. We used factor analysis to explore and test factor structure and multi-group factor analysis to assess measurement equivalence across gender. We calculated item-level discrimination and difficulty parameters and visualized information curves using item response theory analysis, informing the development of a short form. Four hypothesized subconstructs identified in the qualitative data emerged as factors: (1) "He didn't mean to"; (2) "She asked for it"; (3) "It wasn't really rape"; and (4) "Rape is a deviant event." A fifth factor, "She didn't protect herself," included four items from formative data. Confirming formative findings and prior literature, cisgender women had lower RMA than cisgender men, particularly on items related to victim-blaming. The Vietnamese Rape Myths Acceptance Scales were internally consistent and equivalent between cisgender men and women, capturing elements specific to the Vietnamese context and providing a tool for campus climate surveys and evaluations of sexual violence prevention programs.

Socioeconomic Inequalities in Intimate Partner Violence: Evidence from Vietnam

Although socioeconomic inequality has been identified as a significant factor for violence against women, the connection between these two variables has not been widely recognized and addressed in many countries. This study aims to quantify the degree of socioeconomic inequalities in intimate partner violence (IPV) in Vietnam and investigate the contribution of each determinant factor that contributes to the observed inequality. We utilized the Vietnamese National Survey on Domestic Violence against Women (N = 4,019) for the analysis. Household wealth was used as a proxy for socioeconomic status. We used a concentration index to quantify the degree of socioeconomic inequality in emotional, physical, or sexual violence and a combination of these three types of violence. We further decomposed the concentration index to identify the contribution of each determinant to the observed inequality in IPV. We found that the prevalence of IPV was significantly concentrated among the worse-off across all types of IPV and that disparities in husband's occupation (48%), women's education (39%), husband's education (38%), and class (34%) were the primary factors contributing to increased inequalities in IPV. Our results indicated that higher education and engagement in skilled jobs were highly concentrated among the better-off, creating unequal distribution of these variables across wealth. Policy could mitigate the inequality in IPV by expanding women's access to education and economic opportunities. However, interventions should target both men and women and within couples because husband's characteristics also play an important role in explaining socioeconomic inequalities in IPV.

Intergenerational transmission of intimate partner violence among women: Evidence from the 2017 Philippines National Demographic and Health Survey

Intimate partner violence (IPV) substantially harms women's overall health worldwide. The intergenerational cycle of IPV among women remains underexplored from the perspective of victimization and perpetration, and by types of subsequent IPV. The 2017 Philippines National Demographic and Health Survey dataset of 12,248 currently in-union (married or cohabiting) women aged 15 to 49 were utilized in this study. The main exposure variable was measured by the question: "as far as you know, did your father ever beat your mother?". Multivariate logistic regression was performed to investigate the association between being ever exposed to parental IPV and (1) women's IPV victimization (by types: any, physical, sexual, and emotional) and (2) IPV perpetration (physical) by women against their husbands or male partners. Further, multinomial logistic regression examined the association between exposure to parental IPV and the experience of being an IPV victim only, perpetrator only, or both. We have found that women who were exposed to parental IPV were more likely to experience IPV victimization (OR: 2.1, 95% CI: 1.9, 2.4 for any IPV; OR: 2.3, 95% CI: 2.0, 2. for physical IPV; OR: 2.0, 95% CI: 1.6, 2.4 for sexual IPV; and OR: 2.0, 95% CI: 1.8, 2.2 for emotional IPV), and also perpetrate physical IPV themselves (OR: 2.1, 95% CI: 1.9, 2.4) compared to those unexposed to parental IPV. Moreover, women exposed to parental IPV were three times more likely to be both a perpetrator and a victim of IPV (OR: 3.1, 95% CI: 2.7, 3.7), much higher than the odds of being a victim only (OR: 1.9, 95% CI: 1.8, 2.2) or a perpetrator only (OR: 1.9, 95% CI: 1.6, 2.). In summary, exposure to parental IPV was associated with Filipino women being victims and perpetrators of IPV themselves. The integration of violence prevention within parenting and community programs can be considered to prevent the perpetuation of the intergenerational cycle of IPV.

An analysis of changes in the prevalence and patterns of intimate partner violence against women in seven Asian countries

BACKGROUND

Assessments of changes in prevalence and patterns of violence against women are critical to inform prevention and response approaches and to monitor progress towards elimination. Most countries in the Asia Region have data on violence and several have completed second and third waves of surveys. This study sought to assess and compare the prevalence and patterns of physical and/or sexual partner violence in seven Asian countries with at least two rounds of comparable national-level data.

METHODS

We conducted primary descriptive analyses using Demographic and Health data from India, Nepal, and Pakistan (South Asia), and from Cambodia, the Philippines, Timor-Leste, and extracted data from reports from Vietnam (Southeast Asia). We examined differences in partner violence by type of violence, reference periods, severity of violence, and age group. Pearson chi-square tests and Mantel-Haenszel test for trend were used to assess whether differences between time points were significant (p < 0.05).

RESULTS

Prevalence and patterns of violence vary across countries and sub-regions. In Southeast Asia, women in Cambodia and Vietnam experienced increasing and relatively high levels of sexual violence alongside declining physical violence. Reported levels of violence were lowest in the Philippines and prevalence showed consistent declines. Timor-Leste stands out as having the highest prevalence of physical partner violence, and there were consistently significant increases in estimates. Women in South Asia experienced predominantly physical violence and there were consistent declines in all three countries, though physical violence increased among older women in India.

CONCLUSIONS

Data from Asian countries where more than one prevalence survey had been done provided a unique opportunity to analyse differences in estimates of violence against women at two time points. Deeper analyses into types and severity of violence revealed that overall prevalence estimates hid more complex patterns. There are clear limitations in using survey data to understand the nuances which highlighted the need for depth analysis identifying contextual factors of violence to inform situation specific policies and interventions for the greatest impact. It is also clear that more than two data points are necessary to identify change over time, and interventions driving or preventing that change.

Intimate Partner Violence and Depression in Women in China

Intimate partner violence (IPV) is recognized as a major public health and social problem globally, with consequences for the individual, family, and society. But there is relatively little research on IPV in China. The aim of this study was to estimate the prevalence of different types of violence among women and to determine the risk factors and the association with depression. A cross-sectional study among women who had ever been in a relationship was conducted in six provinces across the three regions of China from July to September 2018 using a self-completion questionnaire developed for the study. The provincial capital and one rural county were purposively selected in each province. Questionnaires were distributed in hospitals and public places. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depression. Data for 2,987 women were analyzed. The prevalence of psychological, physical, and sexual violence was 77.7%, 40.2%, and 11%, respectively: 52% had experienced two or three types of violence in their life. After adjustment, risk factors for all-type IPV were low occupational status, having one child or more, living in western provinces, having an income lower than partner's, and economic pressure. The prevalence of depression was 65.8% in women who experienced psychological violence, 69.5% for physical violence, and 75.8% for sexual violence. For psychological, physical, and sexual violence, the odds ratio for depression were 2.57 (95% confidence interval [CI] = [2.15, 3.07]), 2.07 [1.76, 2.43], and 2.26 [1.73, 2.95], respectively, after controlling for age, occupation, education attainment, and residence. There is a clear need to raise awareness about IPV and to develop approaches for prevention and management. The new Domestic Violence Law represents a step in the right direction.

Evaluating the effects of two alcohol reduction counseling interventions on intimate partner violence perpetration: secondary analysis of a three-arm randomized controlled trial among Vietnamese men with HIV

BACKGROUND AND AIMS

Evidence suggests that alcohol reduction interventions decrease intimate partner violence (IPV) perpetration, although this remains untested in low- and middle-income countries and among men with human immunodeficiency virus (HIV). This study evaluates the effectiveness of alcohol reduction counseling interventions on IPV perpetration among men on anti-retroviral therapy (ART) and tests whether alcohol use explains the intervention effects.

DESIGN

Secondary analysis of data from a three-arm randomized controlled trial among ART patients with hazardous alcohol use. Participants were recruited from March 2016 to May 2017.

SETTING

Thai Nguyen, Vietnam.

PARTICIPANTS, INTERVENTIONS AND COMPARATORS

Male participants (n = 426). Participants received a two-session brief intervention (BI), a six-session combined intervention (CoI) or the standard of care (SOC), comprising alcohol treatment referrals. Alcohol reduction counseling interventions were guided by cognitive-behavioral therapy and motivational enhancement therapy delivered by psychosocial counselors over 3 months.

MEASUREMENTS

IPV perpetration was measured using the shortened Conflict Tactics Scale 2 and alcohol use was measured using timeline followback.

FINDINGS

BI and CoI participants reported reduced IPV perpetration at 3 months compared with SOC participants [BI: adjusted odds ratio (aOR) = 0.27, 95% confidence interval (CI) = 0.11, 0.65; CoI: aOR = 0.50, 95% CI = 0.22, 1.13]; the association was only significant for the BI group. Intervention effects were not sustained at 6 and 12 months. There was little evidence that alcohol use acted as a mediator (indirect effect, BI: aOR = 0.84, 95% CI = 0.63, 1.04; indirect effect, CoI: aOR = 0.86, 95% CI = 0.66, 1.03).

CONCLUSIONS

Among Vietnamese men receiving anti-retroviral therapy, alcohol reduction counseling interventions appeared to reduce intimate partner violence perpetration immediately post-intervention, but reductions were not sustained at 6 and 12 months and were not explained by alcohol reduction.

Exposure to interparental violence and justification of intimate partner violence among women in sexual unions in sub-Saharan Africa

Background

Justification of intimate partner violence (IPV) is one of the critical factors that account for the high prevalence of IPV among women. In this study, we examined the association between exposure to interparental violence and IPV justification among women in sexual unions in sub-Saharan Africa (SSA).

Methods

Data for this study were obtained from the most recent Demographic and Health Surveys (DHS) of 26 countries in SSA conducted between 2010 and 2020. A total of 112,953 women in sexual unions were included in this study. A multivariable binary logistic regression analysis was carried out. The results of the regression analysis were presented using crude odds ratios (cOR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals (CIs).

Results

The prevalence of interparental violence in the countries considered in this study was 23.8%, with the highest (40.8%) and lowest (4.9%) in Burundi and Comoros, respectively. IPV justification was 45.8%, with the highest and lowest prevalence in Mali (80.9%) and South Africa (4.6%) respectively. Women who were exposed to interparental violence were more likely to justify IPV compared to those who were not exposed [aOR = 1.53, 95% CI = 1.47–1.59]. We found higher odds of justification of IPV among women who were exposed to interparental violence compared to those who were not exposed in all the countries, except Burkina Faso, Comoros, Gambia, and Rwanda.

Conclusion

The findings call for several strategies for addressing interparental violence. These may include empowerment services targeting both men and women, formation of stronger social networks to improve women’s self-confidence, and the provision of evidence-based information and resources at the community level. These interventions should pay critical attention to young people exposed to interparental violence. Public health education and messaging should emphasise on the negative health and social implications of interparental violence and IPV.

Exploring the Roles of Familial and Dating Relationship Violence and Sexual Assault on Adolescent Girls and Young Women's Risk of Partner Violence in Tanzania

This study explored the role of non-partner violence on adolescent girls and young women's (AGYW) risk of partner violence in Tanzania. Among currently partnered AGYW, 36.7% reported lifetime physical and/or sexual partner violence. Prevalence of parental punishment, dating relationship violence, and sexual assault measured 3.0%, 2.5%, and 2.9%, respectively. There is evidence that exposure to all forms of non-partner abuse is associated with partner violence. Population attributable fractions suggest that 20% of partner violence incidence was because of non-partner violence. Adolescence and young adulthood is a critical intervention age group to prevent multiple forms of violence including in intimate relationships.

Determination of the factors affecting sexual violence against women in Turkey: a population-based analysis

Background

Sexual violence is one of the most investigated types of violence by national and international decision makers. The purpose of this study was to detect the factors that affect sexual violence against women in Turkey.

Methods

In this study, a cross-sectional data set was employed from the survey titled the National Research on Domestic Violence against Women in Turkey, which was conducted by the Hacettepe University Institute of Population Studies. Binary logistic and probit regression analyses were used to determine the factors influential in women’s exposure to sexual violence.

Results

The findings obtained from the analyses indicated that women’s exposure to sexual violence was influenced by a variety of factors including region, age, level of education, employment status, health condition, marital status, number of children as well as exposure to physical, economic, and verbal abuse. In addition, it was determined that the level of education, employment status, drug use, infidelity and other variables related to the husband/partner of the women who participated in the survey affected the women’s exposure to sexual violence.

Conclusion

There remains a higher probability of exposure to sexual violence among women residing in rural and less developed regions. A decrease in the women’s level of education increased their probability of exposure to sexual violence. An increase in the women's age and an increase in the level of education of the women’s husbands/partners lowered the probability of their exposure to sexual violence. There was a higher probability of exposure to sexual violence among women who had experienced physical, economic, and verbal abuse.

Intimate partner violence during pregnancy in Vietnam: role of husbands

Intimate partner violence (IPV) perpetrators are often husbands. Understanding factors pertaining to women's male partners is essential for programming interventions against IPV. The objective of the study was to describe husband-related social and behavioural risk factors and assess how they are associated with IPV during pregnancy. Cross-sectional data were collected among 1309 pregnant women with husbands in Dong Anh district, Vietnam. Information on sociodemographic characteristics of husbands, the husband's behaviour and the husband's involvement in pregnancy care was indirectly collected via women's report at first antenatal care visit. Data on exposure to intimate partner violence during pregnancy were collected when the women returned for antenatal care in 30-34 gestational weeks. Logistic regression analyses were used to measure the relationships between IPV during pregnancy and risk factors from the husband. Pregnant women who had husbands who were younger or blue-collar worker/farmer/unemployed had more likelihood to be exposed to IPV. Women with husbands who drank alcohol before sexual intercourse and gambled were more likely to be exposed to IPV repeated times. Those with husbands who had intentions of having a child had over three times increased OR to be exposed to IPV once (AOR = 3.2, 95% CI 1.1-9.7). If the husband had a preference for sons, the woman had 1.5 times increased OR (AOR = 1.5; 95% CI 1.1-1.9) to be exposed to IPV repeated times during pregnancy. This study highlights significant associations between IPV and maternal perceptions of husbands' behaviours and involvement in pregnancy. Findings may help to identify at-risk pregnant women to IPV and guide the development of targeted interventions to prevent IPV from husbands.

Child and Family Factors Associated With Child Maltreatment in Vietnam

This study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and the occurrence of multiple types of child maltreatment. Cross-sectional data of 1,851 secondary and high school students aged 12 to 17 years (47.3% boys) in four provinces of Northern Vietnam were obtained using self-report questionnaires. Results indicated that the likelihood of emotional abuse, witnessing parental conflict, and experiencing multiple types of child maltreatment during lifetime increased with age. Boys had a higher risk than girls on lifetime sexual abuse, and past year and lifetime physical abuse. Living in a single parent family was the risk factor related to most types of child maltreatment including lifetime sexual abuse, neglect, and multiple types of child maltreatment, and both past year and lifetime witnessing parental conflict. Interestingly, low socioeconomic status (SES) and parental unemployment were associated with a decreased risk on experiencing emotional abuse in the past year and during lifetime, respectively. "Tiger parenting," a parenting style observed frequently in East Asian parents, may be more common in families with high SES and might explain this finding. This study highlights the importance of prioritizing single parent families in parenting programs and implementing child maltreatment interventions early because of the risk on child maltreatment increased with age. More research on emotional abuse and "Tiger parenting" in Vietnam could clarify the association of emotional abuse with high SES and parental employment. Finally, the underlying mechanisms of the risk factors in Vietnam should be studied more to inform interventions.

Women's empowerment and elective cesarean section for a single pregnancy: a population-based and multivariate study in Vietnam

Background

Women’s empowerment, and maternal and neonatal health are important targets of the Sustainable Development Goals. Our objective is to examine the relationship between women’s empowerment and elective cesarean section (ECS), focusing on Vietnam, a country where the use of CS has increased rapidly in recent decades, which raises public health concerns.

Methods

We hypothesized that in the context of the developing biomedicalization of childbirth, women’s empowerment increases the use of ECS due to a woman’s enhanced ability to decide her mode of delivery. By using microdata from the 2013–2014 Multiple Indicator Clusters Survey, we conducted a multivariate analysis of the correlates of ECS. We studied a representative sample of 1343 institutional single birth deliveries. Due to higher ECS rates among multiparous (18.4%) than primiparous women (10.1%) and the potential interaction between parity and other correlates, we used separate models for primiparous and multiparous women.

Results

Among the indicators of women’s external resources, which include a higher level of education, having worked during the previous 12 months, and having one’s own mobile phone, only education differed between primiparous and multiparous women, with a higher level among primiparous women. Among primiparous women, no resource indicator was significantly linked to ECS. However, considering women’s empowerment facilitated the identification of the negative impact of having had fewer than 3 antenatal care visits on the use of ECS.

Among multiparous women, disapproval of intimate partner violence (IPV) was associated with a doubled likelihood of undergoing ECS (odds ratio = 2.415), and living in an urban area also doubled the likelihood of ECS. The positive association with living in the richest household quintile was no longer significant when attitude towards IPV was included in the model. In both groups, being aged 35 or older increased the likelihood of undergoing ECS, and this impact was stronger in primiparous women.

Conclusions

These results underline the multidimensionality of empowerment, its links to other correlates and its contribution to clarifying the influence of these correlates, particularly for distinguishing between medical and sociocultural determinants. The results advocate for the integration of women's empowerment into policies aimed at reducing ECS rates.

A Qualitative Study of the Health-Related Perceptions of Married Iranian Women Who Have Experienced Domestic Violence

INTRODUCTION

Violence against women occurs all over the world; it is a phenomenon that is considered an invasion of human rights. The most common form of this phenomenon is domestic violence (DV).

AIM

The purpose of this study was to explore the health-related perceptions of married women in Iran who have experienced DV.

METHOD

This qualitative study was carried out using conventional content analysis method. In total, a purposive sample of 27 women who had been subjected to violence by their spouses agreed to participate in this study. Individual, in-depth, and semistructured interviews were conducted.

FINDINGS

Three main categories emerged from the data: (a) perceptions related to physical health (including non-sex-organ injuries and sex organ injuries), (b) perceptions related to psychological health (including fear, concern, and the creation of challenges), and (c) perceptions related to sociocultural health (specifically social health and cultural health).

CONCLUSION

In Iran, DV threatens women's health and is influenced by personal, familial, social, and cultural factors. Nurses should consider various aspects of physical, psychological, and sociocultural health when caring for women who have experienced DV. Social and cultural-based interventions are needed to address negative attitudes, stigma, and false beliefs that sanction DV in Iran.

A Qualitative Study With Women Living With HIV on Perceived Gender Norms and Experiences of Intimate Partner Violence in Northern Vietnam

Although the prevalence of intimate partner violence (IPV) in Southeast Asia is one of the highest in the world, IPV remains understudied in the region, especially among women living with HIV (WLWH). This study aims to understand how gender and violence norms influence how WLWH interpret and prioritize violence as a health issue. We also explore whether HIV disclosure was seen as a trigger for IPV. We conducted in-depth interviews with 20 WLWH (median age = 35.5 years; range = 28-54 years) in northern Vietnam. Participants were recruited from an outpatient antiretroviral treatment (ART) clinic. Semi-structured interviews were transcribed, translated, and analyzed to identify themes using a gender-focused theoretical framework. Twelve participants reported experiencing IPV by their current or former husbands, most of which occurred before their HIV diagnoses. Only one participant felt her HIV status was a factor for the IPV she experienced; the remaining participants did not explicitly link IPV and HIV. None expressed fear or experience of IPV after disclosing to their husbands. When asked about a woman's role in society, the majority spoke about the responsibility to build family harmony by doing housework, raising children, making a steady income, and being faithful to her husband. Participants viewed marital conflict as the woman's problem to avoid by acting docile or to resolve peacefully by bearing violence quietly. Almost all reported contracting HIV from their husbands. Regardless of whether their children were infected (n = 8) or not (n = 10), participants spoke about being compelled to initiate and adhere to ART to care for their children emotionally and financially. In the context of Vietnamese gender norms, participants expressed low urgency for help-seeking after experiencing IPV and high urgency for help-seeking after being diagnosed with HIV. Multilevel interventions are needed to shift social norms around acceptability of IPV.

Alcohol use, depressive symptoms, and intimate partner violence perpetration: A longitudinal analysis among men with HIV in northern Vietnam

Background

While the link between alcohol use and male-perpetrated intimate partner violence (IPV) has been well-established, research is needed to test whether psychosocial factors interact with alcohol use to exacerbate IPV perpetration. We tested whether depressive symptoms influenced the strength and/or direction of the alcohol-IPV relationship among men with HIV in Vietnam.

Methods

This study is a secondary analysis using data from a randomized controlled trial conducted in Thai Nguyen, Vietnam. Participants were clinic patients with HIV and hazardous alcohol use. Questionnaires were administered at baseline, three, six, and 12 months. Alcohol use was assessed as proportion of days alcohol abstinent. Analyses were restricted to males who reported being married/cohabitating at baseline (N = 313). Multilevel growth models were used to test whether time-varying depressive symptoms modified the time-varying effect of alcohol use on IPV perpetration.

Results

Time-varying depressive symptoms modified the effect of proportion of days alcohol abstinent on IPV perpetration. However, the pattern of effect modification was not as expected, as reporting depressive symptoms weakened the alcohol-IPV relationship. At times when participants screened negative for depressive symptoms, those who reported higher proportion of days alcohol abstinent than usual had significantly lower odds of IPV perpetration (Odds Ratio [OR] = 0.17, 95% Confidence Interval 0.06, 0.45, p = 0.0004). At times when participants screened positive for depressive symptoms, there was no observed effect of alcohol use on IPV perpetration (OR = 4.28, 95% CI 0.80, 22.78, p = 0.09).

Conclusion

The findings highlight the complex nature of the alcohol-IPV relationship and the need to investigate the intersection between hazardous drinking, mental health, and IPV. Men who concurrently report depressive symptoms and heightened alcohol use may be socially isolated from an intimate partner or experiencing fatigue, leading to less alcohol-related IPV perpetration. Mental health interventions addressing depression and alcohol misuse integrated into HIV services may reduce IPV perpetration.

Perpetration of Intimate Partner Violence Among Men Living with HIV in Northern Vietnam

We examined the prevalence of intimate partner violence (IPV) perpetration and characteristics of HIV-infected male perpetrators. The cross-sectional study was conducted in Vietnam with male antiretroviral treatment clients (N = 1099; mean age = 40.2 years). Bivariable associations were tested between psychological or physical/sexual IPV perpetration in the last 12 months and sociodemographic, psychosocial, and sexual behavioral factors using prevalence ratios. Factors significant at p < 0.10 were entered in multivariable models for each IPV outcome using a modified Poisson approach. Results showed 15.6% (N = 171/1099) reported perpetrating psychological IPV and 7.6% (N = 84/1099) perpetrating physical/sexual IPV in the last 12 months. HIV risk behaviors, including hazardous drinking and multiple sexual partners, having witnessed interparental violence as a child, and depressive symptoms were associated with perpetrating IPV. HIV interventions targeting HIV-infected men in Vietnam should intervene on IPV perpetration by addressing the co-occurring factors of sexual risk, depression, alcohol use, and child maltreatment that are correlated with IPV.

Longitudinal analysis of alcohol use and intimate partner violence perpetration among men with HIV in northern Vietnam

BACKGROUND

Alcohol use is a known risk factor for male-perpetrated intimate partner violence (IPV), although few studies have been conducted globally and among men with HIV (MWH). We estimated the longitudinal effects of alcohol use on IPV perpetration among MWH.

METHODS

This study is a secondary analysis of randomized controlled trial data among male and female antiretroviral treatment patients with hazardous alcohol use in Thai Nguyen, Vietnam. Analyses were restricted to male participants who were married/cohabitating (N = 313). Alcohol use was assessed as proportion days alcohol abstinent, heavy drinking, and alcohol use disorder (AUD) using the Timeline Followback and Mini International Neuropsychiatric Interview questionnaire. Multilevel modeling was used to estimate the effects of higher versus lower average alcohol use on IPV perpetration (between-person effects) and the effects of time-specific deviations in alcohol use on IPV perpetration (within-person effects).

RESULTS

Participants with higher average proportion days alcohol abstinent had decreased odds of IPV perpetration (adjusted Odds Ratio [aOR] = 0.43, p = 0.03) and those with higher average heavy drinking and AUD had increased odds of IPV perpetration (Heavy drinking: aOR = 1.05, p = 0.002; AUD: aOR = 4.74, p < 0.0001). Time-specific increases in proportion days alcohol abstinent were associated with decreased odds of IPV perpetration (aOR = 0.39, p = 0.02) and time-specific increases in AUD were associated with increased odds of IPV perpetration (aOR = 2.95, p = 0.001). Within-person effects for heavy drinking were non-significant.

CONCLUSIONS

Alcohol use is associated with IPV perpetration among Vietnamese men with HIV. In this context, AUD and frequent drinking are stronger correlates of IPV perpetration as compared to heavy drinking.

Determinants of intimate partner violence against women in Ethiopia: A multi-level analysis

Intimate partner violence (IPV) continues to be a major public health problem globally. Although Ethiopia has a high prevalence of IPV, previous studies in this country have only investigated individual-level determinants of IPV within small geographic areas. The current study aimed to identify the individual-, relationship-, community-, and societal-level determinants of IPV directed against women in Ethiopia since women are predominantly affected. A retrospective analysis of nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS) was conducted. A sample of 3,897 married women of reproductive age (15-49 years) who participated in the domestic violence module of the survey were included in the analysis. Three-level mixed-effects multilevel logistic regression models were used to estimate the individual-, relationship-, community-, and societal-level determinants of IPV. Variability at the community- and societal-level were also assessed. About 1,328 (34.1%) of 3,897 participants reported experiencing IPV (a composite measure of physical, sexual and emotional abuse). In adjusted models, the odds of lifetime IPV experience were higher among women who were older, were married before the age of 18 years, witnessed inter-parental violence during their childhood, had a partner who drank alcohol, and lived in a community with high IPV accepting norms. Alternatively, the odds of IPV were lower among women who had decision-making autonomy in the household, had the same or lower educational attainment as their partner, and lived in a community with low proportions of educated women. These findings reveal that although individual-level factors were significant determinants of IPV, higher level factors, including female education and IPV acceptance in the community, were also important influences on this major public health issue in Ethiopia. These findings suggest combined interventions at different levels may reduce IPV in this country.

Multilevel factors associated with perpetration of five types of intimate partner violence among men who have sex with men in China: an ecological model-informed study

In China, intimate partner violence (IPV) among men who have sex with men remains poorly investigated. Informed by the ecological model, this study explored multilevel factors associated with perpetration of IPV among men who have sex with men. The participants were recruited from 15 cities in mainland China. Univariate and multivariate regression analyses showed that the prevalence of committing physical, sexual, monitoring, controlling and emotional IPV was 8.6%, 7.1%, 15.2%, 7.6% and 17.1%, respectively. Committing physical IPV showed a positive association with perceived public discrimination and self-stigma towards homosexuality. Committing sexual IPV showed a positive association with involvement with a homosexual support agency and more sex partners. Monitoring IPV was positively associated with higher education and perceived stress, but negatively associated with instrumental and emotional support. Committing controlling IPV showed a positive association with drug use during sex and self-stigma but a negative association with self-esteem, self-efficacy and older age at first homosexual sex. Committing emotional IPV showed a positive association with commercial sex behaviour and perceived stress, but a negative association with resilience. Committing IPV was prevalent in this population. It is necessary to distinguish the various types of IPV in future studies, given their differences in associated factors.

Domestic violence and its association with pre-term or low birthweight delivery in Vietnam

Objective

To examine the association between various types of domestic violence (DV) during pregnancy (emotional violence, physical violence, and sexual violence) and pre-term or low birthweight delivery in women living in Ho Chi Minh city, Vietnam.

Methods

A cross-sectional study was conducted in ten districts of Ho Chi Minh city during the period of January 1, 2015–July 4, 2016, with 1,099 women aged 18–49 years old who had delivered at least one child within the past 2years and were living in Ho Chi Minh city.

Results

DV prevalence during pregnancy among women aged 18–49 years in Ho Chi Minh city was 23.4%. Emotional violence accounted for 16.8%; physical violence 7.3%, and sexual violence 12.4%. Results of multivariable logistic regression analysis showed that DV during pregnancy was associated with a 1.44-times increased risk of pre-term or/and low birthweight delivery (POR=1.44, 95% CI=1.04–1.99).

Conclusion

Domestic violence during pregnancy was associated with increased risk of pre-term/low birthweight delivery in Vietnamese women. These findings suggest the need for DV screening during antenatal care. Once DV is detected, the victims should be provided with counseling services and referred to available local support services so that they are provided with timely intervention.

Unequal power relations and partner violence against women in Tanzania: a cross-sectional analysis

Background

Research on factors associated with partner violence against women is often framed within the context of gender inequality and power imbalances between husbands and wives—inequalities that are considered products of broader structural systems. Tanzania, a patriarchal society where high levels of partner violence exists, has gone through rapid economic and social changes over the past two decades. Increasing numbers of women are seeking paid work, and men’s ideals of manhood have reshaped with evidence of extra marital relations and alcohol use. Nationally representative population-based data documents 46.2% of ever-married women have experienced physical or sexual partner violence in their lifetime; 29.6% in the past year. In order to plan appropriate interventions to end violence against women, factors consistently associated with abuse need to be understood.

Methods

This study uses “couples” data from the 2015 Tanzania Demographic and Health Survey to examine correlates of past year partner violence against women. Multivariate regression analysis was used to explore individual and relational-level variables—including socio-demographic characteristics and history of abuse among women, partner behavioural characteristics, and indicators of gender and economic inequality—among 1278 married and cohabiting couples.

Results

At the individual level, women’s experiences of non-partner violence (sexual abuse by a non-partner and witnessing violence in childhood) was strongly associated with risk and highlights that all forms of violence against women serve to keep them subordinated. Partner behavioural characteristics (polygamy and problematic alcohol use) were also associated with risk. Household socio-economic status, however, was not significantly associated with women’s risk in the final multivariate model. At the relational-level, men’s age difference of 10 or more years; and any employment (compared to none/unpaid) were associated with lower risk. When considering attitudes tolerant towards wife abuse, the strongest association with risk of violence was when both partners held tolerant views.

Conclusion

The findings support the assertions of violence being associated with women’s prior/additional experiences of abuse and with men’s harmful expressions of masculinity. In addition to interventions that focus on transforming gender norms and attitudes (at the individual and community levels), addressing economic, legal and political structural barriers are also required.

Emotional violence and maternal mental health: a qualitative study among women in northern Vietnam

Background

Worldwide, intimate partner violence (IPV) during pregnancy is a pressing and prevalent public health problem. Existing research has found close associations between IPV and perinatal mental health, yet little is known about women’s own perceptions of these associations. This study aimed to explore Vietnamese women’s experiences of emotional partner violence and their perceptions of the implications of such violence for their mental health.

Methods

The data were collected through in-depth interviews with 20 women living in Hanoi, Vietnam who had reported exposure to emotional partner violence and attained high depression scores in a prospective cohort study. Ten women were pregnant and ten had recently given birth. The data were analysed by qualitative content analysis.

Results

The women described emotional partner violence as a major life stressor. Their accounts pointed to three particularly significant dimensions of emotional violence: being ignored by the husband; being denied support; and being exposed to controlling behaviours. These experiences affected the women’s sense of wellbeing profoundly, causing sadness and distress. The women’s accounts indicated that experiences of emotional violence were significantly shaped by dominant kinship arrangements: practices of patrilocal residence and principles of patrilineal descent tended to aggravate women’s vulnerabilities to partner violence.

Conclusions

This qualitative study from Vietnam documents close associations between emotional partner violence and perinatal distress, while also pointing to kinship arrangements as particularly significant structural contexts shaping women’s experiences of partner violence. The study findings suggest that effective policies and programs to decrease women’s vulnerability to intimate partner violence must take into account the kinship arrangements that prevail in a given society.

Negative attitudes related to violence against women: gender and ethnic differences among youth living in Serbia

OBJECTIVES

This study aimed to identify to what extent negative attitudes towards intimate partner violence against women are present among young women and men living in Serbia, in Roma and non-Roma settlements.

METHODS

We used the data from the 2010 Multiple Indicator Cluster Survey conducted in Serbia, for the respondents who were 15-24 years old. Regression analyses were used to examine the association between judgmental attitudes, socio-demographic factors and life satisfaction.

RESULTS

In Roma settlements, 34.8% of men and 23.6% of women believed that under certain circumstances men are justified to be violent towards wives, while among non-Roma it was 5.6 and 4.0%, respectively. These negative attitudes were significantly associated with lower educational level, lower socio-economic status and being married. In multivariate model, in both Roma and non-Roma population women who were not married were less judgmental, while the richest Roma men were least judgmental (OR 0.40, 95% CI 0.18-0.87).

CONCLUSIONS

Violence prevention activities have to be focused on promoting gender equality among youth in vulnerable population groups such as Roma, especially through social support, strengthening their education and employment.