Prevalence and Risk Factors of Women's Past-Year Physical IPV Perpetration and Victimization in Tanzania

Predicting Intimate Partner Violence Perpetration Among Young Adults Experiencing Homelessness in Seven U.S. Cities Using Interpretable Machine Learning

Young adults experiencing homelessness (YAEH) are at higher risk for intimate partner violence (IPV) victimization than their housed peers. This is often due to their increased vulnerability to abuse and victimization before and during homelessness, which can result in a cycle of violence in which YAEH also perpetrates IPV. Identifying and addressing factors contributing to IPV perpetration at an early stage can reduce the risk of IPV. Yet to date, research examining YAEH's IPV perpetration is scarce and has largely employed conventional statistical approaches that are limited in modeling this complex phenomenon. To address these gaps, this study used an interpretable machine learning approach to answer the research question: What are the most salient predictors of IPV perpetration among a large sample of YAEH in seven U.S. cities? Participants (N = 1,426) on average were 21 years old (SD = 2.09) and were largely cisgender males (59%) and racially/ethnically diverse (81% were from historically excluded racial/ethnic groups; i.e., African American, Latino/a, American Indian, Asian or Pacific Islander, and mixed race/ethnicity). Over one-quarter (26%) reported IPV victimization, and 20% reported IPV perpetration while homeless. Experiencing IPV victimization while homeless was the most important factor in predicting IPV perpetration. An additional 11 predictors (e.g., faced frequent discrimination) were positively associated with IPV perpetration, whereas 8 predictors (e.g., reported higher scores of mindfulness) were negatively associated. These findings underscore the importance of developing and implementing effective interventions with YAEH that can prevent IPV, particularly those that recognize the positive association between victimization and perpetration experiences.

Examining gender and sexual orientation differences in physical intimate partner violence experienced and perpetrated by youth living in eThekwini district South Africa during the COVID-19 pandemic

BACKGROUND

Young women and Lesbian, Gay, Bisexual, Trans, Non-binary/no gender, or Questioning (LGBTQ+) youth in South Africa face some of the highest global levels of intimate partner violence (IPV). Given limited evidence in the wake of the COVID-19 pandemic, which has fuelled IPV globally, we aimed to describe and compare experiences and perpetration of IPV of youth aged 16-24 by sexual orientation and gender identity (SOGI).

METHODS

During the study period (December 2021-May 2022), youth aged 16-24 from eThekwini district, South Africa completed an online survey to understand multilevel impacts of the pandemic on youth. Participants were asked about experiences and perpetration of physical IPV since the start of the COVID-19 pandemic (March 2020). Descriptive statistics and adjusted logistic regressions compared the likelihood of experiencing and/or perpetrating physical IPV between cisgender and transgender inclusive heterosexual men; heterosexual women; gay, bisexual, or questioning men [GBQM]; lesbian, gay, bisexual, or questioning women [LGBQW]; or gender/sexual non-conforming youth [non-conforming].

RESULTS

Of 1,588 youth (mean age = 21.7 [SD = 2.3]; 71.7% Black) with non-missing SOGI and physical IPV data, 238 (15.0%) were LGBTQ+ (40.3% LGBQW and 36.1% non-conforming). Overall, 14.6% of respondents experienced physical IPV and 9.8% perpetrated physical IPV since the start of the pandemic, which differed by SOGI (12.3% of heterosexual men, 13.9% of heterosexual women, 22.0% of GBQM, 18.2% of LGBQW, and 25.0% of non-conforming youth experienced and 10.3% of heterosexual men; 7.7% of heterosexual women; 10.0% of GBQM; 18.2% of LGBQW; and 16.7% of non-conforming youth perpetrated). In adjusted models, compared to heterosexual women, non-conforming youth had increased odds of experiencing (adjusted odds ratio [aOR] = 2.36; 95%CI, 1.26-4.39) physical IPV and compared to heterosexual men, non-conforming youth had greater odds of perpetrating physical IPV (aOR = 2.19; 95%CI, 1.07-4.48) during the pandemic.

CONCLUSION

Over one in six youth in our study experienced and one in ten perpetrated physical IPV since the onset of the COVID-19 pandemic, with gender and sexual non-conforming youth experiencing and perpetrating IPV at significantly greater rates than cisgender/heterosexual peers. Our findings highlight the need for gender transformative efforts that move beyond the gender binary to support healthy relationships and IPV prevention for LGBTQ + youth in South Africa and globally.

Psychometric Properties and Refinement of the ATT-IPV Scale to Measure Attitudes about Intimate Partner Violence among Married Adolescents and Their Husbands in Niger

(1) Background: This study sought to assess the appropriateness of a five-item scale to measure attitudes towards IPV (ATT-IPV) among married adolescent girls and their husbands in Niger, a population in which this scale has not yet been tested. (2) Methods: Using data collected from 1100 pairs of married adolescents, aged 13-19 years old, and their husbands across 48 villages in rural Niger, we performed classical test theory reliability and exploratory factor analysis, followed by item response theory (IRT) analyses and testing differential item functioning (DIF) by gender. (3) Results: The ATT-IPV scale was found to be internally consistent (alpha = 0.8) and unidimensional in this population, with all items loading onto one factor. We found differential item functioning of the following item: "In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she burns his food?" by gender, suggesting that in order to have a scale that performs similarly in men and women, that item should be removed. (4) Conclusions: The ATT-IPV scale is useful as a measure of attitudes towards IPV among married adolescents and their husbands in Niger. However, it may need to be updated to reflect additional forms of violence and to eliminate gender-differential responses in order to be a more effective measure.

Quantitative Proxies for Social Norms: A Proposed Approach for Interrogating Clustering, Reference Groups, and Validity

A growing number of researchers studying intimate partner violence (IPV) employ aggregate measures of relevant attitudes to serve as proxy measures for norms around IPV. However, there is a lack of consistency in how these measures are constructed and how their validity is confirmed. The first aim of this study is to demonstrate and validate innovative techniques for exploring social norms proxies in quantitative data and identifying the relative appropriateness of different available reference groups. The second aim is to demonstrate how such an approach can contribute to IPV research. The analysis employed data from the 2016 Tanzania International Men and Gender Equality Survey, including 1008 men and 1008 women ages 15-49 years. An attitudinal score measuring acceptance of IPV and two measures for individual-level descriptive and injunctive norms were constructed. The intraclass correlation coefficient (ICC) was used to assess the extent of clustering for the attitudinal score within several sets of groupings. Bivariate multi-level Ordinary Least Squares regressions estimated the predictive effect of an individual's group norm proxy on their descriptive or injunctive norms. Attitudinal clustering was most significant for reference groups defined as males only across villages and males only across a combination of villages and marital status, with ICCs of 0.229 and 0.236, respectively. Men's social norms were found to be correlated with reference groups comprised of both men only and women only, though men's norms were substantially more correlated with the attitudes of men in their reference group than with women's. Results highlight the importance of critically examining the validity of proxy measures for social norms prior to their inclusion in analysis. Findings also underscore the importance of collecting attitudinal data from men to better understand norms around IPV.

Relative Risk of Intimate Partner Violence According to Access to Instrumental Social Support Among Pregnant Women in Eswatini Whose Partners Do and Do Not Drink Alcohol

Intimate partner violence (IPV) affects one in three women around the world and is the tenth leading cause of death for women in Africa aged 15 to 29 years. Partner alcohol use, access to social support, and poverty all affect women's likelihood of experiencing violence. We sought to understand how partner alcohol use differentially affected the hypothesized association between a protective role of instrumental social support (in the form of food or financial loans) against IPV for a clinic-based sample of women in the Kingdom of Eswatini (formerly known as Swaziland). We use cross-sectional data from a parent study of women recruited from urban and rural antenatal clinics in Eswatini (n = 393) to calculate the association between experiencing IPV and perception of one's ability access to large cash loans, small cash loans, and food loans-both for the full sample and stratified by partner alcohol use. In fully adjusted models, the perception that one could access loans of food or money was associated with decreased relative risk of IPV for all women. These associations were modified by partner alcohol use. Access to instrumental support (loans of food or money) is associated with decreased risk of IPV, but this association varies according to the type of loan and whether or not a woman's partner drinks alcohol. Economic empowerment interventions to reduce IPV must be carefully tailored to ensure they are appropriate for a woman's specific individual, relationship, and community context.

Prevalence and Risk Factors for Women's Reports of Past-Year Intimate Partner Violence: A Comparative Analysis of Six East African National Surveys

Violence against women, in all its forms, has been acknowledged as a violation of basic human rights and research evidence shows that it could lead to adverse health consequences. In this study we aimed to determine the prevalence and coexistence of different forms of IPV as well as examine individual-level factors associated with ever experiencing any form of IPV in the 12 months preceding the survey using the most recent Demographic Health Survey data from six East African countries. Results show that the prevalence ranged between 16.5% (Burundi) and 29.3% (Uganda) for emotional, 16.8% (Ethiopia) and 26.6% (Tanzania) for physical, and 8.3% (Rwanda and Ethiopia) and 18.4% (Burundi) for sexual IPV. The prevalence of any IPV ranged from 26.7% to 39.3%. In terms of coexistence, 15.6% to 19.0% of women reported experiencing all the three forms of IPV, with higher proportions reporting experiencing two of the three forms of IPV. The prevalence of both physical and emotional IPV was highest in Tanzania (49.1%), both emotional and sexual IPV in Uganda (28.0%), and both physical and sexual IPV in Burundi (26.2%). A partner's use of alcohol and a woman's justification of wife beating were both statistically significant common risk factors for IPV across the six countries. Women whose partners got drunk often were found to be up to nine times more likely to experience IPV compared to those whose partners did not drink. Younger women and those with larger families were at an increased risk of experiencing IPV, while other significant factors were country specific. In conclusion, our findings highlight the need for integrated and context-specific approaches that deconstruct gendered norms related to power dynamics and patriarchal nuances at household and community level in order to holistically address different forms of IPV.

Risk factors for violence against women in high-prevalence settings: a mixed-methods systematic review and meta-synthesis

INTRODUCTION

Violence against women (VAW) affects one in three women globally. In some countries, women are at much higher risk. We examined risk factors for VAW in countries with the highest 12-month prevalence estimates of intimate partner violence (IPV) to develop understanding of this increased risk.

METHODS

For this systematic review, we searched PUBMED, CINAHL, PROQUEST (Middle East and North Africa; Latin America and Iberia; East and South Asia), Web of Science, EMBASE and PsycINFO (Ovid) for records published between 1 January 2000 and 1 January 2021 in English, French and Spanish. Included records used quantitative, qualitative, or mixed-methods, reported original data, had VAW as the main outcome, and focused on at least one of 23 countries in the highest quintile of prevalence figures for women's self-reported experiences of physical and/or sexual violence in the past 12 months. We used critical interpretive synthesis to develop a conceptual model for associations between identified risk factors and VAW.

RESULTS

Our search identified 12 044 records, of which 241 were included for analysis (2 80 360 women, 40 276 men, 274 key informants). Most studies were from Bangladesh (74), Uganda (72) and Tanzania (43). Several quantitative studies explored community-level/region-level socioeconomic status and education as risk factors, but associations with VAW were mixed. Although fewer in number and representing just one country, studies reported more consistent effects for community-level childhood exposure to violence and urban residence. Theoretical explanations for a country's high prevalence point to the importance of exposure to other forms of violence (armed conflict, witnessing parental violence, child abuse) and patriarchal social norms.

CONCLUSION

Available evidence suggests that heightened prevalence of VAW is not attributable to a single risk factor. Multilayered and area-level risk analyses are needed to ensure funding is appropriately targeted for countries where VAW is most pervasive.

PROSPERO REGISTRATION NUMBER

The review is registered with PROSPERO (CRD42020190147).

Experiences and Perpetration of Recent Intimate Partner Violence Among Women and Men Living in an Informal Settlement in Nairobi, Kenya: A Secondary Data Analysis

Evidence suggests an overlap between intimate partner violence (IPV) experience and perpetration. However, few studies in sub-Saharan Africa have investigated experience and perpetration of IPV among women and men within the same community. This study reports prevalence of past-year IPV experience and perpetration among women and men living in an informal settlement in Nairobi, Kenya, and factors associated with IPV. Data analyzed for this study involved a geographically distributed random sample of 273 women and 429 men who participated in a community survey. We approximated prevalence of IPV experience and perpetration and used logistic regression for estimating associations between individual-level factors and IPV. Women and men experienced similar levels of IPV, but a significantly higher proportion of men reported physical and sexual IPV perpetration. Witnessing violence between parents in childhood was associated with women's physical and sexual, and men's sexual IPV experience; and with women perpetrating emotional, and men perpetrating sexual IPV. Less equitable gender attitudes were associated with men's perpetration of physical IPV. More equitable gender knowledge was associated with women's experience of sexual IPV, and with men perpetrating IPV. Perceived skills to challenge gender inequitable practices were negatively associated with men perpetrating sexual IPV. In conclusion, we found IPV experience and perpetration were highly correlated, and that, contrary to commonly reported gender gaps, men and women experienced similar rates of IPV. We make suggestions for future research, including on IPV prevention interventions in areas with such IPV prevalence that would be beneficial for women and men and future generations.

A Systematic Review and Meta-Analysis of Associated Factors of Gender-Based Violence against Women in Sub-Saharan Africa

A systematic review and meta-analysis were employed to address the associated factors of gender-based violence (GBV) in sub-Saharan African (SSA) countries. The Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus and Web of Science were used to source articles with stringent eligibility criteria. A total of 4931 studies were found and 50 studies met the inclusion criteria. Pooled meta-analyses revealed that low educational attainment, higher alcohol consumption, substance use, history of child and family abuse, limited decision-making skills, experiencing depression, males having multiple sexual partners, and younger age were found to be individual- and family-associated factors that increase the experiences of GBV. Community tolerant attitudes to violence, women's unemployment, being Muslim, lower socioeconomic class, food and social insecurity were found to be community- and societal-associated factors of GBV. Alcohol consumption, low educational attainment, experiencing depression, being younger, a history of child and family abuse, tolerant attitudes to violence, and low socioeconomic status were poignant factors associated with GBV amongst women in SSA countries. The need to develop a multipronged approach of intervention is a top priority in SSA to reach the Sustainable Development Goals' (SDGs) target of 2030 to eliminate all forms of violence. Socio-behavioural change communication interventions at individual and community levels need to be introduced, and interventions need to address the prevention of child and family abuse and increase women's feelings of empowerment in order to prevent GBV in SSA.

Gender Based Violence against Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

This study aimed to systematically review studies that examined the prevalence of gender based violence (GBV) that included intimate partner violence (IPV) and non-IPV among women in sub-Saharan Africa (SSA). This evidence is an important aspect to work towards achieving the Sustainable Development Goals (SDG's) target of eliminating all forms of violence in SSA. The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus and Web of Science were used to source articles with stringent eligibility criteria. Studies on GBV in SSA countries that were published in English from 2008 to 2019 were included. A random effect meta-analysis was used. Fifty-eight studies met the inclusion criteria. The pooled prevalence of IPV among women was 44%, the past year-pooled prevalence of IPV was 35.5% and non-IPV pooled prevalence was 14%. The highest prevalence rates of IPV that were reported included emotional (29.40%), physical (25.87%) and sexual (18.75%) violence. The sub-regional analysis found that women residing in Western (30%) and Eastern (25%) African regions experienced higher levels of emotional violence. Integrated mitigation measures to reduce GBV in SSA should focus mainly on IPV in order to achieve the SDG's that will lead to sustainable changes in women's health.