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Storholm ED, Reynolds HE, Muthuramalingam S, Nacht CL, Felner JK, Wagner GJ, Stephenson R, Siconolfi DE. Intimate Partner Violence and the Sexual Health of Sexual Minority Men. LGBT Health 2023; 10:S39-S48. [PMID: 37754928 PMCID: PMC10623463 DOI: 10.1089/lgbt.2023.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Purpose: This qualitative study explores the pathways by which various forms of intimate partner violence (IPV) impact the sexual health behaviors of cisgender identified sexual minority men (SMM). Methods: Semi-structured interviews were conducted with 23 racially and ethnically diverse SMM who recently experienced IPV and 10 clinical and social service providers focused on how experiences of IPV directly or indirectly influences sexual risk as well as engagement in HIV prevention behaviors (e.g., pre-exposure prophylaxis [PrEP] use). Applied thematic analysis, including cycles of analytic memo writing and coding, aided the identification of patterns across the data. Results: Analyses yielded three overarching themes: use of condoms, use of PrEP, and HIV and sexually transmitted infections (STIs). Participants described different ways condom use or nonuse was a mechanism by which power and/or control might be asserted by one partner over the other partner. A range of responses to questions about PrEP were identified, including partners encouraging PrEP use, as well as avoidance of conversations about PrEP or actual PrEP use, to prevent experiencing aggression or IPV from partners. Responses regarding HIV/STIs included those ranging from a new diagnosis being a potential trigger for violence to the exploitation of status to control partners. Conclusion: These findings suggest that in relationships with IPV, HIV prevention strategies can be sources of relationship control and trigger abuse. Addressing IPV may help to prevent HIV/STI transmission and promote the health of SMM. In addition, long-acting formulations of PrEP may be a promising strategy for SMM experiencing IPV when oral PrEP medications may be a risk factor for violence.
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Affiliation(s)
- Erik D. Storholm
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Hannah E. Reynolds
- School of Public Health, San Diego State University, San Diego, California, USA
| | | | - Carrie L. Nacht
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Jennifer K. Felner
- School of Public Health, San Diego State University, San Diego, California, USA
| | | | - Rob Stephenson
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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Zheng A, Nelson HN, McCall-Hosenfeld JS, Lehman EB, Chuang CH. Recent Intimate Partner Violence and Oral Contraceptive Pill Adherence in a Cohort of Reproductive-Aged Women. J Womens Health (Larchmt) 2022; 31:1703-1709. [PMID: 36126298 PMCID: PMC9805850 DOI: 10.1089/jwh.2021.0622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective: Intimate partner violence (IPV) is an important public health problem that impacts reproductive decision-making. Although previous literature has reported a negative impact on contraceptive adherence overall, this study specifically aims to investigate the association between IPV and oral contraceptive pill (OCP) adherence. Methods: We analyzed baseline survey data from 373 OCP users participating in the MyNewOptions study. Recent IPV was defined as any positive response to HARK, a 4-question tool assessing emotional, sexual, and physical abuse in the past year, or self-report of sexual coercion in the past 6 months. High OCP adherence was defined by self-report of missing ≤1 pill per month, which was then corroborated by pharmacy claims data. Multivariable regression analyses were performed to assess the influence of recent IPV history and patient-level variables on OCP adherence. Results: Just over half of our participants were highly adherent to OCPs (53.6%), and approximately one-quarter reported recent IPV exposure (25.2%). Women with recent IPV were significantly less likely to be OCP adherent than those without IPV (adjusted odds ratio (AOR) 0.54, 95% confidence interval (CI): 0.32-0.92). Protestant religion was also associated with high OCP adherence (AOR 2.41, 95% CI: 1.24-4.65, compared with no religious affiliation), while younger age groups (18-25 and 26-33 years) were less likely to have high OCP adherence compared with the 34-40 age group (AOR 0.45, 95% CI: 0.20-1.00 and AOR 0.40, 95% CI: 0.18-0.91, respectively). Conclusion: Recent IPV exposure is associated with low OCP adherence among women of reproductive age. ClinicalTrials.gov identifier: NCT02100124.
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Affiliation(s)
- Amy Zheng
- Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Hallie N. Nelson
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, USA
| | - Jennifer S. McCall-Hosenfeld
- Division of General Internal Medicine and Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Erik B. Lehman
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Cynthia H. Chuang
- Division of General Internal Medicine and Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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Paul P, Mondal D. Association Between Intimate Partner Violence and Contraceptive Use in India: Exploring the Moderating Role of Husband's Controlling Behaviors. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP15405-NP15433. [PMID: 34000903 DOI: 10.1177/08862605211015212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Existing studies show a mixed relationship between intimate partner violence (IPV) and contraceptive use. This study assesses the association between women's exposure to IPV and contraceptive use in India. Furthermore, we aim to determine whether husband's controlling behaviors play a moderating role in the IPV-contraception link. We used nationally representative data from the recent round of the National Family Health Survey (NFHS-4), conducted in 2015-2016. In this study, the use of contraceptives is the outcome variable, categorized into three groups: no/traditional methods, modern methods, and female sterilization. Women's exposure to IPV in the past year is the key exposure of interest. Socio-economic and demographic variables were used as covariates. Multinomial logistic regression models were performed to examine the association between women's exposure to IPV and contraceptive use. Of the total participants (N = 58,891), approximately one in every four women (24.1%) experienced any form of IPV in the past year. Slightly over half (50.8%) reported using either traditional methods of contraception or no contraceptive at all. About 14% of the respondents were using modern methods of contraception and 34.9% had undergone sterilization. After controlling for confounding factors, women who experienced IPV were 8% (95% CI [.87, .99]) less likely to report using modern contraceptives than those who did not face any IPV. Conversely, women who faced IPV were 14% (95% CI [1.09, 1.20]) more likely to undergo sterilization. Furthermore, women who experienced any form of IPV and whose husbands endorse controlling attitudes were 12% (95% CI [.81, .95]) less likely to report using modern contraceptives and 11% (95% CI [1.04, 1.17]) more likely to undergo sterilization. Interventions should be made to prevent violence against women that would increase their ability to choose appropriate contraception methods to avoid unintended pregnancies.
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Affiliation(s)
- Pintu Paul
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Dinabandhu Mondal
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India
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Irani L, Verma S, Mohanan PS, Hazra A. Identifying the association of women’s empowerment with reproductive and maternal health practices using a cross-sectional study in the context of self-help groups in rural India. Gates Open Res 2022. [DOI: 10.12688/gatesopenres.13468.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Globally, women’s empowerment is captured through different combinations of indicators related to their collective and individual empowerment. In this paper, the association of diverse domains related to women’s collective and individual empowerment on their reproductive and maternal health practices were assessed. Collective empowerment referred to a cluster of indicators measuring mutual support, rights, and access to services women received, as a result of membership in self-help groups (SHGs) focused on micro-finance activities. Women’s individual empowerment was measured through their perception to make decisions on their own, be mobile, financially self-reliant, self-confident in expressing themselves, having self-esteem and being free from spousal violence. Methods: Cross-sectional data were collected in 2017 from 2,197 SHG members across 57 administrative blocks of Uttar Pradesh, India. Using exploratory and confirmatory factor analysis, the sub-domains of individual and collective empowerment were developed. The reproductive and maternal health indicators included antenatal care, delivery preparedness, postnatal care and current contraceptive use. Bivariate and multivariate analyses, using logistic regression, were carried out to measure the association of sub-domains of women’s empowerment with health practices. Results: Collective and individual empowerment were independently and jointly associated with correct health practices. Women with greater empowerment through independent mobility, high self-esteem, access to financial resources, and confidence in interacting with a frontline worker, were more likely to access antenatal care. Similarly, delivery preparedness—which entailed deciding on the place of delivery, arranging for transportation during labor, and managing expenses for the delivery—was positively influenced by collective support from fellow SHG members. Receiving postnatal care was positively associated with self-confidence and financial autonomy, and current family planning method use was positively associated with self-confidence, lower spousal violence and confidence in support from the group. Conclusions: Women’s collective and individual empowerment were independently and jointly positively associated with health outcomes among SHG members.
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Bandara P, Page A, Senarathna L, Wijewardene K, Silva T, Gunnell D, Knipe D, Rajapakse T. Clinical and psychosocial factors associated with domestic violence among men and women in Kandy, Sri Lanka. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000129. [PMID: 36962126 PMCID: PMC10021245 DOI: 10.1371/journal.pgph.0000129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 02/13/2022] [Indexed: 11/19/2022]
Abstract
Domestic violence (DV) is a violation of human rights with adverse intergenerational consequences on physical and mental health. Clinical and psychosocial correlates of DV have been documented internationally, but evidence from South Asia is limited, especially among men. This is a nested cross-sectional study of the control population (N = 856) of a large case-control study in Kandy, Sri Lanka. Multivariable logistic regression models were conducted to estimate the association between clinical and psychosocial factors and experience of DV. Overall associations were examined and stratified by sex and type of abuse. Overall, 19% (95% CI 16%-21%) of the sample reported DV of any form in past year, with a similar prevalence being reported in both men (18% 95% CI 14%-22%) and women (19% 95% CI 15%-23%). Depression symptoms (adjusted OR [AOR] 3.28 95% CI 2.13-5.05), suicidal ideation (AOR 6.19 95% CI 3.67-10.45), prior diagnosis of a mental illness (AOR 3.62 95% CI 1.61-8.14), and previous self-harm (AOR 6.99 95% CI 3.65-13.38) were strongly associated with DV, as were indicators of perceived poor social support (AOR range 2.48-14.18). The presence of in-laws (AOR 2.16 95% CI 1.34-3.48), having three or more children (AOR 2.15 95% CI 1.05-4.41) and being divorced/separated/widowed were also strongly associated with DV (AOR 2.89 95% CI 1.14-7.36). There was no statistical evidence that any associations differed by sex. A multi-sectoral approach is needed to address DV in this context. Enhanced coordination between DV support services and mental health services may be beneficial. Further research and support for men as well as women is needed.
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Affiliation(s)
- Piumee Bandara
- Translational Health Research Institute, Western Sydney University, New South Wales, Australia
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, New South Wales, Australia
| | - Lalith Senarathna
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Health Promotion, Faculty of Applied Sciences, Rajarata University of Sri Lanka, Mihintale, Sri Lanka
| | - Kumudu Wijewardene
- Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayawardenepura, Nugegoda, Sri Lanka
| | - Tharuka Silva
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Duleeka Knipe
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Thilini Rajapakse
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Giacci E, Straits KJ, Gelman A, Miller-Walfish S, Iwuanyanwu R, Miller E. Intimate Partner and Sexual Violence, Reproductive Coercion, and Reproductive Health Among American Indian and Alaska Native Women: A Narrative Interview Study. J Womens Health (Larchmt) 2022; 31:13-22. [PMID: 34747659 PMCID: PMC8785763 DOI: 10.1089/jwh.2021.0056] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: The disproportionately high prevalence of poor reproductive and sexual health outcomes among American Indian and Alaska Native (AI/AN) women is related to histories of colonization, oppression, and structural racism. Intimate partner violence (IPV) and sexual violence (SV) contribute to these health outcomes. Materials and Methods: Narrative interviews were conducted with AI/AN women from four tribal reservation communities. Interviews explored connections among sexual and reproductive health, IPV, SV, reproductive coercion (RC), and pregnancy experiences as well as women's experiences of healing and recovery. Results: Among the 56 women interviewed (aged 17-55 years, 77% were aged 40 years and younger), all described multiple exposures to violence and highlighted lack of disclosure related to sexuality, childhood abuse, SV, and historical trauma. Access to confidential reproductive health services and contraceptive education was limited. Almost half (45%) reported experiencing RC in their lifetime. Use of substances occurred in both the context of SV and for surviving after exposure to violence. Women underscored the extent to which IPV, SV, and RC are embedded in histories of colonization, racism, and ongoing oppression. Interventions that incorporate AI/AN traditions, access to culturally responsive reproductive health and advocacy services, organizations, and services that have AI/AN personnel supporting survivors, public discussion about racism, abuse, sexuality, and more accountable community responses to violence (including law enforcement) are promising pathways to healing and recovery. Conclusions: Findings may advance understanding of AI/AN women's reproductive health in the context of historical trauma and oppression. Intervention strategies that enhance resiliency of AI/AN women may promote reproductive health.
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Affiliation(s)
- Elena Giacci
- Advocate and Training Specialist (Dine), Albuquerque, New Mexico, USA
| | - Kee J.E. Straits
- Tinkuy Life Community Transformations, LLC, Albuquerque, New Mexico, USA
| | - Amanda Gelman
- Chinle Comprehensive Health Care Facility, Chinle, Arizona, USA
| | - Summer Miller-Walfish
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rosemary Iwuanyanwu
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Samad N, Das P, Dilshad S, Al Banna H, Rabbani G, Sodunke TE, Hardcastle TC, Haq A, Afroz KA, Ahmad R, Haque M. Women's empowerment and fertility preferences of married women: analysis of demographic and health survey’2016 in Timor-Leste. AIMS Public Health 2022; 9:237-261. [PMID: 35634022 PMCID: PMC9114782 DOI: 10.3934/publichealth.2022017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/26/2021] [Accepted: 01/04/2022] [Indexed: 11/21/2022] Open
Abstract
A recently independent state, Timor-Leste, is progressing towards socioeconomic development, prioritizing women empowerment while its increased fertility rate (4.1) could hinder the growth due to an uncontrolled population. Currently, limited evidence shows that indicators of women's empowerment are associated with fertility preferences and rates. The objective of this study was to assess the association between women empowerment and fertility preferences of married women aged 15 to 49 years in Timor-Leste using nationally representative survey data. The study was conducted using the data of the latest Timor-Leste Demographic and Health Survey 2016. The study included 4040 rural residents and 1810 urban residents of Timor-Leste. Multinomial logistic regression has been performed to assess the strength of association between the exposures indicating women's empowerment and outcome (fertility preference). After adjusting the selected covariates, the findings showed that exposures that indicate women empowerment in DHS, namely, the employment status of women, house and land ownership, ownership of the mobile phone, and independent bank account status, contraceptive use, and the attitude of women towards negotiating sexual relations are significantly associated with fertility preferences. The study shows higher the level of education, the less likely were the women to want more children, and unemployed women were with a higher number of children. Our study also found that the attitude of violence of spouses significantly influenced women's reproductive choice. However, employment had no significant correlation with decision-making opportunities and contraceptive selection due to a lack of substantial data. Also, no meaningful data was available regarding decision-making and fertility preferences. Our findings suggest that women's empowerment governs decision-making in fertility preferences, causing a decline in the fertility rate.
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Affiliation(s)
- Nandeeta Samad
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Pranta Das
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
| | - Segufta Dilshad
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Hasan Al Banna
- Institute of Social Welfare and Research, University of Dhaka, Dhaka, Bangladesh
| | - Golam Rabbani
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | | | - Ahsanul Haq
- Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhanmondi, Dhaka-1205, Bangladesh
| | - Khandaker Anika Afroz
- Deputy Manager (Former), Monitoring, Learning, and Evaluation, CEP, BRAC, Bangladesh
| | - Rahnuma Ahmad
- Department of Physiology, Medical College for Women and Hospital, Dhaka, Bangladesh
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sugai Besi, 57000 Kuala Lumpur, Malaysia
- * Correspondence: ,
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8
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Women's (limited) agency over their sexual bodies: Contesting contraceptive recommendations in Brazil. Soc Sci Med 2021; 290:114276. [PMID: 34565613 DOI: 10.1016/j.socscimed.2021.114276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 07/10/2021] [Accepted: 07/27/2021] [Indexed: 12/27/2022]
Abstract
Unintended pregnancies constitute a serious public health concern in Brazil, representing up to 55% of all pregnancies, and are prevalent among women with low income and low educational backgrounds. Lack of assistance to women in their decision-making has hindered the adoption of more effective contraceptive models. Although clinical consultations constitute an important locus to assist women in decision-making and to facilitate access to subsidized methods, our current knowledge of how contraception is discussed and decisions are reached in actual consultations is limited. Just as scarce is our knowledge of how patients respond and resist contraception recommendations and how physicians counter or accommodate patients. Using a corpus of 103 audio-recorded medical visits and conversation analytic (CA) methods, this paper examines recommendation sequences in the under-investigated gynecological consultations in the Brazilian public healthcare system (SUS). The quantitative analysis reveals a strong orientation to physicians as having primary rights to govern the oversight of women's bodies: 94% of the recommendations are delivered as pronouncements (e.g., "You'll take X″), the most authoritative action type. Patients largely assume an agreeable and passive role (66%), leading to scarce negotiation and minimal involvement in decision-making. However, in a few cases (12%), all involving contraception, patients become overtly agentive, responding with active resistance. A qualitative analysis of that subset shows that despite women's gaining some agency over their sexual bodies, that agency is still limited. Whereas physicians accommodate patient resistance on grounds of biomedically-related side-effects and incorrect assumptions about the women's lives, they overlook patient resistance based on gendered struggles over contraceptive methods in the domestic sphere. By failing to consider women's lack of agency in choosing whether to have sex or to use condoms, doctors show unawareness of significant consequences of the recommended method, which might include domestic dispute and violence and, paradoxically, ultimately misfire, leading to unwanted pregnancy.
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9
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Lozano M, Obiol MA, Peiró J, Iftimi A, Ramada JM. Professional counseling in women with serious mental illness: achieving a shift toward a more effective contraceptive method. J Psychosom Obstet Gynaecol 2021; 42:221-227. [PMID: 32050830 DOI: 10.1080/0167482x.2020.1725463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Mental disorders in reproductive-aged women have significant implications for the risk of unintended pregnancies. The objective of this study is to assess the professional counseling in clinical practice based on motivational interview in women with serious mental illness (SMI) in order to achieve a change to a more effective contraceptive method. STUDY DESIGN A prospective observational cohort study (2012-2017) was conducted in a convenience sample of women with severe-moderate psychiatric disorders (n = 91). Information related to psychiatric health, contraceptive use, sexual and reproductive health and socio-demographics was collected. To assess the variation in the contraceptive method, follow-up visits were planned before and after medical counseling. All participants underwent an evidence-based individual motivational interview for contraception counseling. A multivariate logistic model was carried out to identify the factors involved in changing to a more effective contraceptive method. RESULTS After evidence-based counseling, 51.6% of participants changed their contraceptive method to a more effective one. This change was associated with gender violence (β coefficient = 1.58, p value = .006). The relation between changing to a more effective contraceptive method and both previous abortions and having children was also positive, although the coefficients did not reach statistical significance. CONCLUSIONS Evidence-based contraception counseling in clinical practice, based on an adapted protocol to patients with SMI, has shown, in this study, to be adequate to promote the shift to more effective contraceptive methods, avoiding the need of daily compliance in this population. Gender violence has been significantly associated with the shift to very high effectiveness methods as well as previous abortions and having children, not significantly.
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Affiliation(s)
- Manuel Lozano
- Departament de Medicina Preventiva i Salut Pública, Ciències de l'Alimentació, Toxicologia i Medicina Legal, Universitat de València, València, Spain
| | - María Antonia Obiol
- Centre de Salut Sexual i Reproductiva Font de Sant Lluís, Hospital Universitari Dr. Peset, València, Spain
| | - Juanjo Peiró
- Departament d'Estadística i Investigació Operativa, Universitat de València, València, Spain
| | - Adina Iftimi
- Departament d'Estadística i Investigació Operativa, Universitat de València, València, Spain
| | - José María Ramada
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Akoth C, Oguta JO, Gatimu SM. Prevalence and factors associated with covert contraceptive use in Kenya: a cross-sectional study. BMC Public Health 2021; 21:1316. [PMID: 34225673 PMCID: PMC8256600 DOI: 10.1186/s12889-021-11375-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 06/25/2021] [Indexed: 11/24/2022] Open
Abstract
Background Family planning (FP) is a key intervention for preventing unplanned pregnancies, unsafe abortions, and maternal death. Involvement of both women and their partners promotes contraceptive acceptance, uptake and continuation, couple communication and gender-equitable attitude. Partner involvement is a key strategy for addressing about 17.5% of the unmet needs in FP in Kenya. This study assessed the prevalence and factors associated with covert contraceptive use (CCU) in Kenya. Methods We used data from the sixth and seventh rounds of the performance monitoring for accountability surveys. We defined CCU as “the use of contraceptives without a partner’s knowledge”. We used frequencies and percentages to describe the sample characteristics and the prevalence of CCU and assessed the associated factors using bivariate and multivariable logistic regressions. Results The prevalence of CCU was 12.2% (95% CI: 10.4–14.2%); highest among uneducated (22.3%) poorest (18.2%) and 35–49 years-old (12.8%) women. Injectables (53.3%) and implants (34.6%) were the commonest methods among women who practice CCU. In the bivariate analysis, Siaya county, rural residence, education, wealth, and age at sexual debut were associated with CCU. On adjusting for covariates, the odds of CCU were increased among uneducated women (aOR 3.79, 95% CI 1.73–8.31), women with primary education (aOR 1.86, 95% CI 1.06–3.29) and those from the poorest (aOR 2.67, 95% CI 1.61–4.45), poorer (aOR 1.79, 95% CI 1.05–3.04), and middle (aOR 2.40, 95% CI 1.52–3.78) household wealth quintiles and were reduced among those with 2–3 (aOR 0.49, 95% CI 0.33–0.72) and ≥ 4 children (aOR 0.62, 95% CI 0.40–0.96). Age at sexual debut (aOR 0.94, 95% CI 0.89–0.99) reduced the odds of CCU. Conclusion About one in 10 married women in Kenya use contraceptives covertly, with injectables and implants being the preferred methods. Our study highlights a gap in partner involvement in FP and calls for efforts to strengthen their involvement to increase contraceptive use in Kenya while acknowledging women’s right to make independent choices.
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Affiliation(s)
- Catherine Akoth
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya.
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11
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Tiruye TY, Harris ML, Chojenta C, Holliday E, Loxton D. Intimate partner violence against women in Ethiopia and its association with unintended pregnancy: a national cross-sectional survey. Int J Public Health 2020; 65:1657-1667. [PMID: 33048193 DOI: 10.1007/s00038-020-01510-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/07/2020] [Accepted: 10/07/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To investigate the association between intimate partner violence (IPV) and unintended pregnancy among women in Ethiopia. METHODS A retrospective analysis of nationally representative data was conducted among 2969 married women of reproductive age (15-49 years). Logistic regression models were used to estimate the association of IPV with the outcome variable. RESULTS Unintended pregnancy was reported by 26.5% of women. About 36% of participants reported having ever experienced IPV (a composite measure of physical, sexual, and emotional abuse) and 56% had experienced at least one act of partner controlling behaviour. After controlling for potential confounders, a significant association was observed between IPV and unintended pregnancy (AOR 1.39, 95% CI 1.05, 1.85) and between multiple acts of partner controlling behaviours and unintended pregnancy (AOR 1.57, 95% CI 1.16, 2.14). CONCLUSIONS In Ethiopia, which has a high fertility rate (4.6 children per woman) and low use of contraception (36%), IPV including partner controlling behaviour further contributes to the problem of unintended pregnancy. Reproductive health programs should be sensitive to the relational aspects of fertility control and incorporate IPV interventions into reproductive health services.
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Affiliation(s)
- Tenaw Yimer Tiruye
- Public Health Department, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia.
| | - Melissa L Harris
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Catherine Chojenta
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Elizabeth Holliday
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Deborah Loxton
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
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Boydell V, Nulu N, Hardee K, Gay J. Implementing social accountability for contraceptive services: lessons from Uganda. BMC Womens Health 2020; 20:228. [PMID: 33046065 PMCID: PMC7549211 DOI: 10.1186/s12905-020-01072-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/10/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Growing evidence shows that social accountability contributes to improving health care services, with much promise for addressing women's barriers in contraceptive care. Yet little is known about how social accountability works in the often-complex context of sexual and reproductive health, particularly as sex and reproduction can be sensitive topics in the open and public formats typical of social accountability. This paper explores how social accountability operates in the highly gendered and complex context of contraceptive care. METHODS This exploratory research uses a case study approach to provide a more grounded understanding of how social accountability processes operate in the context of contraceptive information and services. We observed two social accountability projects that predominantly focused on contraceptive care in Uganda over a year. Five instruments were used to capture information from different source materials and multiple respondents. In total, one hundred and twenty-eight interviews were conducted and over 1000 pages of project documents were collected. Data were analyzed and compiled into four case studies that provide a thick description of how these two projects operated. RESULTS The case studies show the critical role of information, dialogue and negotiation in social accountability in the context of contraceptive care. Improved community and health system relationships, community empowerment, provider and health system responsiveness and enhanced availability and access to services were reported in both projects. There were also changes in how different actors related to themselves and to each other, and contraceptive care, a previously taboo topic, became a legitimate area for public dialogue. CONCLUSION The study found that while social accountability in the context of contraceptive services is indeed sensitive, it can be a powerful tool to dissolving resistance to family planning and facilitating a more productive discourse on the topic.
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Affiliation(s)
- Victoria Boydell
- Global Health Centre, Geneva Graduate Institute, Chemin Rigot 2, 1202, Geneva, Switzerland.
| | - Nanono Nulu
- Department of Population Studies, Makerere University, Kampala, Uganda
| | | | - Jill Gay
- MIA, What Works Association, Washington, DC, USA
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Tiruye TY, Harris ML, Chojenta C, Holliday E, Loxton D. The mediation effect of contraceptive use and women's autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia. BMC Public Health 2020; 20:1408. [PMID: 32938435 PMCID: PMC7493352 DOI: 10.1186/s12889-020-09514-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/07/2020] [Indexed: 11/17/2022] Open
Abstract
Background Intimate partner violence (IPV) affects one in every three women globally. Previous studies have revealed that women’s experiences of different forms of IPV are significantly associated with a higher rate of unintended pregnancy, reduced uptake of contraception, and reduced ability to make decisions regarding their fertility. The aim of this study was to investigate whether previously observed relationships between IPV and unintended pregnancy in Ethiopia are mediated by contraceptive use and women’s autonomy. Methods This study was performed using nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS). A subsample of married women of reproductive age reporting a pregnancy within the 5 years preceding 2016 and who participated in the domestic violence sub-study of the survey were included in analyses. Logistic regression models, together with the product of coefficients method, were used to estimate direct and mediated effects. Results Twenty six percent of participants reported an unintended pregnancy in the 5 years preceding the survey. Sixty-four percent reported having ever experienced IPV (a composite measure of physical, sexual, emotional abuse, and partner controlling behaviour). After adjusting for potential confounding factors, unintended pregnancy was significantly positively associated with reporting sexual IPV, emotional IPV, IPV (a composite measure of physical, sexual, or emotional abuse), and multiple partner controlling behaviour. However, IPV (as a composite of all four forms), physical IPV, and partner control (single act) were not significantly associated with unintended pregnancy. Women’s autonomy, but not contraception use, had a significant partial mediation effect in the relationships between some forms of IPV and unintended pregnancy. Women’s autonomy mediated about 35, 35, and 43% of the total effect of emotional IPV, IPV (physical, sexual, and/or emotional), and multiple partner control on unintended pregnancy respectively. Conclusion Women’s autonomy appears to play a significant role in mediating the effect of IPV on unintended pregnancy in Ethiopia. Maternal health service interventions in Ethiopia could incorporate measures to improve women’s decision-making power to reduce the negative reproductive health effects of IPV.
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Affiliation(s)
- Tenaw Yimer Tiruye
- Public health department, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia. .,Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, the University of Newcastle, Newcastle, Australia.
| | - Melissa L Harris
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, the University of Newcastle, Newcastle, Australia
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, the University of Newcastle, Newcastle, Australia
| | - Elizabeth Holliday
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, the University of Newcastle, Newcastle, Australia
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Haddad S, Martin-Marchand L, Lafaysse M, Saurel-Cubizolles MJ. Repeat induced abortion and adverse childhood experiences in Aquitaine, France: a cross-sectional survey. EUR J CONTRACEP REPR 2020; 26:29-35. [PMID: 32914679 DOI: 10.1080/13625187.2020.1815697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of the study was to analyse the relationship between adverse childhood experiences (ACEs) and repeat induced abortion, with regard to the potential effects of social deprivation and intimate partner violence. METHODS An observational cross-sectional survey was conducted across each of the 25 abortion centres in Aquitaine, France, from 15 June to 15 September 2009. The sample comprised 806 women >18 years who had requested an induced abortion. Data were collected through a self-reported anonymous questionnaire on ACEs and experience of previous abortion. The main outcome measure was the percentage of repeat induced abortions. RESULTS Among the participants, 473 (58.7%) were having their first induced abortion and 333 (41.3%) had already had a previous induced abortion. The abortion rank (first, second, third or more) was inversely related to the proportion of women with no ACE exposure (28%, 20% and 9%, respectively) and positively related to the proportion of women with a high ACE exposure (17%, 27% and 32%, respectively). Compared with women with no ACE exposure who were having a first induced abortion, in those with high ACE exposure, the odds of a third or more request for abortion was high: adjusted odds ratio 7.73 (95% confidence interval 3.56, 16.77). CONCLUSION We found a strong graded link between the extent of ACE exposure and the occurrence of repeat induced abortion.
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Affiliation(s)
- Sami Haddad
- Service de Gynécologie-Obstétrique, Centre Hospitalier de Périgueux, Périgueux, France
| | - Laetitia Martin-Marchand
- University of Paris Centre for Research on Epidemiology and Statistics (EPOPé), Sorbonne Paris Cité (CRESS), National Institute for Health and Medical Research (INSERM), INRA, Paris, France
| | | | - Marie-Josèphe Saurel-Cubizolles
- University of Paris Centre for Research on Epidemiology and Statistics (EPOPé), Sorbonne Paris Cité (CRESS), National Institute for Health and Medical Research (INSERM), INRA, Paris, France
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Musa A, Chojenta C, Loxton D. High rate of partner violence during pregnancy in eastern Ethiopia: Findings from a facility-based study. PLoS One 2020; 15:e0233907. [PMID: 32497059 PMCID: PMC7272015 DOI: 10.1371/journal.pone.0233907] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/14/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Intimate partner violence during pregnancy can contribute to maternal mortality and morbidity by limiting women's ability to receive maternal health services including antenatal care and skilled delivery care. In Ethiopia, evidence regarding intimate partner violence during pregnancy is limited, and no previous studies have been conducted in the Harari region. Therefore, this study aimed to investigate the prevalence and associated factors of intimate partner violence during pregnancy among women who had given birth in public hospitals in Harari regional state, eastern Ethiopia. METHODS A hospital-based cross-sectional study was conducted from November 2018 to April 2019 among women who had given birth in public hospitals in Harari regional state, East Ethiopia. A systematic random sampling method was employed to select 648 participants. Data were collected using an interviewer-administered standardized questionnaire based on the World Health Organization Multi-Country Study on Women's Health and Domestic Violence against Women survey. Crude and adjusted odds ratios with respective confidence intervals were computed. Variables with a p-value of ≤0.05 were considered to have a significant association with intimate partner violence during pregnancy. RESULTS The prevalence of intimate partner violence during the most recent pregnancy was found to be 39.81%. Furthermore, the prevalence of physical, emotional and sexual violence were found to be 25.93%, 25.62% and 3.7%, respectively. Longer duration of marriage (adjusted odds ratio = 1.68, 95% confidence interval = 1.01-2.79), most recent pregnancy being unplanned (adjusted odds ratio = 1.55, 95% confidence interval = 1.03-2.34), experiencing controlling behaviour by a partner, (adjusted odds ratio = 2.23, 95% confidence interval = 1.46-3.40) and having an attitude that justifies intimate partner violence (adjusted odds ratio = 1.60, 95% confidence interval = 1.09-2.36) were associated with experiencing intimate partner violence. CONCLUSION The prevalence of intimate partner violence during pregnancy was found to be high. Pregnancy monitoring programs, which can detect and intervene with regard to partner's controlling behaviors and women's perception regarding justification of intimate partner violence, especially in those women with an unplanned pregnancy, could help to reduce intimate partner violence during pregnancy. Further, changing social norms that condone violence through advocacy and awareness creation might help in preventing partner violence.
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Affiliation(s)
- Abdulbasit Musa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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Affiliation(s)
- Andrew Gibbs
- Gender and Health Research Unit, South African Medical Research Council, South Africa
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
- Corresponding author.
| | - Abigail Hatcher
- University of North Carolina, Chapel Hill, United States
- University of the Witwatersrand, South Africa
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Intimate partner violence and contraceptive use in developing countries: How does the relationship depend on context? DEMOGRAPHIC RESEARCH 2020. [DOI: 10.4054/demres.2020.42.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Karberg E, Wildsmith E, Manlove J, Johnson M. Do young men's reports of hormonal and long-acting contraceptive method use match their female partner's reports? Contracept X 2019; 1:100003. [PMID: 32550523 PMCID: PMC7286140 DOI: 10.1016/j.conx.2019.100003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 12/02/2022] Open
Abstract
Objective To assess whether young men's reports of hormonal and long-acting contraceptive methods match their female partner's reports. Study design We analyzed a sample of 1096 heterosexual couples (aged 18–26) from the National Longitudinal Study of Adolescent to Adult Health Romantic Pair subsample. We compared male and female partner reports of hormonal/long-acting method use using class of method (hormonal/long-acting) rather than type (e.g., intrauterine device). Regression analyses linked men's reports of individual and relationship characteristics with alignment of reporting. Results Sixteen percent of young men reported hormonal/long-acting method use at last sex differently than their female partner, that is, had a mismatched report. Men who had fewer lifetime sexual partners, had greater relationship satisfaction, believed their partner was monogamous and had a matched report of condom use at last sex were more likely to match their partner's report of hormonal/long-acting contraceptive use. Men living with children (from either partner) were less likely to have a matched report. Hispanic men were more likely to have a matched report than black men. Conclusions Men are an increasingly important part of pregnancy prevention efforts. Pregnancy prevention and healthy relationship programs that incorporate communication skills may also indirectly improve young men's knowledge of their partner's contraceptive use and engagement in contraceptive decision making. Implications Analyses showed that nearly two thirds of the 16% of young men that did not accurately report their partner's hormonal/long-acting method use at last sex underreport method use. Men at increased risk of misreporting may benefit the most from targeted pregnancy prevention programs.
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Cizmeli C, Lobel M, Harland KK, Saftlas A. Stability and Change in Types of Intimate Partner Violence Across Pre-pregnancy, Pregnancy, and the Postpartum Period. ACTA ACUST UNITED AC 2018; 5:153-169. [PMID: 30505877 DOI: 10.1080/23293691.2018.1490084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Computer-assisted telephone interviews were conducted after childbirth with 2,709 female residents of Iowa to examine experience of intimate partner violence (IPV) across pre-pregnancy, pregnancy, and postpartum. IPV was most prevalent during the postpartum period, followed by pre-pregnancy, and pregnancy. Violence in one period increased the likelihood of violence in subsequent periods. Latent Transition Analysis revealed three classes of women: those who experienced No IPV, Predominantly Sexual IPV, or Physical IPV Only. Change in IPV type across time was associated with whether women had intended, and whether their partners wanted, the pregnancy and with marital status. Findings suggest a continuity of violence for childbearing women who experience IPV prior to conception and have numerous implications for clinicians, researchers, and policymakers.
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Affiliation(s)
| | - Marci Lobel
- Stony Brook University, Department of Psychology, Stony Brook, NY 11794-2500
| | - Karisa K Harland
- University of Iowa, Department of Emergency Medicine, Iowa City, IA 52242
| | - Audrey Saftlas
- University of Iowa, Department of Epidemiology, Iowa City, IA 52242
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Barber JS, Kusunoki Y, Gatny H, Budnick J. The Dynamics of Intimate Partner Violence and the Risk of Pregnancy during the Transition to Adulthood. AMERICAN SOCIOLOGICAL REVIEW 2018; 83:1020-1047. [PMID: 30739942 PMCID: PMC6364682 DOI: 10.1177/0003122418795856] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Using a reproductive coercion framework, we investigate the role of intimate partner violence (IPV) in pregnancy during the transition to adulthood. We use two types of data from a population-based sample of 867 young women in a Michigan county: a 60-minute survey interview with 2.5 years of weekly follow-up surveys, and semi-structured interviews with a subsample of 40 pregnant women. The semi-structured interviews illustrate the violence women experienced. Discrete-time logit hazard models demonstrate that threats and physical assault are associated with higher pregnancy rates during ages 18 to 22. However, this holds only when the violence is recent; violence occurring more than a month earlier is not associated with higher pregnancy rates. These associations are independent of violent experiences with prior partners, which are also associated with higher pregnancy rates. Fixed-effects models show that during violent weeks, women perceive more pregnancy desire from their partners, have more sex, and use less contraception than during nonviolent weeks. Finally, mediation analyses and the semi-structured interviews are consistent with reproductive coercion: violent young men are more likely to want their girlfriends pregnant, and they use threats and physical assault to implement their preferences via sex and contraceptive non-use, which in turn increase pregnancy rates.
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Wandera SO, Kwagala B, Odimegwu C. Intimate partner violence and current modern contraceptive use among married women in Uganda: a cross-sectional study. Pan Afr Med J 2018; 30:85. [PMID: 30344869 PMCID: PMC6191265 DOI: 10.11604/pamj.2018.30.85.12722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 02/20/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction This paper examined the relationship between Intimate Partner Violence (IPV) and current modern contraceptive use (MCU) among married women in Uganda. Methods We used the 2011 Uganda Demographic and Health Survey (UDHS) data, selecting a weighted sample of 1,307 married women from the domestic violence module. Chi-squared tests and multivariate complementary log-log (clog-log) regressions were used to examine the relationship between IPV and current MCU, controlling for women's socio-demographic factors. Results Significant predictors of current MCU (25.3%) among married women were: women's reported ability to ask a partner to use a condom, number of living children and wealth index. The odds of current MCU were higher among women who could ask their partners to use a condom (aOR = 1.87, 95% CI: 1.26-2.78), had more than one child (aOR = 2.05, 95% CI: 1.07,3.93) and were from better wealth indices for example the richest (aOR = 2.52, 95% CI: 1.25-5.08). IPV was not associated with current MCU independently and after adjusting for women's socio-demographic factors. Conclusion In Uganda's context, IPV was not associated with current MCU. Interventions to promote MCU should enhance women's capacity to negotiate MCU within union and target women of lower socio-economic status.
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Affiliation(s)
- Stephen Ojiambo Wandera
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda.,Demography and Population Studies, Schools of Social Sciences and Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Betty Kwagala
- Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | - Clifford Odimegwu
- Demography and Population Studies, Schools of Social Sciences and Public Health, University of the Witwatersrand, Johannesburg, South Africa
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Samari G. Women's empowerment and short- and long-acting contraceptive method use in Egypt. CULTURE, HEALTH & SEXUALITY 2018; 20:458-473. [PMID: 28786755 PMCID: PMC6103444 DOI: 10.1080/13691058.2017.1356938] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Egypt is ranked one of the most gender unequal countries, and fertility is at a two-decade high of 3.5 births per woman. Women's empowerment is a strategy used to promote contraceptive use and lower fertility, yet evidence from the Middle East is limited. This study uses 2005, 2008 and 2014 Egyptian Demographic and Health Survey data to examine recent patterns of contraceptive method choice and how women's empowerment is associated with contraceptive method type: none, short-acting or long-acting reversible contraceptive (LARC) methods. Using a nationally representative sample of 47,545 married women in their childbearing years, multinomial logistic regression models examine women's agency, specifically household decision-making and attitudes towards intimate partner violence and contraceptive method type. In 2014, LARC use significantly declined and short-acting method use was higher than in 2008. Women who made household decisions and were less accepting of intimate partner violence were more likely to use LARC (vs. no method). Women who made more joint decisions with spouses were more likely to use LARC (vs. no method) compared to those making individual decisions. Findings have implications for family planning programmes, and efforts involving men to increase household gender equality and lower the acceptance of intimate partner violence may promote LARC use in Egypt.
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Affiliation(s)
- Goleen Samari
- Population Research Center, University of Texas at Austin, Austin, TX, USA
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WOMEN'S EMPOWERMENT AND INTIMATE PARTNER VIOLENCE IN BANGLADESH: INVESTIGATING THE COMPLEX RELATIONSHIP. J Biosoc Sci 2018; 51:188-202. [PMID: 29506586 DOI: 10.1017/s0021932018000068] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of this study was to assess whether women's empowerment ensures reduced intimate partner violence (IPV). The differential relationship between women's empowerment and IPV among married women in Bangladesh was investigated using 2007 Demographic and Health Survey data. Logistic regression models were used to assess whether women's empowerment had any influence on their likelihood of experiencing IPV while controlling for other covariates. The analyses revealed that older cohorts of women, who were more empowered, were more vulnerable to physical violence than less-empowered, younger women. The likelihood of being affected by physical violence among less-empowered, childless women was greater than that of more-empowered women with only male children. Less-empowered, uneducated women were more likely to experience physical violence than more-empowered, primary-educated women. Less-empowered women who had been married for less than 5 years were more likely to suffer from physical violence than more-empowered women who had been married for more than 19 years. The likelihood of experiencing sexual violence was not found to have any significant association with women's empowerment. The findings suggest that although women's empowerment in Bangladesh is gradually improving, some sub-groups of empowered women are still susceptible to IPV.
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Izugbara C. Spousal age differences and violence against women in Nigeria and Tanzania. Health Care Women Int 2018; 39:872-887. [DOI: 10.1080/07399332.2018.1426001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chibuogwu Izugbara
- Human Economy Programme, University of Pretoria, Pretoria, South Africa
- Department of Sociology, University of Pretoria, Pretoria, South Africa
- Department of Psychology and Sociological Studies, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
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Rosenfeld EA, Miller E, Zhao X, Sileanu FE, Mor MK, Borrero S. Male partner reproductive coercion among women veterans. Am J Obstet Gynecol 2018; 218:239.e1-239.e8. [PMID: 29056537 DOI: 10.1016/j.ajog.2017.10.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/29/2017] [Accepted: 10/12/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Male partner reproductive coercion is defined as male partners' attempts to promote pregnancy through interference with women's contraceptive behaviors and reproductive decision-making. Male partners may try to promote pregnancy through birth control sabotage such as taking away or destroying their partners' contraceptives, refusing to wear condoms, and/or verbally pressuring their partners to abstain from contraceptive use. Reproductive coercion is associated with an elevated risk for unintended pregnancy. Women who experience intimate partner violence, who are in racial/ethnic minorities, and who are of lower socioeconomic status are more likely to experience reproductive coercion. Women veterans who use Veterans Affairs for health care may be particularly vulnerable to reproductive coercion because they are disproportionally from racial/ethnic minority groups and experience high rates of intimate partner violence. OBJECTIVES We sought to examine the prevalence, correlates, and impact of reproductive coercion among women veterans who are served by the Veterans Affairs healthcare system. STUDY DESIGN We analyzed data from a national telephone survey of women veterans aged 18-44 years, with no history of sterilization or hysterectomy, who had received care within the Veterans Affairs system in the previous 12 months. Participants who had sex with men in the last year were asked if they experienced male partner reproductive coercion. Adjusted logistic regression was used to examine the relationship between participant characteristics and male partner reproductive coercion and the relationship between reproductive coercion and the outcomes of contraceptive method used at last sex and pregnancy and unintended pregnancy in the last year. RESULTS Among the 1241 women veterans in our study cohort, 11% reported experiencing male partner reproductive coercion in the past year. Black women, younger women, and single women were more likely to report reproductive coercion than their white, older, and married counterparts. Women who experienced military sexual trauma were also more likely to report reproductive coercion compared with women who did not report military sexual trauma. In adjusted analyses, compared with women who did not experience reproductive coercion, those who did were less likely at last sex to have used any method of contraception (76% vs 80%; adjusted odds ratio, 0.61; 95% confidence interval, 0.38-0.96), prescription contraception (43% vs 55%; adjusted odds ratio, 0.62; 95% confidence interval, 0.43-0.91), and their ideal method of contraception (35% vs 45%; adjusted odds ratio, 0.63; 95% confidence interval, 0.43-0.93). Those who reported coercion were more likely to have had a pregnancy in the last year (14% vs 10%; adjusted odds ratio, 2.07; 95% confidence interval, 1.17-3.64); there were no significant differences in unintended pregnancy by coercion status (6% vs 4%; adjusted odds ratio, 1.63; 95% confidence interval, 0.71-3.76). CONCLUSION Eleven percent of women veterans in our sample experienced male partner reproductive coercion, which may impact their use of contraception and ability to prevent pregnancy.
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Affiliation(s)
- Elian A Rosenfeld
- Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System.
| | - Elizabeth Miller
- Division of Adolescent Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh
| | - Xinhua Zhao
- Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System
| | - Florentina E Sileanu
- Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System
| | - Maria K Mor
- Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System; Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh
| | - Sonya Borrero
- Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System; Center for Research on Health Care, University of Pittsburgh School of Medicine
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Murshid NS. Intimate partner violence and contraception in Pakistan: Results from Pakistan Demographic and Health Survey 2012–13. WOMENS STUDIES INTERNATIONAL FORUM 2017. [DOI: 10.1016/j.wsif.2017.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Stewart DE, Vigod SN, MacMillan HL, Chandra PS, Han A, Rondon MB, MacGregor JCD, Riazantseva E. Current Reports on Perinatal Intimate Partner Violence. Curr Psychiatry Rep 2017; 19:26. [PMID: 28417270 DOI: 10.1007/s11920-017-0778-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW The purpose of this study was to review the literature on perinatal intimate partner violence, focusing on recent knowledge to guide mental health professionals on the best approaches to identify and treat women exposed to perinatal intimate partner violence. RECENT FINDINGS Risk factors have been broadened from individual victim and perpetrator factors to include relationship, community, and societal factors which interact together. Better information is now available on how to identify, document, and treat women exposed to violence around the time of conception, pregnancy, and the postpartum period. Recent information helps psychiatrists and other mental health professionals assist women exposed to violence related to the perinatal period; however, further research is needed to provide improved evidence for optimal interventions for better patient outcomes.
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Affiliation(s)
- Donna E Stewart
- University Health Network Centre for Mental Health, University of Toronto, 200 Elizabeth Street, EN-7-229, Toronto, ON, M5G2C4, Canada.
| | - Simone N Vigod
- Women's College Hospital and Research Institute and University of Toronto, Toronto, Canada
| | - Harriet L MacMillan
- Departments of Psychiatry and Behavioural Sciences, and of Pediatrics, McMaster University, Hamilton, Canada
| | - Prabha S Chandra
- National Institute of Mental Health and Neuroscience, Bengaluru, India
| | - Alice Han
- Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Marta B Rondon
- Psychiatry and Mental Health Unit, Universidad Peruana Cayetano Heredia, Lima, Peru
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Olorunsaiye CZ, Brunner Huber L, Laditka SB, Kulkarni S, Boyd AS. Associations between women's perceptions of domestic violence and contraceptive use in seven countries in West and Central Africa. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 13:110-117. [PMID: 28844351 DOI: 10.1016/j.srhc.2017.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 10/06/2016] [Accepted: 01/07/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study examined associations of women's attitudes toward domestic violence (DV) and contraceptive use in West and Central Africa. STUDY DESIGN We used data from the Multiple Indicator Cluster Surveys for women in seven countries in West and Central Africa (2009-2011, n=80,055). MAIN OUTCOME MEASURE We measured contraceptive use as none, traditional, or modern contraceptives. DV approval was measured as no, low, or high tolerance of wife beating. Multinomial logistic regression estimated odds of using traditional or modern methods versus none, adjusting for age, education, wealth, residence, parity, marital structure, spousal age-difference, and religion. RESULTS Many women had no or low DV tolerance (41%, 44%, respectively); most used no contraception (81%). In adjusted results, women with low DV tolerance had lower odds of using traditional contraceptive methods (odds ratio, OR=0.87; 95% confidence interval, CI: 0.78-0.98) or modern methods (OR=0.86; 95% CI: 0.78-0.95) compared to women with no tolerance. Women with high DV tolerance had 28% lower odds of traditional contraceptive use (95% CI: 0.60-0.90), and 38% lower odds of modern contraceptive use (95% CI: 0.59-0.88) compared to women with no tolerance. CONCLUSION The high prevalence of DV approval may threaten the success of programs aimed at improving women's reproductive health, including contraceptive use.
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Affiliation(s)
- Comfort Z Olorunsaiye
- Health Services Research Program at the University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.
| | - Larissa Brunner Huber
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.
| | - Sarah B Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.
| | - Shanti Kulkarni
- School of Social Work, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.
| | - A Suzanne Boyd
- School of Social Work, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.
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McCloskey LA, Doran KA, Gerber MR. Intimate Partner Violence is Associated with Voluntary Sterilization in Women. J Womens Health (Larchmt) 2017; 26:64-70. [DOI: 10.1089/jwh.2015.5595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Kelly A. Doran
- School of Education, Indiana University, Bloomington, Indiana
| | - Megan R. Gerber
- VA Boston Healthcare System, Boston University School of Medicine, Boston, Massachusetts
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Singh N, Shukla SK. Does violence affect the use of contraception? Identifying the hidden factors from rural India. J Family Med Prim Care 2017; 6:73-77. [PMID: 29026753 PMCID: PMC5629904 DOI: 10.4103/2249-4863.214987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: The objective of this study is to investigates the relationship between domestic violence and use of contraception among married women in rural India. Data: Third round of National Family Health Survey (NFHS-III). Methodology: Cross tabulation as bivariate analysis and Binary Logistic Regression as multivariate analysis has been employed to fulfill the objective. Findings: The result shows that there are several hidden factors. between physical violence and contraception use. Alternate explanatory variables are significantly affected the use of contraception. With physical violence which reflects that there is a relationship between physical violence and socioeconomic status such as education, awareness, empowerment of women and subsequently the use of contraception. Originality/value: The paper throws light on the hidden factors which are obstacle in use of contraception with physical violence. Results of this study have potentially important implications for programs aimed at preventing violence and promoting family planning programs.
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Affiliation(s)
- Nishikant Singh
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Sudheer Kumar Shukla
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India
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Sacks R. Domestic abuse. Sex Transm Infect 2016; 93:81-82. [PMID: 27601727 DOI: 10.1136/sextrans-2015-052211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/11/2016] [Accepted: 07/17/2016] [Indexed: 11/04/2022] Open
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Tsai LC, Cappa C, Petrowski N. The Relationship between Intimate Partner Violence and Family Planning among Girls and Young Women in the Philippines. Glob J Health Sci 2016; 8:54382. [PMID: 27157175 PMCID: PMC5064061 DOI: 10.5539/gjhs.v8n9p121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 11/16/2015] [Indexed: 11/12/2022] Open
Abstract
This study explored the relationship between intimate partner violence (IPV) and family planning among adolescent girls and young women in formal unions in the Philippines. Analyzing a sample (n =1,566) from the 2013 Philippines Demographic and Health Survey, logistic regression models were separately run for current contraception use and unmet need for family planning on recent physical violence (yes/no), recent sexual violence (yes/no), and recent emotional (yes/no). Findings revealed that the odds of using contraception were significantly higher among girls and young women who reported recent physical IPV (OR=1.84; 95% CI=1.13, 2.99; p<0.05) and sexual IPV (OR=2.18; 95% CI=1.17, 4.06; p<0.05). No significant relationship between recent emotional IPV and contraception use was found. Having an unmet need for family planning showed no significant relationship to IPV. The study adds to a growing body of literature revealing a positive association between IPV and contraception use. Findings hold implications for the provision of family planning services for adolescents and young women in response to the recent passage of landmark legislation pertaining to reproductive health in the Philippines, the Responsible Parenthood and Reproductive Health Act.
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Microfinance participation and contraceptive decision-making: results from a national sample of women in Bangladesh. Public Health 2016; 139:141-147. [PMID: 27475448 DOI: 10.1016/j.puhe.2016.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 06/06/2016] [Accepted: 06/20/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Our objective was to assess whether microfinance participation affords greater contraceptive decision-making power to women. STUDY DESIGN Population based secondary data analysis. METHODS In this cross-sectional study using nationally representative data from the Bangladesh Demographic and Health Survey 2011 we conducted multinomial logistic regression to estimate the odds of contraceptive decision-making by respondents and their husbands based on microfinance participation. Microfinance participation was measured as a dichotomous variable and contraceptive decision-making was conceptualized based on who made decisions about contraceptive use: respondents only; their partners or husbands only; or both. RESULTS The odds of decision-making by the respondent, with the reference case being joint decision-making, were higher for microfinance participants, but they were not significant. The odds of decision-making by the husband, with the reference case again being joint decision-making, were significantly lower among men who were partnered with women who participated in microfinance (RRR = 0.70, P < 0.01). CONCLUSION Microfinance participation by women allowed men to share decision-making power with their wives that resulted in higher odds of joint decision-making.
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Mundhra R, Singh N, Kaushik S, Mendiratta A. Intimate Partner Violence: Associated Factors and Acceptability of Contraception Among the Women. Indian J Community Med 2016; 41:203-7. [PMID: 27385873 PMCID: PMC4919933 DOI: 10.4103/0970-0218.183589] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: To determine the prevalence of various types of domestic violence and to find out the impact of intimate partner violence (IPV) on adoption of contraceptive measures among the women who are victim to this. Materials and Methods: This questionnaire-based, cross-sectional study was conducted in the department of obstetrics and gynecology of a tertiary care hospital in Delhi. Four hundred and one postpartum females were randomly selected over a period of 5 months and were questioned about their age, parity, educational status, occupation, husband's education, monthly family income, and, if present, IPV in detail. These study participants were enquired about their contraceptive knowledge and use. Results: Sexual violence was seen in 38.4% of the cases, physical violence in 22.4% of the cases, and verbal abuse was seen in nearly 32.7% of the cases. In response to any of the three violence faced, only 23 women (11.79%) reacted by discussing with parents and friends. In 4.61% of the cases, the violence was so severe that she had to inform police. This study showed that higher percentage of women without IPV accepted immediate postpartum contraception methods as compared to those with IPV (35.9% vs. 25%, P = 0.023), but the overall frequency of using contraceptive methods was higher in those with IPV as compared to those without IPV (49% vs. 47%, P = 0.690). Conclusion: IPV is associated with increased contraceptive adoption.
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Affiliation(s)
- Rajlaxmi Mundhra
- Department of Obstetrics and Gynaecology, University College of Medical Sciences, Delhi, India
| | - Nilanchali Singh
- Department of Obstetrics and Gynaecology, University College of Medical Sciences, Delhi, India
| | - Somya Kaushik
- Department of Obstetrics and Gynaecology, University College of Medical Sciences, Delhi, India
| | - Anita Mendiratta
- Department of Family Planning, University College of Medical Sciences, Delhi, India
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Baiden F, Mensah GP, Akoto NO, Delvaux T, Appiah PC. Covert contraceptive use among women attending a reproductive health clinic in a municipality in Ghana. BMC WOMENS HEALTH 2016; 16:31. [PMID: 27266263 PMCID: PMC4893877 DOI: 10.1186/s12905-016-0310-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 06/04/2016] [Indexed: 11/25/2022]
Abstract
Background Covert contraceptive use (CCU) in sub-Saharan Africa is an indication of women’s inability to exercise autonomy in their reproductive choices. The aim of this study was to assess the prevalence and determinants of CCU among a sample of FP clients in a municipality of Ghana. Methods We conducted a mixed method study among women attending a public reproductive health clinic in Sunyani, a city of over 250,000 inhabitants in Ghana. An initial survey inquired into sociodemographic characteristics, use of family planning (FP) methods and partner awareness of contraceptive use. The predictors of CCU were explored using logistic regressions. We used the findings to develop a guide which we applied in-depth interviews and focus group discussions with attendants at the same facility. Qualitative data analysis was conducted using a framework approach. Results We interviewed 300 women, 48 % of whom were aged between 26–33 years. The injectable was the most widely used method (56 %). The prevalence of CCU was 34 %. In multivariate analysis, single women were more likely to practice CCU than married or co-habiting women (Adjusted OR = 12.12, 95 % C.I. 4.73–31.1). Muslim and traditionalist women were similarly more likely to practice CCU than non-Muslim, non-traditionalist (Adjusted OR = 4.56, 2.29–9.06). Women who preferred to have their first or next child in 4 or more years from the time of the interview were more likely to be in CCU than women who intended to have children within 4 years of the interview (2.57; 1.37–4.83). Single women saw in covert use a statement of their social autonomy. To succeed in CCU, women wished that clinic attendance cards would not be given to them to keep at home. Though many participants saw in CCU a source of anxiety, they expected health workers to consider it and uphold confidentiality in the provision of services. Conclusions Covert contraceptive use was high in this municipality and being single was the strongest predictor of the practice. Providers of FP services should reflect on how to adequately address the challenges faced by women who practice CCU.
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Affiliation(s)
- F Baiden
- Epidemiology Unit, Ensign College of Public Health, Kpong, ER, Ghana. .,Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR, Ghana.
| | - G P Mensah
- Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR, Ghana
| | - N O Akoto
- Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, BAR, Ghana
| | - T Delvaux
- Unit of HIV/AIDS Policy, Institute of Tropical Medicine, Antwerpen, Belgium.,Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium
| | - P C Appiah
- Municipal Health Directorate, Ghana Health Service, Sunyani, BAR, Ghana
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Cha S, Masho SW, Heh V. Partner violence victimization and unintended pregnancy in Latina and Asian American women: Analysis using structural equation modeling. Women Health 2016; 57:430-445. [DOI: 10.1080/03630242.2016.1170094] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Liu F, McFarlane J, Maddoux JA, Cesario S, Gilroy H, Nava A. Perceived Fertility Control and Pregnancy Outcomes Among Abused Women. J Obstet Gynecol Neonatal Nurs 2016; 45:592-600. [PMID: 26968241 DOI: 10.1016/j.jogn.2016.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe the degree of perceived fertility control and associated likelihood of unintended pregnancy and poor pregnancy outcomes among women who report intimate partner violence. DESIGN Cross-sectional cohort study design. SETTING Five domestic violence shelters and one district attorney's office in a large urban metropolis in the United States. PARTICIPANTS A total of 282 women who reported intimate partner violence and reached out for the first time to a shelter or district attorney's office for assistance. METHODS This 7-year prospective longitudinal study began in 2011. Participants in the overarching study are being interviewed every 4 months. During the 32-month interview period, participants responded to a one-time, investigator-developed, fertility control questionnaire in addition to the ongoing repeated measures. RESULTS Almost one third (29%) of the participants reported at least one unintended pregnancy attributed to their abusers' refusal to use birth control, and 14.3% of the participants reported at least one unintended pregnancy as a result of their abusers' refusal to allow them to use birth control. Participants were 28 times more likely to have abuse-induced miscarriages if their pregnancies resulted because their abusers did not use birth control (OR = 28.70, p < .05). Finally, participants were 8 times more likely to report premature births if they were abused because of their use of birth control (OR = 8.340, p < .05). CONCLUSION Women in abusive relationships reported compromised fertility control associated with abuse and increased risk for unintended pregnancy as well as the adverse pregnancy outcomes of premature birth and miscarriage.
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Park J, Nordstrom SK, Weber KM, Irwin T. Reproductive coercion: uncloaking an imbalance of social power. Am J Obstet Gynecol 2016; 214:74-8. [PMID: 26314520 DOI: 10.1016/j.ajog.2015.08.045] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/10/2015] [Accepted: 08/19/2015] [Indexed: 11/30/2022]
Abstract
Reproductive coercion involves behavior that interferes with contraceptive and pregnancy choices of women and occasionally men. This includes birth control sabotage (intentional destruction of a woman's chosen method of contraception), pregnancy pressure (behaviors to coerce pregnancy against one's wishes), and pregnancy coercion (threats to direct the outcome of a pregnancy). All are associated with serious reproductive consequences including unintended pregnancy, abortion, sexually transmitted infections, poor pregnancy outcomes, and psychological trauma. This article presents an overview of the recent literature surrounding reproductive coercion and how it relates to the reproductive health outcomes of women, adolescents, and the lesbian, gay, bisexual, and transgender community. Men's experience with reproductive coercion will also be discussed. Clinical implications and evidence-based strategies for assessment and intervention will be identified.
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Affiliation(s)
- Jeanna Park
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, Chicago, IL.
| | - Sherry K Nordstrom
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, Chicago, IL; Department of Obstetrics and Gynecology, Advocate Medical Group, Oak Lawn, IL
| | - Kathleen M Weber
- The CORE Center, Cook County Health and Hospital Systems and Hektoen Institute of Medicine, Chicago, IL
| | - Tracy Irwin
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA
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Tancredi DJ, Silverman JG, Decker MR, McCauley HL, Anderson HA, Jones KA, Ciaravino S, Hicks A, Raible C, Zelazny S, James L, Miller E. Cluster randomized controlled trial protocol: addressing reproductive coercion in health settings (ARCHES). BMC WOMENS HEALTH 2015; 15:57. [PMID: 26245752 PMCID: PMC4527212 DOI: 10.1186/s12905-015-0216-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 07/30/2015] [Indexed: 11/15/2022]
Abstract
Background Women ages 16–29 utilizing family planning clinics for medical services experience higher rates of intimate partner violence (IPV) and reproductive coercion (RC) than their same-age peers, increasing risk for unintended pregnancy and related poor reproductive health outcomes. Brief interventions integrated into routine family planning care have shown promise in reducing risk for RC, but longer-term intervention effects on partner violence victimization, RC, and unintended pregnancy have not been examined. Methods/Design The ‘Addressing Reproductive Coercion in Health Settings (ARCHES)’ Intervention Study is a cluster randomized controlled trial evaluating the effectiveness of a brief, clinician-delivered universal education and counseling intervention to reduce IPV, RC and unintended pregnancy compared to standard-of-care in family planning clinic settings. The ARCHES intervention was refined based on formative research. Twenty five family planning clinics were randomized (in 17 clusters) to either a three hour training for all family planning clinic staff on how to deliver the ARCHES intervention or to a standard-of-care control condition. All women ages 16–29 seeking care in these family planning clinics were eligible to participate. Consenting clients use laptop computers to answer survey questions immediately prior to their clinic visit, a brief exit survey immediately after the clinic visit, a first follow up survey 12–20 weeks after the baseline visit (T2), and a final survey 12 months after the baseline (T3). Medical record chart review provides additional data about IPV and RC assessment and disclosure, sexual and reproductive health diagnoses, and health care utilization. Of 4009 women approached and determined to be eligible based on age (16–29 years old), 3687 (92 % participation) completed the baseline survey and were included in the sample. Discussion The ARCHES Intervention Study is a community-partnered study designed to provide arigorous assessment of the short (3-4 months) and long-term (12 months) effects of a brief, clinician-delivered universal education and counseling intervention to reduce IPC, RC and unintended pregnancy in family planning clinic settings. The trial features a cluster randomized controlled trial design, a comprehensive data collection schedule and a large sample size with excellent retention. Trial Registration ClinicialTrials.gov NCT01459458. Registered 10 October 2011.
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Affiliation(s)
- Daniel J Tancredi
- UC Davis Department of Pediatrics and Center for Healthcare Policy and Research, 2103 Stockton Blvd Suite 2224, Sacramento, CA, 95817, USA.
| | - Jay G Silverman
- Division of Global Public Health in the Department of Medicine & Center on Gender Equity and Health, University of California, San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E4142, Baltimore, MD, 21205, USA.
| | - Heather L McCauley
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA.
| | - Heather A Anderson
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA.
| | - Kelley A Jones
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA.
| | - Samantha Ciaravino
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA
| | - Angela Hicks
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA
| | - Claire Raible
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA
| | - Sarah Zelazny
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA
| | - Lisa James
- Futures Without Violence, 100 Montgomery Street, The Presidio, San Francisco, CA, 94129, USA.
| | - Elizabeth Miller
- Department of Pediatrics, Division of Adolescent Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 3420 Fifth Ave, Pittsburgh, PA, 15213, USA.
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Kazmerski T, McCauley HL, Jones K, Borrero S, Silverman JG, Decker MR, Tancredi D, Miller E. Use of reproductive and sexual health services among female family planning clinic clients exposed to partner violence and reproductive coercion. Matern Child Health J 2015; 19:1490-6. [PMID: 25416386 PMCID: PMC10641793 DOI: 10.1007/s10995-014-1653-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To examine the associations of recent intimate partner violence (IPV) and reproductive coercion (RC) with frequency of use of reproductive and sexual health services, a cross-sectional survey was administered to 16-29 year old women seeking care in five family planning clinics (n = 1,262). We evaluated associations of recent experiences of IPV, RC, or both IPV and RC with recent care seeking for pregnancy testing, emergency contraception, and sexually transmitted infection testing using multinomial logistic regression. Sixteen percent of respondents reported IPV and 13.5 % reported RC in the past 3 months. Four percent of all respondents reported both IPV and RC. Recent RC without IPV was associated with increased odds of seeking one (AOR = 2.0, 95 % CI 1.3-2.9) or multiple pregnancy tests (AOR = 2.3, 95 % CI 1.2-4.5), multiple STI tests (AOR = 2.5, 95 % CI 1.5-4.1), or using emergency contraception once (AOR = 2.6, 95 % CI 1.2-5.8) or multiple times (AOR = 2.2, 95 % CI 1.7-2.7). Recent IPV without RC was associated with increased odds of seeking one (AOR = 1.4, 95 % CI 1.1-1.7) or multiple pregnancy tests (AOR = 2.2, 95 % CI 1.4-3.2) and using emergency contraception once (AOR = 1.6, 95 % CI 1.3-2.0). The combined effect of recent IPV and RC increased the odds of seeking multiple pregnancy tests (AOR = 3.6, 95 % CI 3.3-3.8), using emergency contraception multiple times (AOR = 2.4, 95 % CI 1.5-4.1) and seeking STI testing once (AOR = 2.5, 95 % CI 1.6-3.9) or multiple times (AOR = 2.9, 95 % CI 1.02-8.5). Frequent requests for pregnancy and STI testing and emergency contraception among young females seeking care may be an indicator of greater risk for recent RC, alone and in combination with IPV.
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Affiliation(s)
- Traci Kazmerski
- Children's Hospital of Pittsburgh of UPMC, 4401 Penn Ave. AOB 3rd Floor, Suite 3300, Pittsburgh, PA, 15224, USA,
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Bergmann JN, Stockman JK. How does intimate partner violence affect condom and oral contraceptive Use in the United States?: A systematic review of the literature. Contraception 2015; 91:438-55. [PMID: 25708504 PMCID: PMC4442065 DOI: 10.1016/j.contraception.2015.02.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 01/20/2015] [Accepted: 02/16/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Intimate partner violence (IPV) is estimated to affect 25% of adult women in the United States alone. IPV directly impacts women's ability to use contraception, resulting in many of unintended pregnancies and STIs. This review examines the relationship between IPV and condom and oral contraceptive use within the United States at two levels: the female victim's perspective on barriers to condom and oral contraceptive use, in conjunction with experiencing IPV (Aim 1) and the male perpetrator's perspective regarding condom and oral contraceptive use (Aim 2). STUDY DESIGN We systematically reviewed and synthesized all publications meeting the study criteria published since 1997. We aimed to categorize the results by emerging themes related to each study aim. RESULTS We identified 42 studies that met our inclusion criteria. We found 37 studies that addressed Aim 1. Within this we identified three themes: violence resulting in reduced condom or oral contraceptive use (n=15); condom or oral contraceptive use negotiation (n=15); which we further categorized as IPV due to condom or oral contraceptive request, perceived violence (or fear) of IPV resulting in decreased condom or oral contraceptive use, and sexual relationship power imbalances decreasing the ability to use condoms or oral contraceptives; and reproductive coercion (n=7). We found 5 studies that addressed Aim 2. Most studies were cross-sectional, limiting the ability to determine causality between IPV and condom or oral contraceptive use; however, most studies did find a positive relationship between IPV and decreased condom or oral contraceptive use. CONCLUSIONS Quantitative, qualitative, and mixed methods research has demonstrated the linkages between female IPV victimization/male IPV perpetration and condom or oral contraceptive use. However, additional qualitative and longitudinal research is needed to improve the understanding of dynamics in relationships with IPV and determine causality between IPV, intermediate variables (e.g., contraceptive use negotiation, sexual relationship power dynamics, reproductive coercion), and condom and oral contraceptive use. Assessing the relationship between IPV and reproductive coercion may elucidate barriers to contraceptive use as well as opportunities for interventions to increase contraceptive use (such as forms of contraception with less partner influence) and reduce IPV and reproductive coercion.
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Affiliation(s)
- Julie N Bergmann
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA; Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
| | - Jamila K Stockman
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
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Cha S, Chapman DA, Wan W, Burton CW, Masho SW. Intimate partner violence and postpartum contraceptive use: the role of race/ethnicity and prenatal birth control counseling. Contraception 2015; 92:268-75. [PMID: 25935298 DOI: 10.1016/j.contraception.2015.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/23/2015] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Intimate partner violence (IPV) is a major problem that could affect reproductive decision making. The aim of this study is to examine the association between IPV and contraceptive use and assess whether the association varies by receipt of prenatal birth control counseling and race/ethnicity. STUDY DESIGN This study analyzed the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS) that included 193,310 women with live births in the United States. IPV was determined by questions that asked about physical abuse by a current or former partner in the 12 months before or during pregnancy. The outcome was postpartum contraceptive use (yes vs. no). Multiple logistic regression analyses were conducted to assess the influence of experiencing IPV at different periods (preconception IPV, prenatal IPV, both preconception and prenatal IPV, preconception and/or prenatal IPV). Data were stratified to assess differential effects by race/ethnicity and receipt of birth control counseling. RESULTS Approximately 6.2% of women reported IPV, and 15.5% reported no postpartum contraceptive use. Regardless of the timing of abuse, IPV-exposed women were significantly less likely to report contraceptive use after delivery. This was particularly true for Hispanic women who reported no prenatal birth control counseling and women of all other racial/ethnic groups who received prenatal birth control counseling. CONCLUSIONS IPV victimization adversely affects the use of contraceptive methods following delivery in women with live births. Birth control counseling by health providers may mitigate these effects; however, the quality of counseling needs further investigation. Better integration of violence prevention services and family planning programs is greatly needed. IMPLICATIONS Consistent with national recommendations by the U.S. Preventive Service Task Force, clinicians and public health workers are strongly encouraged to screen for IPV. Health providers should educate women on effective contraceptive options and discuss long-acting reversible contraceptives that are not partner dependent within the context of abusive relationships.
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Affiliation(s)
- Susan Cha
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA.
| | - Derek A Chapman
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA
| | - Wen Wan
- Department of Biostatistics, Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA
| | - Candace W Burton
- Department of Family and Community Health Nursing, Virginia Commonwealth University, School of Nursing, Richmond, VA 23298, USA
| | - Saba W Masho
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA
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Effective dual method contraceptive use and HPV vaccination among U.S. adolescent and young adult females. Womens Health Issues 2015; 24:543-50. [PMID: 25213746 DOI: 10.1016/j.whi.2014.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 04/30/2014] [Accepted: 05/28/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Problem Behavior Theory posits that risky behaviors cluster in individuals, implying that protective behaviors may follow a similar pattern. The purpose of this study was to determine whether the protective behavior of effective dual method contraception use at first and most recent sexual intercourse is associated with HPV vaccination among adolescent and young adult females. METHODS National Survey of Family Growth (2006-2010) data were used to examine the association between women's contraception use during first and most recent sexual intercourse and HPV vaccination. Women aged 15 to 24 years (n = 1,820) served as the study sample. FINDINGS At first and last sexual intercourse, effective dual method contraception use was reported by 15.3% and 16.8% women, respectively; 27.8% reported receiving at least one dose of the human papillomavirus (HPV) vaccine. Higher HPV vaccination rates were observed among dual method users at first and last sexual intercourse (36.4% and 48.2%, respectively). This trend was also observed across age groups (15-19 year olds vs. 20-24 year olds). In adjusted models, among all respondents, dual users at last sexual intercourse were significantly more likely to be vaccinated, whereas at first sexual intercourse only younger dual users were more likely to report HPV vaccination. CONCLUSIONS Findings suggest that the protective behavior of dual method contraceptive use at first and most recent sexual intercourse may serve as a predictor of another complementary health behavior, HPV vaccination, particularly among adolescent females. More research is needed to understand behavioral clustering to design related multi-focused women's health interventions.
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Wildsmith E, Manlove J, Steward-Streng N. Relationship characteristics and contraceptive use among dating and cohabiting young adult couples. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2015; 47:27-36. [PMID: 25581462 DOI: 10.1363/47e2515] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 08/13/2014] [Accepted: 08/14/2014] [Indexed: 05/25/2023]
Abstract
CONTEXT Contraceptive decision making occurs in the context of relationships. Although many individual-level characteristics have been linked to youths' contraceptive use, less is known about associations between contraceptive use and relationship-level characteristics. METHODS Data from the 2001-2002 romantic pair subsample of the National Longitudinal Study of Adolescent Health were used to describe characteristics of 322 dating relationships and 406 cohabiting relationships among young adults aged at least 18 years. Logistic regression was employed to assess associations between these characteristics and hormonal or long-acting contraceptive use and condom use. Data from both partners allowed discordance in reports between partners in some measures to be examined. RESULTS Cohabiting couples were less likely than dating couples to have used condoms (19% vs. 37%) and hormonal or long-acting methods (40% vs. 57%) at last sex. In dating relationships, couples reporting discordant levels of intimacy and couples in which neither partner reported a high level of intimacy had greater odds of condom use than couples in which both partners reported high intimacy (odds ratios, 4.5 and 3.3, respectively); mistrust and male problem drinking were negatively associated with condom use (0.3 for each). For cohabiting couples, frequency of sex was negatively associated with condom use and hormonal method use (0.8 for each). CONCLUSIONS At least for dating couples, contraceptive use is linked to multiple dimensions of relationships, particularly measures reflecting relationship quality-both positive and negative.
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Maxwell L, Devries K, Zionts D, Alhusen JL, Campbell J. Estimating the effect of intimate partner violence on women's use of contraception: a systematic review and meta-analysis. PLoS One 2015; 10:e0118234. [PMID: 25693056 PMCID: PMC4334227 DOI: 10.1371/journal.pone.0118234] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 01/09/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is an important global public health problem. While there is a growing literature on the association between IPV and women's reproductive health (RH) outcomes, most studies are cross-sectional-which weakens inference about the causal effect of IPV on women's RH. This systematic review synthesizes existing evidence from the strongest study designs to estimate the impact of IPV on women's use of contraception. METHODS We searched 11 electronic databases from January of 1980 to 3 December 2013 and reviewed reference lists from systematic reviews for studies examining IPV and contraceptive use. To be able to infer causality, we limited our review to studies that had longitudinal measures of either IPV or women's use of contraception. RESULTS Of the 1,574 articles identified by the search, we included 179 articles in the full text review and extracted data from 12 studies that met our inclusion criteria. We limited the meta-analysis to seven studies that could be classified as subject to low or moderate levels of bias. Women's experience of IPV was associated with a significant reduction in the odds of using contraception (n = 14,866; OR: 0.47; 95% CI: 0.25, 0.85; I2 = 92%; 95% CII2: 87%, 96%). Restricting to studies that measured the effect of IPV on women's use of partner dependent contraceptive methods was associated with a reduction in the heterogeneity of the overall estimate. In the three studies that examined women's likelihood of using male condoms with their partners, experience of IPV was associated with a significant decrease in condom use (OR: 0.48; 95% CIOR: 0.32, 0.72; I2 = 51%; 95% CII2: 0%, 86%). CONCLUSIONS IPV is associated with a reduction in women's use of contraception; women who experience IPV are less likely to report using condoms with their male partners. Family planning and HIV prevention programs should consider women's experiences of IPV.
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Affiliation(s)
- Lauren Maxwell
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montréal, Québec, Canada
| | - Karen Devries
- Social and Mathematical Epidemiology Group and Gender Violence and Health Centre, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Danielle Zionts
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montréal, Québec, Canada
| | - Jeanne L. Alhusen
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, Maryland, United States of America
| | - Jacquelyn Campbell
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, Maryland, United States of America
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Abstract
BACKGROUND In 2006, the U.S. Centers for Disease Control and Prevention issued 10 recommendations on preconception care, which included the statement that reproductive life planning should be considered an individual's responsibility across his or her life span. PURPOSE The purpose of this article is to provide a concept analysis of reproductive life planning using Walker and Avant's method as an organizing framework. METHODS Search engines were employed to review the existing knowledge base of the concept of reproductive life planning. FINDINGS The findings suggest that reproductive life planning is integral to preconception care and family planning. Attributes, antecedents, and consequences associated with reproductive life planning are discussed. Model, borderline, and contrary cases are also provided to illustrate the concept. PRACTICE IMPLICATIONS A reproductive life plan can serve as a framework for promoting reproductive health across the life span of both men and women. Healthcare providers must assess the individual's ability to understand and utilize educational resources to ensure full and effective participation in reproductive life planning.
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Affiliation(s)
- Fuqin Liu
- Texas Woman's University College of Nursing, Denton, TX
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Khadra C, Wehbe N, Lachance Fiola J, Skaff W, Nehmé M. Symptoms of post-traumatic stress disorder among battered women in Lebanon: an exploratory study. JOURNAL OF INTERPERSONAL VIOLENCE 2015; 30:295-313. [PMID: 24860080 DOI: 10.1177/0886260514534774] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Intimate partner violence against women is common in Lebanon and can lead to major health problems. However, the incidence of symptoms of post-traumatic stress disorder (PTSD) in battered women has not been extensively explored in the Lebanese cultural context. The objectives of this study were as follows: (a) to determine the prevalence of PTSD symptoms among women in Lebanon who have been physically abused by their partners, (b) to assess whether the rate of PTSD symptoms varied according to sociodemographic variables, and (c) to reveal other attributes that might be risk factors for developing symptoms of PTSD. Of the 95 physically abused women who met inclusion criteria, 85 completed a questionnaire including sociodemographic questions, the physical abuse subscale of the Composite Abuse Scale (CAS), and the PTSD Checklist-Civilian Version (PCL-C). Results showed a high prevalence of PTSD symptoms (97%), positively correlated with physical violence (r = .719). Lower education level and recent abuse were correlated with symptom severity, as were the number of problematic habitual behaviors in the abusive partner and the use of psychotherapy. Increased involvement of health care professionals in the detection of women at risk, with referral to appropriate resources, is suggested to improve prevention and management efforts.
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Meiksin R, Meekers D, Thompson S, Hagopian A, Mercer MA. Domestic Violence, Marital Control, and Family Planning, Maternal, and Birth Outcomes in Timor-Leste. Matern Child Health J 2014; 19:1338-47. [DOI: 10.1007/s10995-014-1638-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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DuPont-Reyes MJ, Fry D, Rickert VI, Bell DL, Palmetto N, Davidson LL. Relationship Violence, Fear, and Exposure to Youth Violence Among Adolescents in New York City. JOURNAL OF INTERPERSONAL VIOLENCE 2014; 29:2325-2350. [PMID: 24457218 DOI: 10.1177/0886260513518433] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Previous research has shown that there is an overlap between experiences of youth violence and adolescent relationship violence. Yet, little research exists which investigates the sex differences in the associations between specific types of youth violence and relationship violence while controlling for potential confounders. This study addresses this gap in the literature by exploring the associations between experiences of youth violence and receiving and delivering relationship violence in an urban adolescent sample. From 2006 to 2007, 1,454 adolescents aged 13 to 21 years in New York City completed an anonymous survey that included the validated Conflict in Adolescent Relationships Inventory that estimates experiences of relationship violence in the previous year as well as the prevalence of various exposures to youth violence. Bivariate and multivariate analyses assessed the overlap between experiencing other types of youth violence and delivering and receiving physical relationship violence and sexual coercion. Compared with youth in nonviolent relationships, we found a significant association between delivering and receiving relationship physical violence and sexual coercion with participating in a fight, missing school due to fear, being threatened/injured with a weapon, gang membership, and carrying a weapon among both males and females. We also identified the sex differences between these specific associations of youth and relationship violence. Service providers working with adolescents experiencing relationship violence should be aware that they face a higher concurrent risk of experiencing or participating in other forms of youth violence. Likewise, providers working in the area of youth violence intervention and prevention should consider the possibility of concurrent relationship violence. Based on these findings, further research should explore whether interventions targeting relationship violence can also impact participation in youth violence and vice versa.
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Affiliation(s)
| | - Deborah Fry
- University of Edinburgh/NSPCC Child Protection Research Centre, Scotland
| | | | - David L Bell
- Columbia University, New York, NY, USA New York-Presbyterian Hospital, NY, USA
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Ramaswamy M, Kelly PJ. Factors associated with sterilization use among women leaving a U.S. jail: a mixed methods study. BMC Public Health 2014; 14:773. [PMID: 25080032 PMCID: PMC4133605 DOI: 10.1186/1471-2458-14-773] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 07/24/2014] [Indexed: 11/30/2022] Open
Abstract
Background Despite the high rates of reported sterilization use among women who have spent time in correctional facilities, little is known about the context in which women in this population choose this option. The objective of our study was to use both quantitative and qualitative methods to understand factors associated with sterilization use among women leaving a U.S. jail. Methods We administered a cross-sectional survey with 102 jailed women who were participating in a study about contraceptive use after release from jail, and then conducted semi-structured interviews with 29 of those women after their release from jail. We used logistic regression and analytic induction to assess factors associated with self-reported sterilization use. Results In our cross-sectional survey, one-third of our sample reported a history of sterilization use. Controlling for age and past pregnancies, the only factor associated with sterilization use was physical abuse history before age 16. In semi-structured interviews, we found that women’s primary motivation for sterilization was the desire to limit childbearing permanently, in some cases where other contraceptive methods had failed them. The decision for sterilization was generally supported by family, partners, and providers. Many women who opted for sterilization expressed financial concern about supporting children and/or reported family histories of sterilization. Conclusions The decision to use the permanent method of sterilization as a contraceptive method is a complex one. Results from this study suggest that while explicit coercion may not be a factor in women’s choice for sterilization, interpersonal relationship histories, negative experiences with contraceptives, and structural constraints, such as financial concerns and ongoing criminal justice involvement, seem to influence sterilization use among the vulnerable group of women with criminal justice histories. Public health programs that connect women to reproductive health services should acknowledge constraints on contraceptive decision-making in vulnerable populations.
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Affiliation(s)
- Megha Ramaswamy
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, Kansas 66160, USA.
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