Predictors of intimate partner violence in women seeking medication abortion

An explorative study on consequences of abuse on psychological wellbeing and cognitive outcomes in victims of gender-based violence

Background

The issue of gender-based violence has been a public health problem for years. Considering its systemic nature, the possible consequences at the individual level on the psychological and cognitive wellbeing of victims have been examined. The present research aims to explore the differences in the various types and forms of violence.

Methods

A non-probability and convenience sample was used; a total of 83 participants joined the research. Inclusion criteria were minimum age of 18 years, female gender, and knowledge of the Italian language. Two non-parametric One-Way ANOVAs (Kruskal-Wallis) were performed according to the type of violence experienced and the type of self-reported abuse (i.e., no victimization, single victimization, complex victimization).

Results and discussion

Results showed that victims of violence scored higher overall than non-victims on all subscales of the Depression, Anxiety, Stress Scale. Analyses among the three groups-no violence, single violence, and complex violence-showed no differences in any of the dimensions between those who experienced single and complex violence, while differences emerged between the "no victimization" group and the other groups. The results were discussed in relation to the existing literature on the topic, highlighting the limitations and future applications of the collected data.

Reproductive Health Concerns among Substance-Using Women in Community Corrections in New York City: Understanding the Role of Environmental Influences

Women living in urban settings who are engaged in the criminal justice system are disproportionately affected by HIV and also contend with poor sexual and reproductive health (SRH). While studies have examined environmental influences of HIV, few have examined how these influences relate to poor SRH among this population. We used baseline data from an HIV-risk reduction study among substance-using women with a pregnancy history in community corrections in New York City (N = 299). We examined risk environment factors typically associated with HIV, and SRH outcomes of abortion, and miscarriage. We used logistic regression models to examine associations between risk environment factors with SRH outcomes. Most women identified as black and ranged in age from 18 to 62. Approximately half had miscarriages and/or abortions in their lifetime. Few women used birth control despite not wanting children in the future. While most women faced high rates of environmental influences of HIV risk, only intimate partner violence (IPV) was associated with SRH outcomes. Women experiencing IPV were significantly more likely to report both miscarriage and abortion. Community corrections present a unique opportunity for intervention around HIV risk reduction and SRH outcomes, given that effective programming for each often requires multiple and formal contacts with health providers.

Should violence services be integrated within abortion care? A UK situation analysis

The prevalence of violence against women worldwide raises the question of the desirability and feasibility of integrating interpersonal violence (IPV) services within abortion care. By examining present services and context in an Inner London borough in the UK, this situation analysis explored the hypothesis that an established, integrated, health-based service (comprising raised awareness, staff training in routine IPV enquiry and referral to a community-based in-reach IPV service) would be transferable into abortion services. Four sources of qualitative data investigated views on integrating services: key stakeholder in-depth interviews including with providers of abortion and IPV services and commissioners and IPV survivors with past abortion service use (3 user, 15 provider); qualitative analysis of the open-ended part of a survey of current abortion service users with and without experience of IPV; feedback from an interactive workshop and data from field observations. While there was consensus among all informants that women experiencing IPV and seeking abortion have unidentified, unaddressed needs, how any intervention might be organised to address these needs was contested; thus questions remain about whether, when and how to raise the topic of IPV and what to offer. Two major anxieties surfaced: a practical concern in terms of interrupting a streamlined abortion service that suits the majority of staff and patients, and a conceptual concern about risk of stigmatising abortion seekers as 'victims in crisis'. Thus, our findings indicate: when integrating IPV interventions into abortion services, local context, the integrity of separate pathways, and women's safety and agency must be considered, especially when abortion rights are under attack. Novel approaches are required and should be researched.

Associations between intimate partner violence and termination of pregnancy: a systematic review and meta-analysis

BACKGROUND

Intimate partner violence (IPV) and termination of pregnancy (TOP) are global health concerns, but their interaction is undetermined. The aim of this study was to determine whether there is an association between IPV and TOP.

METHODS AND FINDINGS

A systematic review based on a search of Medline, Embase, PsycINFO, and Ovid Maternity and Infant Care from each database's inception to 21 September 2013 for peer-reviewed articles of any design and language found 74 studies regarding women who had undergone TOP and had experienced at least one domain (physical, sexual, or emotional) of IPV. Prevalence of IPV and association between IPV and TOP were meta-analysed. Sample sizes ranged from eight to 33,385 participants. Worldwide, rates of IPV in the preceding year in women undergoing TOP ranged from 2.5% to 30%. Lifetime prevalence by meta-analysis was shown to be 24.9% (95% CI 19.9% to 30.6%); heterogeneity was high (I (2)>90%), and variation was not explained by study design, quality, or size, or country gross national income per capita. IPV, including history of rape, sexual assault, contraceptive sabotage, and coerced decision-making, was associated with TOP, and with repeat TOPs. By meta-analysis, partner not knowing about the TOP was shown to be significantly associated with IPV (pooled odds ratio 2.97, 95% CI 2.39 to 3.69). Women in violent relationships were more likely to have concealed the TOP from their partner than those who were not. Demographic factors including age, ethnicity, education, marital status, income, employment, and drug and alcohol use showed no strong or consistent mediating effect. Few long-term outcomes were studied. Women welcomed the opportunity to disclose IPV and be offered help. Limitations include study heterogeneity, potential underreporting of both IPV and TOP in primary data sources, and inherent difficulties in validation.

CONCLUSIONS

IPV is associated with TOP. Novel public health approaches are required to prevent IPV. TOP services provide an opportune health-based setting to design and test interventions.

Association between intimate partner violence and preventive screening among women

BACKGROUND

Intimate partner violence (IPV) is defined as physical, sexual, or psychological harm that can be perpetrated by a former/current spouse. IPV has been linked to adverse health outcomes and risky behaviors, and victims of IPV tend to need more healthcare overall than nonvictims of IPV. The purpose of this study was to determine the association between IPV and preventive screening among women.

METHODS

The study used data from eight states/territories, which collected IPV information in the 2006 and 2007 Behavioral Risk Factor Surveillance System (n=30,182). IPV and preventive screening for HIV, cervical cancer, colorectal cancer, cholesterol, and breast cancer were determined by self-report. Multivariable logistic regression models provided adjusted estimates of odds ratios (aOR) and 95% confidence intervals (CI).

RESULTS

Approximately one in four women reported a history of lifetime IPV. Relative to those who did not report a history of IPV, IPV victims were twice as likely to have had an HIV test (aOR: 2.34; 95% CI: 2.06 to 2.66) or a breast exam (aOR: 1.76; 95% CI: 1.37 to 2.27). IPV victims are vigilant about certain screening practices related to sexual health (HIV testing) and passive screening (breast exam) compared to active screening.

CONCLUSION

The strongest association between IPV and preventive screening was seen for HIV testing, which likely reflects the women's perceived risk for HIV infection. That these women are in contact with the healthcare system provides support for recommendations for widespread adoption of IPV screening and counseling.