Patterns of Intimate Partner Violence Victimization Among South African Women and Their Relation to Emotional Distress During Pregnancy and Postpartum

Knowledge and attitudes of antenatal mothers towards intimate partner violence in the Gambia: A cross-sectional study

Intimate partner violence is a severe public health and human rights issue that 1 in 3 women experience in their lifetime. A woman's knowledge and attitudes towards intimate partner violence might influence her experience of violence from an intimate partner. This study aimed at analysing the knowledge and attitudes of antenatal mothers towards intimate partner violence. This study employed a descriptive cross-sectional technique. Pregnant women seeking antenatal care were selected from 6 public healthcare facilities in the Gambian Upper River Region (URR). We used the single proportion formula to calculate the sample size, which was 373 women. Data were entered, cleaned and analysed using SPSS version 21.Majority of the participants had good knowledge about IPV (77%). The most common intimate partner violence known to the women was denial of money to hurt her (80.2%). Only 58% of the women knew that a male partner's insistence on knowing their whereabouts at all times and expecting them to seek permission before accessing healthcare is a form of violence. Eighty-seven per centof the participants had a negative attitude towards IPV (i.e., they were not precisely against the stated forms of violence perpetrated by their partners). When asked about what would warrant them to leave their partners, 67% claimed they would never leave their partners despite facing violence. According to 36% of the respondents, women stay in abusive marriages because of their children.Despite the relatively high knowledge of pregnant women on IPV, their attitudes tell a different story, which is: acceptance of violent behaviours from their partners. More work needs to be done to sensitise women on their rights not to be violated and engage the whole society in changing the social norms unfavourable to them.

Patterns of Women's exposure to psychological violence: A global examination of low- and middle-income countries

Introduction

Under Sustainable Development Goal 5, prevalence of intimate partner violence (IPV) is a globally reportable indicator. There is a lack of consensus on how to measure and report psychological IPV, affecting prevalence estimates and cross-country comparability. We examine similarities and differences in the patterning of women's experiences of psychological abuse in low- and middle-income countries (LMICs) to inform common cut points.

Methods

Data include 13,452 ever-partnered women from six LMICs participating in the WHO multi-country study on women's health and domestic violence against women and 306,101 from 47 LMICs participating in the Demographic and Health Surveys. A confirmatory latent class analysis (LCA) approach was applied to identify the optimal class structure using the 3 DHS and 4 WHO psychological IPV items, assessed the impact of physical and sexual IPV on class structure, and tested class generalizability across countries. We validated the three-class solution by regressing the classes on physical IPV, sexual IPV, controlling behaviors, and injury due to domestic violence. We used item response theory (IRT) methods to assess item-level characteristics of the items.

Results

Analysis confirmed the three-class structure in most countries. Addition of physical and sexual IPV did not change overall class structure or improve discrimination or homogeneity of the items. The three-class structure was invariant within most WHO-classified regions. Operationalized classes informed by the LCA resulted in prevalences of roughly 90% low-to-no class, 7% moderate-intensity class, and 3% high-intensity class. Classes showed convergent validity with all outcomes tested. IRT analysis revealed good discriminations but substantial information overlaps over a narrow range of the latent psychological violence construct.

Conclusions

This study confirms the three-class pattern but suggests some differences across countries. and regions. We suggest cut points distinguishing violent from non-violent acts and demarcating levels of severity for future study. Findings offer evidence-based guidance to rectify challenges.

Profiles of Intimate Partner Violence Victimization: A Systematic Review

Person-centered approaches, such as latent class analysis (LCA) and latent profile analysis (LPA), aid the identification of subgroups within sample populations. These methods can identify the patterns of co-occurrence between different forms of intimate partner violence (IPV), providing valuable information for prevention and intervention efforts. The aim of this systematic review was to yield a summary and conduct a critical evaluation of the current research that utilizes LCA/LPA to investigate IPV victimization profiles. We provide an outline of 14 relevant studies, retrieved from searches conducted on PsycInfo, Scopus, and Eric databases. There was a large amount of variability in relation to the forms of IPV assessed, measures utilized, number of classes identified, and the sample populations recruited. However, broad similarities were revealed as there were some commonly identified classes, including the no/low violence class, the physical and psychological victimization class, and the multiple victimization class, yet the labels assigned to those classes differed across studies. A range of external criteria (risk factors and consequences) were also identified as being associated with class membership. We highlight the methodological features which may have impacted data collection and class enumeration, including the differences in sample population, the range of IPV indicators assessed, the time period from which IPV data were recorded, and whether data were collected regarding participants' current or previous relationships. Marginalized populations were underrepresented, and psychological abuse was most inconsistently operationalized. Recommendations for future research are provided, including recommendations with regard to labeling the classes for greater consistency across studies.

Perception, and Experience of Domestic Violence among Women in a Rural Community in Kaduna State, Nigeria

Background

Domestic violence (DV) occurs in all settings, transcending socio-cultural and demographic profiles. It is pervasive, insidious, carried out in private domain, and usually inflicted by family members. It continues over long period and limits avenues of escape for victims. The aim of this study was to assess the perception and experience of DV among rural women in Sabon Gari LGA of Kaduna State, Nigeria.

Methodology

A cross-sectional descriptive study conducted in Tohu community, Sabon Gari LGA, Kaduna State. Sample size of 365 was determined using Fisher's formula, at p-value, reliability coefficient, confidence interval, degree of freedom, and possible attrition rate of 0.5, 1.96, 95%, 0.05, and 16% respectively. The study population comprised all women of reproductive age group in Tohu. Eligible respondents who had been in the community for at least one year were included in the study, while those who were ill were excluded. A semi-structured, interviewer-administered questionnaire was administered by female research assistants, and data collected was analyzed using SPSS version 21.0. Frequencies and percentages were reported for categorical data. Respondents' perception of DV was assessed using 19 questions across 5domains. Composite score of 0-19 was expected for each respondent. Scores of >10, and <10 were considered to be good, and poor perception of DV respectively. Relationships between variables were determined using appropriate test statistics at p-value <0.05.

Results

Fifty-three percent of respondents have good perception of DV, with age, marital status, and occupation affecting respondents' perception. Seventeen percent of respondents had experienced physical and/or verbal abuse. Marital status and level of education were found to affect respondents' experience of DV.

Conclusion

DV is still rife in rural parts of Nigeria. Civil rights groups should intensify efforts toward awareness creation so that victims can report to the appropriate authorities and the perpetrators prosecuted.

Partnership Dynamics and HIV-Related Sexual Behaviors Among Adolescent Mothers in South Africa: A Longitudinal Analysis of HIV Prevention Trials Network 068 Data

PURPOSE

In South Africa, adolescent mothers have a three times higher risk of HIV acquisition than nonadolescent mothers. Yet, limited evidence exists regarding how early childbearing may affect HIV risk. A better understanding of adolescent mothers' partnership dynamics and sexual behaviors is critical to tailoring interventions to prevent new infections.

METHODS

Data are from HIV Prevention Trials Network 068, a longitudinal study of adolescent girls and young women (AGYW) aged 13-20 in South Africa who were followed annually for up to 6 years. Log-binomial regression models were used to assess whether adolescent motherhood was associated with partnership dynamics (intimate partner violence, gender inequitable norms, low relationship power, no HIV prevention communication) and if the association between partnership dynamics and sexual behaviors (unprotected sex and transactional sex) varied by adolescent motherhood. Generalized estimating equations, with an exchangeable correlation structure, were used to account for nonindependence.

RESULTS

Adolescent mothers were more likely than nonadolescent mothers to be in partnerships characterized by intimate partner violence, low relationship power, gender inequitable norms, and no HIV prevention communication. A higher proportion were also more likely to experience these dynamics, as well as engage in transactional sex, after giving birth. Poor partnership dynamics put AGYW at a higher risk for unprotected sex and transactional sex, regardless of adolescent motherhood status.

DISCUSSION

Engaging adolescent mothers in interventions post birth and developing interventions that address power imbalances in AGYW's sexual partnerships have the potential to reduce engagement in HIV-related sexual behaviors and HIV risk in the long term.

The Intersection of Intimate Partner Violence Perpetration and Sexual Risk Behavior Among Young Men in Tanzania: A Latent Class Analysis of Patterns and Outcomes

Few studies of intimate partner violence (IPV) perpetration and sexual risk behavior among men have examined how multiple dimensions of these behaviors intersect in ways that may uniquely elevate health risks. The current study used latent class analysis to: (1) identify distinct patterns of IPV and sexual risk behavior in a sample of Tanzanian men (n = 985) and (2) examine associations between identified patterns and health outcomes. Four classes were identified: normative (64% of the sample), IPV only (14%), sexual risk only (13%), and comorbid IPV/sexual risk (5%). Compared to men in the normative subgroup, men in the comorbid group had significantly higher odds of STI infection, higher perceived HIV risk, and greater odds of substance use. Findings provide evidence that engaging in IPV and multiple sexual partnerships (i.e., a comorbid pattern) denotes elevated health risks across a range of indicators, suggesting the importance of targeted treatment and prevention efforts for men in this subgroup.

Intimate partner violence in Nepal: Latent patterns and association with depressive symptoms

Existing data suggest that there are distinct patterns (or classes) of intimate partner violence (IPV) experience that depart from dichotomous categorizations used to monitor progress toward Sustainable Development Goal 5.2. Less is known about the patterning of IPV in non-Western settings. This study estimates distinct classes of IPV experience in Nepal and examines potential community-level variability in these classes and in the association between IPV class and depressive symptoms. This study used data collected in 2016 from a random sample of Nepalese married women of reproductive age (N = 1440) living in 72 communities in three districts (Nawalparasi, Chitwan, and Kapilvastu). We used fixed effects and random effects latent class models of 2 through 6 classes. We fit a negative binomial regression model adjusted for relevant confounders to examine the relationship of the latent IPV classes with depressive symptoms. A four-class model was the best fitting. It included a "low exposure" class (77.36% of the sample) characterized by a low probability of experiencing any form of IPV, a "sexual violence" class (9.03% of the sample) characterized by a high probability of experiencing a form of sexual violence, a "moderate violence" class (6.60% of the sample) characterized by modest probabilities of experiencing less severe emotional and physical IPV, and a "systematic violence" class (7.01% of the sample) characterized by a high probability of being exposed to all forms of IPV. Adding random effects did not improve model fit, suggesting no community-level variations in classes. Relative to membership in the low exposure class, membership in all other classes was associated with a higher count of depressive symptoms. Those in the systematic class had a mean weighted symptom count 2.29 times that of the low exposure group. Classes of IPV exposure must be identified to ensure that surveillance and programming are attuned to women's experiences of violence.

A longitudinal study of the relationship between intimate partner violence and postpartum unsafe sex among newly diagnosed HIV-infected South African women

HIV-positive women who engage in postpartum unsafe sex are at risk for sexually transmitted infection (STI), unintended pregnancy, and secondary transmission of HIV to uninfected partners. One factor that may increase risk for postpartum unsafe sex among HIV-positive women is intimate partner violence (IPV) victimization; few studies, however, have examined this association. This longitudinal study examined whether patterns of psychological, physical, and sexual IPV, assessed during pregnancy, predicted unsafe sex at 14 weeks postpartum among South African women diagnosed as HIV-positive during pregnancy (n = 561). In a latent class analysis, we identified three distinct patterns of IPV victimization: non-victims (74%), moderate IPV (20%), and multiform severe controlling IPV (5%). Compared to non-victims, victims of multiform severe controlling IPV were significantly more likely to engage in postpartum unsafe sex (p = .01), even after adjusting for potential confounding factors. Moderate IPV was not associated with postpartum unsafe sex. Findings support the need for targeted sexual risk reduction interventions for HIV-positive pregnant women who have experienced severe patterns of IPV.