Domestic Violence Among Iranian Women: A Systematic Review and Meta-Analysis

Iranian Immigrant Women's Experiences of Intimate Partner Violence: A Literature Review

Immigrant and refugee women are vulnerable to experiencing intimate partner violence (IPV) due to a range of factors associated with immigration. This study aims to consolidate existing research concerning IPV among Iranian immigrant women and examine its impact on their lives. A comprehensive literature search for articles of any design published in the English language in the past 15 years was performed using Medline, Embase, CINAHL, International Bibliography of the Social Sciences (ProQuest) and PsycINFO databases. The topic of IPV among Iranian immigrant women has been underexplored in research, and only 11 studies were identified that met the inclusion criteria for this topic. The findings from these studies indicate that Iranian immigrant women have experienced different forms of IPV, with psychological IPV being prominent and replacing physical violence. These experiences have had adverse effects on the women's physical and mental health. The women's experiences of IPV were influenced by various cultural, religious, and individual factors. They predominantly sought informal help rather than accessing formal resources to address their situations. There is a need for rigorous studies to thoroughly investigate IPV among Iranian immigrant and refugee women. Such research is essential for establishing effective strategies that are culturally sensitive to reduce IPV incidents within this population. Moreover, it is essential to enhance IPV awareness among these women and ensure their access to formal resources that are proficient in addressing IPV. This comprehensive approach not only tackles the immediate issue but also fosters a safer environment and promotes long-term wellbeing within this community.

The predictive role of intimate partner violence in treatment adherence among women with chronic illness: A cross-sectional study

OBJECTIVE

This study was an attempt to shed light on the predictive role of intimate partner violence in adhering to treatment regimens in women with chronic illnesses.

METHOD

In a descriptive-analytical study, 400women with chronic illnesses in Bushehr were selected through convenience sampling. The data were collected by distributing a demographic information form and two questionnaires, including the intimate partner violence (IPV) questionnaire and the treatment adherence scale.

RESULTS

According to the results, the 40 to 59 years age group (P = 0.046, β = 0.104), the 60 to 79 years age group (P = 0.019, β = 0.122), and the group receiving education about chronic illness (P = 0.031, β = 0.106) showed a direct relationship with treatment adherence, while IPV (P < 0.001, β = 0.284) had a significant inverse relationship with treatment adherence.

CONCLUSION

The results of the study showed that predictors of treatment adherence are IPV in women aged 40 and older with chronic illnesses, and receiving education about chronic illnesses. It is necessary for healthcare providers to consider barriers such as intimate partner violence when providing education in order to increase treatment adherence. To avoid nonadherence, managers and health planners should implement policies to increase the level of awareness of healthcare staff on how to manage care of women with chronic illnesses who are abused by an intimate partner and refer them to counselors and family helpers.

Examining the Psychometric Properties of the Revised Scale of Economic Abuse among Iranian Women

Economic abuse, in the context of intimate relationships, is a pervasive form of violence that merits further empirical attention. We know from limited research that the rates of economic abuse appear to be high in Iran; however, there is a lack of culturally appropriate measures that can assess the extent to which women experience economic harm as a result of their partners' actions. The present study was conducted with the aims of (a) investigating the psychometric properties of the 14-item Revised Scale of Economic Abuse (SEA2) which was translated into Persian for this study and (b) examining the prevalence of economic abuse among a sample of 371 married housewives in Qazvin, Iran. Confirmatory factor analysis supports the two-factor structure of the SEA2, with the exception of one item. Composite reliability and Cronbach's alpha demonstrated good internal consistency. The average variance extracted method, along with correlations with other financial variables, demonstrated evidence of good convergent validity. Correlations with related, but distinct forms of abuse, support the scale's discriminant validity. Based on the collective findings, this measure can be used as a reliable and valid tool to study economic abuse among Iranian women which, within our sample, appears to be a common phenomenon. Implications for future research and practice are discussed.

Development and psychometric evaluation of a Risky Sexual Behaviour Scale for Married Women (RSBS-MW) in Iran: a mixed-method study

A valid and reliable culture-based scale for the evaluation of risky sexual behaviours for married Iranian women is lacking. This study aimed to develop, and psychometrically test, a risky sexual behaviour scale for married Iranian women. A mixed-method sequential exploratory design was conducted from 2016 to 2020 in Tehran, Iran. First, a qualitative study was employed to define the concept of risky sexual behaviour using 16 semi-structured individual interviews and 10 focus group discussions (n = 100). Then, an item pool was generated, and the scale was developed. Finally, in the quantitative study, the psychometric properties of the scale were evaluated by validity and reliability tests. A maximum likelihood extraction with promax rotation was performed on 400 sexually active married women to assess the construct validity. The six components: (i) 'quality of sexual relations'; (ii) 'unusual pleasures in sexual relations'; (iii) 'sexual coercion'; (iv) 'verbal violence in sexual relations'; (v) 'self-care in sexual relations'; and (vi) 'concealment in sexual relations' could explain 57.49% of the total observed variance. The findings showed that the 27-item Risky Sexual Behaviour Scale (RSBS-MW) for married women in Iran has excellent internal consistency (α = 0.94) and stability (ICC = 0.98). Health care providers can use it to access risky sexual behaviours in married Iranian women.

Domestic violence against Iranian women during the Covid-19 lockdown: A cross-sectional study

Background and Aims

Despite the fact that public health measures such as social isolation can help control the coronavirus disease 2019 (Covid-19) pandemic, these procedures may contribute to elevated levels of stress and escalate various forms of violence against women. The current study aimed to estimate the prevalence of domestic violence and identify factors associated with domestic violence during the Covid-19 lockdown among married women attending healthcare centers in Iran.

Methods

This cross-sectional study, conducted between 2020 and 2021, focused on a sample of 5317 married women who sought healthcare services within urban centers across five major cities in Iran. Sampling was done through a multistage cluster method. The Revised Conflict Tactics Scales (CTS2) were used to assess levels of violence. The collected data was analyzed using descriptive and inferential statistics, including independent sample t-test, Chi-square, and multiple logistic regression) with the SPSS software version 22.

Results

During the Covid-19 lockdown, psychological violence was reported by 66.7% of women (95% confidence interval [CI], 65.44%-67.98%), physical violence by 44.8% (95% CI, 43.43%-46.10%), sexual violence by 28.8% (95% CI, 27.60%-30.03%), and injury by 24.5% (95% CI, 23.39%-25.70%). The multiple logistic regression showed several significant factors associated with domestic violence. These included low levels of social support (p < 0.001), shorter duration of marriage (p < 0.001), unemployment of both women (p < 0.007) and their spouses (p < 0.001), poor economic status (p < 0.001), as well as substance abuse by the husband, including alcohol (p < 0.001) and drug abuse (p < 0.01), and smoking (p < 0.01).

Conclusion

The findings highlighted the magnitude of domestic violence against women during the Covid-19 lockdown. It is crucial to implement comprehensive strategies that encompass preventive and responsive measures to address domestic violence not only during lockdowns but also in the post-lockdown period.

Relationship Between the Psychological Distress and Spiritual Well-Being in Pregnant Women Exposed to Domestic Violence: A Cross-Sectional Study in Iran

Maternal psychological distress is often associated with domestic violence. Spiritual well-being can affect the psychological capacity to deal with distress. This study aimed to investigate the relationship between psychological distress and spiritual well-being in pregnant women exposed to domestic violence. This cross-sectional study was conducted on 305 pregnant women subjected to domestic violence in southern Iran. The participants were selected using the census method. Data were collected using the Spiritual Well-being Scale (SWB), the Kessler Psychological Distress Scale (K10), and the Hurt, Insult, Threaten, Scream (HITS) screening tool (short form) and were analyzed with descriptive and inferential statistics (t-test, ANOVA, the Spearman correlation coefficient, and multiple linear regression) in SPSS software version 24. The mean scores ± standard deviation of the participants' psychological distress, spiritual well-being, and domestic violence were 24.68 ± 6.43, 79.89 ± 18.98, and 11.24 ± 1.5, respectively. The results showed that psychological distress had a significant negative correlation with spiritual well-being (ρ = - 0.84, P < 0.001) and domestic violence (ρ = - 0.73, P < 0.001). The results of the multiple linear regression analysis also showed that spiritual well-being and domestic violence could predict the psychological distress of pregnant women who were exposed to domestic violence, which explained 73% of the psychological distress in the participants. According to the study results, spiritually oriented education can be provided for women to reduce their psychological distress. Also, it is recommended that necessary interventions be used to reduce domestic violence and empower women to prevent it.

Association Between Health-Promoting Behaviors and Reproductive Health Needs in Women Experiencing Domestic Violence

Violence against women is considered as one of the most serious social problems in all the societies. It is common that the abused women experience physical, psychological, and health problems, as well as reproductive health issues. Domestic violence affects women's health behaviors and ability to seek any form of health care. This study aimed to investigate the relationship between health-promoting behaviors and reproductive health needs in women experienced domestic violence. This cross-sectional study was conducted from May 5 to September 21, 2021, on 380 abused women. Cluster sampling was performed in health centers of Karaj. Data were collected using demographic survey questions, Domestic Violence Survey, Reproductive Health Needs of Domestic Violated Women scale, and health-promoting behaviors questionnaire. The mean (standard deviation) scores for reproductive health needs and health-promoting behaviors were 158.88 (20.24) and 131.08 (20.53), respectively. Psychological violence had the highest (69.5%) prevalence among all types and 37.6% of women reported severe violence. The results of Spearman's rank correlation coefficient test indicated that all dimensions of the reproductive health needs of abused women (men's participation, self-care, support and health services, and sexual and marital relationships) positively and significantly related to the total score and various dimensions of health-promoting behaviors (interpersonal relationship, health responsibility, physical activity, spiritual growth, nutrition, and stress management). The dimensions of health-promoting behaviors together can explain 21.6% of the changes in reproductive health needs based on linear regression. Violence is a global public concern and paying attention to the various health dimensions in abused women is an important aspect of the health policies. Developing health-promoting behaviors in abused women improves their reproductive health state and society as a whole.

Domestic Violence and Its Impact on Abortion in Iran: Evidence From a Nationally Representative Survey

The objective of this article is to assess the effect of domestic violence on abortion and investigate the mediating role of unwanted pregnancy. A secondary analysis was conducted on the National Family Survey data. This survey was a cross-sectional study conducted across Iran in 2018. The association between domestic violence and abortion was analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM) with WarpPLS version 8.0. From among 1,544 married women (mean age 42.8 years) who participated in this survey, 27% (418 women) reported experiencing at-least one-lifetime of abortion. Overall, two in three women (67.3%) experienced at least one form of domestic violence. Almost half of the women with experience of abortion (49.3%) reported at least one unwanted pregnancy in their life course. The bivariate analysis showed a significant positive relationship between domestic violence and abortion, and there was a positive direct effect of domestic violence on unwanted pregnancy. Moreover, age had a negative direct and indirect effect on unwanted pregnancy and abortion. Although, the direct effect of domestic violence on abortion was not significant in the Structure Equation Model, a positive indirect effect of domestic violence on abortion through unwanted pregnancy was confirmed. The effect of unwanted pregnancy on abortion was particularly strong (β = .395, p < .01). These results have some implications for prevention of abortion through interventions against unwanted and unplanned pregnancy and domestic violence. This study makes a unique theoretical contribution to the literature through assessing the mediating role of unwanted pregnancy between domestic violence and abortion by using the SEM model.

A review of the challenges of screening for domestic violence against women from the perspective of health professionals

BACKGROUND

Domestic violence has a significant effect on women's reproductive, physical, and mental health, and it is a significant threat to everyone's health, so that, it sometimes leads women to commit suicide. Although many of these women will refer to receive medical care due to domestic violence, few of them are identified by health care providers. The present study aimed to review the challenges of screening for domestic violence against women from the perspective of health professionals.

MATERIALS AND METHOD

This study is a scoping review. The study was performed in five stages, which include (1) designing the research question, (2) searching and extracting research-related studies in national and international databases such as PubMed, Scopus, Web of Science, Embase, Magiran, Scientific Information Database (SID), IranDoc and Google Scholar search engine, from inception to March 2021, (3) selecting related studies, (4) scheduling and summarizing data and information, and (5) reporting the results.

RESULTS

Out of 411 articles reviewed, 10 article met our inclusion criteria and were included. According to the results of the studies, barriers of screening for domestic violence can be classified into three areas, which include barriers related to employees (lack of knowledge and training, lack of time to conduct screening, lack of staff confidence, client judgment, and lack of security and comfort for asking related questions and forgetting employees), barriers related to the client and the prevailing culture in the society (tolerating and not reporting domestic violence, fear of spouse due to high power of men in society, fear of losing children and life, and racial and cultural issues) and barriers related to the organization (lack of necessary support from the organization, lack of funding from the organization, lack of protocol).

CONCLUSION

Considering the high number of barriers of detecting women affected by the domestic violence, this study could be used in program designation, and implementation of effective interventions to remove barriers of domestic violence screening. Health care providers can use the results of this review to prepare educational packages according to their cultural background to improve understanding and women's cooperation in the domestic violence prevention and screening programs.

Domestic violence risk prediction in Iran using a machine learning approach by analyzing Persian textual content in social media

Domestic violence (DV) against women in Iran is a hidden societal issue. In addition to its chronic physical, mental, industrial, and economic effects on women, children, and families, DV prevents victims from receiving mental health care. On the other hand, DV campaigns on social media have encouraged victims and society to share their stories of abuse. As a result, massive amount of data has been generated about this violence, which can be used for analysis and early detection. Therefore, this study aimed to analyze and classify Persian textual content pertinent to DV against women in social media. It also aimed to use machine learning to predict the risk of this content. After collecting 53,105 tweets and captions in the Persian language from Twitter and Instagram, between April 2020 and April 2021, 1611 tweets and captions were chosen at random and categorized using criteria compiled and approved by an expert in the field of DV. Then, using machine learning algorithms, modeling and evaluation processes were performed on the tagged data. The Naïve Base model, with an accuracy of 86.77% was the most accurate model among all machine learning models for predicting critical Persian content pertinent to domestic violence on social media. The obtained findings indicate that using a machine learning approach, the risk of Persian content related to DV in social media against women can be predicted.

Investigating the relationship between socioeconomic status and domestic violence against women in Isfahan, Iran in 2021: A cross-sectional study

Background and Aims

Domestic violence can include controlling or coercive behaviors and acts, as well as physical, sexual, psychological, and financial elements. Given the significance of domestic violence against women and its complications, this study looked into the relationship between socioeconomic status and domestic violence against women in Isfahan in 2019.

Methods

In 2021, a cross-sectional study of 427 married women referred to comprehensive health centers in Isfahan, Iran, was carried out. The available sampling method was chosen. To collect data, a domestic violence questionnaire and a socioeconomic status index were used. The data were analyzed using SPSS and Latent GOLD software.

Results

The average age of the women in this study was 33.21, 37% worked, and 63 were housewives. Based on Latent class analysis method, women were classified into two groups of high or low socioeconomic status class. The findings revealed a significant relationship between socioeconomic status and different types of violence against women, including light physical violence, emotional violence, verbal violence, and sexual violence (p < 0.05).

Conclusion

The findings revealed that there is a significant relationship between socioeconomic status and domestic violence against women in Isfahan, with women from lower socioeconomic backgrounds being more vulnerable to violence. Given the prevalence of violence against women in the family and its consequences, policy makers should look for the causes of this type of violence as well as solutions to reduce this health and social problem. Factors such as the expansion of counseling and treatment centers in health care facilities, as well as education and life skills training, are particularly important in reducing this phenomenon in society.

The COVID-19 Pandemic, Socioeconomic Effects, and Intimate Partner Violence Against Women: A Population-Based Cohort Study in 2020, Iran

Objectives. To investigate the prevalence, pattern, and socioeconomic risk factors of intimate partner violence (IPV) before and 6 months after the pandemic onset among a cohort of Iranian women. Methods. We conducted a population-based IPV survey among 2502 partnered Iranian women aged 18 to 60 years before (n = 2502) and 6 months after (n=2116) the pandemic's onset. We estimated prevalence and incidence of psychological, physical, and sexual IPV, and the odds of different forms of IPV associated with main exposure variables, adjusted for participant relationship factors. Results. Pandemic prevalence of IPV (65.4%; 95% confidence interval [CI] = 63.4%, 67.4%) was higher than prepandemic prevalence (54.2%; 95% CI = 52.2%, 56.3%). At follow-up, the incidence of IPV was 25.5% (95% CI = 22.9%, 28.4%). The highest incidence was in cases of physical and sexual IPV. Women whose partners lost their employment were at significant risk of new exposure to IPV. Highest socioeconomic status (SES) was associated with less physical IPV (odds ratio = 0.03; 95% CI = 0.01, 0.14). Conclusions. IPV prevalence has risen since the COVID-19 epidemic began with many women who had never experienced IPV now facing it. Unemployment of women or their partners and prepandemic lower socioeconomic status are risk factors of IPV. Monitoring programs should target these populations. (Am J Public Health. 2023;113(2):228-237. https://doi.org/10.2105/AJPH.2022.306839).

The prevalence of violence and its association with mental health among the Iranian population in one year after the outbreak of COVID-19 disease

BACKGROUND

COVID-19 spread between and across nearly every country, with considerable negative health consequences. The current study aimed to determine the prevalence of violence and its association with mental health among Iranians older than 15 years in 2020.

METHODS

Data was collected through National Mental Health Survey on 24,584 Iranians older than 15 years in 2020. were analyzed to determine the prevalence of violence and its association with mental health. Multi-stage sampling method was used, and data on demographic characteristics and domestic-social violence and mental health (GHQ-28) were collected. Data analysis was administered using descriptive statistics and a chi-square test at a 95% level.

RESULTS

The mean age of participants was 44.18 ± 16.4 years. The overall prevalence of domestic and social violence was 11.4% and 5.5%, respectively. Verbal violence was the most common type; with 61.8% and 66.8% for domestic and social violence, respectively. A suspected case of mental disorder, female gender, being younger than 25 years, living apart together, unemployment, low education, and history of COVID-19 infection presented a significant association with domestic and social violence (p > 0.05).

CONCLUSION

In comparison to the previous study in 2015, the prevalence of violence has increased. Therefore, domestic and social violence are the social concerns of Iranian society, indicating the necessity of appropriate interventions, particularly for those suspected of mental disorders and young women with low education levels.

Spouse and Child Abuse Associated With Illicit Drug Use in Iran: A Systematic Review and Meta-Analysis

BACKGROUND

There is a high prevalence of substance use disorders, especially among men, in Iran and is associated with a high burden on families. We aimed to systematically review the association between illicit drug use and spouse and child abuse in Iran.

METHOD

Comprehensive terms were used to search three international databases (ISI, Medline, and Scopus) and a national database of Scientific Information Database up to September 2019. The retrieved citations were screened based on the eligibility criteria and then data were extracted, and the risk of bias was assessed by two independent investigators. Data were analyzed using random-effects model to estimate pooled odds ratios (ORs) and the heterogeneity of studies.

RESULTS

The search yielded 18 articles that met the inclusion criteria. Illicit substance use in husbands was associated with increased odds of current violence (OR = 3.50; 95% CI [2.09, 5.86]), current physical violence (OR = 5.41; 95% CI [3.50, 8.35]), current psychological violence (OR = 6.20; 95% CI [3.74, 10.30]), and current sexual violence (OR = 7.23; 95% CI [4.06, 12.87]) against spouse. In studies on child abuse, the odds of current physical child abuse by parents who used an illicit substance was 3.88 times (95% CI [1.50, 10.01]) higher than parents who did not use any illicit substance.

CONCLUSION

The results of the current study showed that illicit substance use is associated with an increased risk of spouse and child abuse. This is an important social and health consequence of drug use and should be addressed in all drug control plans.

Comparison of associated factors of domestic violence against women by their husbands based on demographic characteristics and life skills in Iran

BACKGROUND

In recent decades, the prevention of domestic violence against women (DVAW) has been considered a priority for women's health in many countries. Identifying factors related to DVAW by their husbands or intimate partner can promise prevention and decrease in prevalence. The objective of this study was to examine and compare associated factors of domestic violence based on demographic characteristics and some life skills.

MATERIALS AND METHODS

This cross-sectional study was conducted in Abadan, Iran. 640 couples completed questionnaires including demographic characteristics, communication skills, anger management, and problem-solving skill. In addition, women completed the questionnaire on domestic violence. Data were analyzed using descriptive statistics (t-test and one-way analysis of variance) and multiple linear regression.

RESULTS

Approximately 57% of the women in this study have been subjected to psychological violence in their lifetime by their husbands. The result of multiple regression indicated that demographic characteristics had a very small contribution to explaining domestic violence (R ²= 0.03) and only the education level of women was identified as a key predictor of domestic violence. The result of multiple regression based on life skills among couples demonstrated that communication skills and anger management of couples were inversely and significantly associated with domestic violence and these variables explained 51% of the variance in domestic violence.

CONCLUSIONS

Empowering couples with anger management and communication skills can play an important role in decreasing domestic violence. Therefore, developing and planning educational interventions by policymakers and health care providers seems necessary for couples.

The impact of social determinants of health on early childhood development: a qualitative context analysis in Iran

BACKGROUND

Social determinants have a significant impact on children's development and their abilities and capacities, especially in early childhood. They can bring about inequity in living conditions of children and, as a result, lead to differences in various dimensions of development including the social, psychological, cognitive and emotional aspects. We aimed to identify and analyze the social determinants of Early Childhood Development (ECD) in Iran and provide policy implications to improve this social context.

METHODS

In a qualitative study, data were collected through semi-structured interviews with 40 experts from October 2017 to June 2018. Based on Leichter's (1979) framework and using the deductive approach, two independent researchers conducted the data analysis. We used MAXQDA.11 software for data management.

RESULTS

We identified challenges related to ECD context in the form of 8 themes and 22 subthemes in 4 analytical categories relevant to the social determinants of ECD including: Structural factors (economic factors: 6 subthemes, political factors: 2 subthemes), Socio-cultural factors (the socio-cultural setting of society: 6 subthemes, the socio-cultural setting of family: 4 subthemes), Environmental or International factors (the role of international organizations: 1 subtheme, political sanctions: 1 subtheme), and Situational factors (genetic factors: 1 subtheme, the phenomenon of air pollution: 1 subtheme). We could identify 24 policy recommendations to improve the existing ECD context from the interviews and literature.

CONCLUSION

With regard to the challenges related to the social determinants of ECD, such as increasing social harms, decreasing social capital, lack of public awareness, increasing socio-economic inequities, economic instability, which can lead to the abuse and neglect of children or unfair differences in their growth and development, the following policy-making options are proposed: focusing on equity from early years in policies and programs, creating integration between policies and programs from different sectors, prioritizing children in the welfare umbrella, empowering families, raising community awareness, and expanding services and support for families, specially the deprived families subject to special subsidies.

Domestic violence and associated factors during COVID-19 epidemic: an online population-based study in Iran

Background

The novel coronavirus disease 2019 has severely affected communities around the world. Fear and stress of being infected, along with pressure caused by lockdown, prevention protocols, and the economic downturn, increased tension among people, which consequently led to the rise of domestic violence (DV). Therefore, this study was conducted to determine the rate of change in DV and its associated factors during the COVID-19 epidemic in Shiraz, Iran.

Methods

In this cross-sectional study, 653 individuals with the age of over 15 years from Shiraz were participated through snowball sampling and filled out an online questionnaire through the WhatsApp platform. A 51-item, self-administered and multidimensional (knowledge, attitude, and practice) questionnaire was designed and assessed 653 participants. The gathered data was analyzed using SPSS software (version 25), and variables with a p-value of less than 0.05 were considered statistically significant.

Results

In this study, 64.2% of the respondents were within the age range of 31–50 years, and 72.6% of the subjects were female. Furthermore, 73.8 and 73.0% of the individuals were married and educated for over 12 years, respectively. The DV increased by 37.5% during the quarantine period, compared to before the pandemic. The emotional type was the most common type of violence; the sexual type was the least frequent. Multivariate analysis indicated that infection with COVID-19, drug use, high level of co-living observation of anti-COVID prevention protocols, and lower level of physical activity during the quarantine period had a positive and significant association with the occurrence of DV.

Conclusion

Based on the obtained results, it is required to implement effective harm-reduction policies and measures in the community due to the increasing rate of DV during the COVID-19 epidemic.

HIV serostatus disclosure to sexual partner: a survey among women in Tehran, Iran

BACKGROUND

Disclosure of HIV-positive status in women is associated with many factors. Consequently, status disclosure remains a challenge for Iranian women living with HIV. This study aimed to assess the prevalence, related factors, and reflections of HIV-positive status disclosure to a sexual partner(s) among Iranian women living with HIV.

METHODS

A cross-sectional study was conducted on 170 HIV-seropositive women. Participants were selected from patients registered in the largest HIV clinic and HIV-positive club of Iran. The "HIV disclosure" questionnaire had 38-items and all the interviews were administered by the researcher. Data were analyzed using SPSS version 21.0 software. We used a logistic regression method to calculate the crude odds ratio (COR) and the adjusted odds ratio (AOR) for self-disclosure as the independent predictor variable and the dependent variable, respectively.

RESULTS

One hundred and seventy HIV-positive women were enrolled. Most of them had disclosed their HIV status to at least one person (94.1%) and their sexual partners (86.5%). In the univariate analysis, being married (COR = 18.66, 95% CI 5.63-61.87), living with a sexual partner (COR = 4.72, 95% CI 1.92-11.62), being aware of sexual partners' HIV status (COR = 6.20, 95% CI 1.79-21.49), and gaining the support of sexual partner (COR = 9.08, 95% CI 3.48-23.64) were associated with higher odds of HIV status disclosure. In the multivariate analysis, being aware of sexual partners' HIV status, and gaining the support of sexual partners remained associated with HIV status disclosure. Most women reported a positive reflection from their sexual partners after disclosure, however, negative reflections from society were more common compared to sexual partners and family members.

CONCLUSION

This study shows high overall HIV disclosure proportions. It should be noted that a large number of women were infected by their sexual partners, especially by their spouses. The high rate of transmission in married people indicates an urgent need for more emphasis on appropriate prevention behaviors by infected partners.

Prevalence and Correlates of Sexual Violence Experienced by Female Sex Workers in Iran: Results from a National HIV Bio-Behavioral Surveillance Survey

Sexual violence increases the risk of adverse health outcomes among female sex workers (FSWs). Using data from the 2015 national bio-behavioral survey, we explored the experience of sexual violence and its associated factors among Iranian FSWs. Lifetime and recent sexual violence were reported by 40.1% and 16.9%, respectively. History of substance use, ever engaging in anal sex, engaging in group sex within the last year, a high number of clients, recent unstable housing, and incarceration increased the likelihood of experiencing recent sexual violence. These findings underscore the need for community-empowerment and policy-level interventions to address violence among FSWs in Iran.

Life loaded with threat and vulnerability: a qualitative inquiry into the experiences of HIV negative married women in serodiscordant heterosexual relationships

Background

Violence against women is a major, complex, multidimensional and widespread public health concern worldwide. The current qualitative study was conducted to understand the experience of violence among HIV negative married women in heterosexual serodiscordant relationships.

Methods

A qualitative description (QD) was conducted from October 2018 to January 2020 in Mashhad, Iran. The participants were 15 HIV negative women, who married and lived with HIV positive men, through purposive sampling method. The data were collected using semi-structured interviews. Data analyzed using conventional content analysis adopted by Graneheim and Lundman.

Results

The main overarching theme emerged entitled: life loaded with threat and vulnerability. This theme consisted of four categories of self-directed violence, intimate partner violence, cultural violence and structural violence. The violence began soon after awareness of husband's infection with acts such as suicide attempts and a sense of abhorrence for living with an infected person, and continued with confrontation with various types of violence in the family and society, which put women in constant threat and vulnerability.

Conclusions

This study provided an insight into different aspects of violence in Iranian women in HIV serodiscordant relationships. Considering the role of men in the occurrence of violence, policymakers must create and execute family-centered interventions to address attitudes and behaviors that lead to marital conflicts and spousal abuse in order to prevent violence. Health care professionals should also be trained to screen women for violence and refer those who require care to specialists to reduce vulnerability.

Frequency and determinants of domestic violence against Iranian women during the COVID-19 pandemic: a national cross-sectional survey

Introduction

Domestic violence (social, legal, and health violence) is the most common type of violence against women. Due to factors such as the current quarantine, this type of violence has increased during the COVID-19 pandemic. The present study aimed to assess the frequency of domestic violence against women and identify the risk factor among Iranian women during the COVID-19 pandemic.

Methods

This online cross-sectional study was conducted on 203 Iranian women during May–June 2020. Data were collected using a domestic violence questionnaire, which measured three forms of violence, including physical, emotional, and sexual violence. A link of the questionnaire was distributed among anonymous subjects through social networking apps, such as WhatsApp and Telegram. The subjects were asked to complete the questionnaire based on their experiences during the COVID-19 pandemic. Data analysis was performed using descriptive statistics and a regression model.

Results

The descriptive results showed that the mean domestic violence against women in all the participants was 34.9 (SD: 17.28). In addition, 26.6% (n = 84), 26.1% (n = 53), and 21.2% of the subjects (n = 43) experienced high levels of physical, emotional, and sexual violence during the COVID-19 pandemic, respectively. The regression model also indicated that lower age, illiteracy/primary education, previous marriage(s), and unwanted/unwise marriage were the significant risk factors for domestic violence against women.

Conclusion

According to the results, domestic violence against women is common among Iranian women during the COVID-19 pandemic. Therefore, strategies are urgently needed to prevent and minimize such domestic violence, and such strategies could be adopted through providing educational opportunities, raising awareness, promoting wanted/wise marriage, and providing social support and rehabilitation opportunities to vulnerable social groups, especially vulnerable women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11791-9.

Development and validation of the Domestic Violence during Quarantine Scale (DVQS)

Background

Domestic violence is a common health problem that often affects women’s mental health. Although domestic violence may not be reported during quarantine, it may increase due to increased restrictions. Therefore, the goal of the present study was to develop and validate the Domestic Violence during Quarantine Scale (DVQS) on a sample from Iran.

Methods

Two hundred and three Iranians participated in this study and completed online questionnaires. This cross-sectional and methodological study consisted of two phases. In the first phase, item pool generation and questionnaire design was carried out through literature review. In the second phase, psychometric properties were assessed via an exploratory factors analysis (EFA). Internal consistency was examined by Cronbach’s alpha coefficient and McDonalds’ Omega.

Results

In the EFA, three factors, including humiliation (seven items), threatening (six items), and restriction (four items) were extracted that together explained 64.4% of the variance of domestic violence during quarantine. Using Cronbach’s alpha coefficient, the internal consistency of humiliation, threatening, and restriction was found to be 0.90, 0.896, and 0.76 respectively, and an alpha of 0.927 was found for the total scale. In addition, using McDonalds’ Omega, internal consistencies of 0.82, 0.84, and 0.78 were found for the three factors respectively.

Conclusion

The DVQS has good validity and reliability; therefore, it can be used in future studies.

Divorce Ambivalence and Reasons for Divorce in Iran

This study examined divorce attitudes and reasons for divorce in Iran, a nation experiencing a rapid increase in divorce. Using instruments translated into Farsi with a sample of 230 Iranian spouses filing for divorce, we found a preponderance of common relational reasons for divorce (such as growing apart and not getting enough attention), along with high rates of interpersonal violence reported by wives. Study participants showed considerable rates of divorce ambivalence, along with openness to reconciliation services. The findings were compared with similar studies of the United States spouses in the divorce process. Clinical implications include a careful approach to considering how discernment counseling might be adapted to the cultural situation of Iran, and particularly the special concerns of Iranian women.

The effect of family-based counseling on domestic violence in pregnant women referring to health centers in Sahneh city, Iran, 2018

BACKGROUND

Domestic violence is a term that shows aggressive behavior with different physical, psychological, economic, and social dimensions. This concept is considered as one of the health priorities regarding its significant effects on pregnancy, postpartum, and the outcome of pregnancy. The present study was conducted to investigate the effect of family-based counseling on domestic violence against pregnant women.

METHODS

An intervention trial was conducted on 92 pregnant women exposed to domestic violence, selected among 274 pregnant women accessible in Sahneh, Iran. Data collection was performed using the standard questionnaire of domestic violence against women of Mohseni Tabrizi. The pregnant women exposed to violence were randomly assigned to intervention and control groups (in two groups of 45 people). In the intervention group, three 45-min individual counseling sessions were held for the pregnant women and their spouses according to Greeting, Ask, Tell, Help, Explain, and Refer (GATHER) principles. Four weeks after the end of the sessions, the two groups again completed the questionnaire.

RESULTS

Family-based counseling intervention reduced the mean score of domestic violence in the intervention group from 68.58 ± 9.21 before the intervention to 49.56 ± 8.83 after intervention. Also, various domains of violence including mental, verbal, financial, physical, sexual, and social violence were significantly declined in the intervention group (P < 0.001); however, there was no significant decrease in emotional violence score (P > 0.001).

CONCLUSION

Family-based counseling plays a significant role in reducing the various types of violence against women through increasing the awareness of couples and by improving the relationship between couples during pregnancy. It will reduce the incidence of violence against a pregnant woman and consequently reduce complications on the mother and pregnancy outcomes. Family-oriented counseling played a significant role in deterring all forms of violence against women by increasing awareness of couples and improving their relationship during pregnancy. Moreover, family-oriented counseling reduced the incidence of violence against pregnant women and thus deterred maternal complications associated with pregnancy.

Epidemiological study of injuries caused by violence and conflict in forensic medical records of selected cities of Sistan and Baluchistan province in 2020

Background and Aims

Interpersonal violence is a socially traumatic and unpleasant phenomenon. These violence-related injuries are sometimes irreparable and can become a permanent problem, Violence in Iran is one of the five most socially harmed and has increased dramatically in recent years, therefore the present research aimed to investigate epidemiological study of injuries caused by violence and conflict in forensic medical records of selected cities of Sistan and Baluchistan province in 2020 considering this subject must be one of our priorities.

Methods

This study was a descriptive study performed in forensic medicine centers of two cities in Sistan and Baluchistan province, Iran. The population consisted of existing citations and records, sample size based on similar studies and the recommendation of professors, all available records were considered and census method was used to select the samples. The data gathering tool consisted of two sections: demographic information and violence and conflict. Content validity method and reliability test were used to determine the validity and reliability. Data were analyzed using SPSS24 software.

Results

The results showed that the majority of the sample was 20-29 years old, male, married, self-employed and high school graduated, living in the eastern part of the city, with no history of mental illness, domestic violence, child abuse, and spouse abuse. The majority of the study units did not use any drugs. The most violent were beatings and bullying. It included several organs such as limbs, soft tissue damage with bleeding.

Conclusion

The results of this study indicate the importance of epidemiological analysis of violence and conflict in the provinces under study and show that appropriate solutions and culture building, as well as increasing awareness of the impact of violence and conflict on individuals and their injuries.

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

INTRODUCTION

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

AIM

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

METHOD

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

FINDINGS

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

CONCLUSION

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

Attitude Toward Violence and its Relationship With Self-Esteem and Self-Efficacy Among Iranian Women

The most widespread form of violence against women is domestic violence, which is associated with social and psychological consequences. The current study aimed to investigate the relationship between violence and self-esteem and self-efficacy in 496 women referred to Jahrom Women's Clinic. Convenience sampling was performed and data were collected using the Violence Against Women Survey Questionnaire, Rosenberg Self-Esteem Scale, and Sherer General Self-Efficacy Scale. The prevalence of violence was 47.4%. Approximately 20.6% of the sample was subjected to physical violence and 44.2% was subjected to non-physical violence. In addition, 74.6% of women had a negative attitude toward violence, which resulted in a statistically significant relationship with their self-efficacy (p = 0.0001). Self-efficacy and self-esteem were decreased in women who reported violence (p = 0.0001). To reduce domestic violence, women's attitudes toward their rights need to be changed to increase their self-esteem and self-efficacy through planning, counseling, and educational classes. [Journal of Psychosocial Nursing and Mental Health Services, 59(4), 31-37.].

Risk Markers for Women's Physical Intimate Partner Violence Victimization in Iran: A Meta-Analysis

In this study, evidence from 14 studies examines 16 unique risk markers for intimate partner violence (IPV) victimization for Iranian women. Large-to-medium effect sizes were found for emotional abuse victimization, depression, poor mental health, poor physical health, partner's drug use, living in a patriarchal household, and partner having experienced child abuse as risk markers. Higher levels of education and higher levels of household income were significant protective markers against IPV victimization for Iranian women. Partner's education, partner's employment, being employed, being pregnant, age, partner's age, and length of the relationship were not significant risk markers for IPV victimization among Iranian women.

Domestic violence against women in Shiraz, South-western Iran

BACKGROUND

Domestic violence against women can lead to short and long term health-related issues. We aimed to estimate the prevalence of domestic violence against married women and its correlates in southwestern, Iran.

METHODS

A population-based survey was carried out from February 1st to May 30th, 2018 in Shiraz, Iran. Currently married or recently separated/divorced women who visited healthcare centers were voluntarily interviewed. World Health Organization (WHO) standard domestic violence questionnaire was used to measure domestic violence. Hence, its prevalence and correlates were assessed. Data were analyzed using multivariable logistic regression.

RESULTS

Lifetime prevalence of overall, mental, physical, and sexual domestic violence were 54.5% (95% CI: 49.6, 59.4), 52.0% (95% CI: 47.1, 57.0), 18.2 % (95% CI: 14.4, 22.0) and 14.0 % (95% CI: 10.6, 17.4), respectively. Living separately, increasing spouse's age, the higher number of children, rental housing, middle to low monthly income, and history of domestic violence in the family of husband and/or wife had a positive correlation with domestic violence in some categories.

CONCLUSIONS

More than half of the married women in southwestern Iran are experiencing domestic violence, and mental domestic violence is the most common type. Economic instability and witnessing domestic violence in childhood are the most correlates of domestic violence. Family violence preventive services and other population-based measures are highly necessary for this region.

Domestic violence and suicide attempts among married women: A case-control study

AIMS AND OBJECTIVES

To investigate the impact of domestic violence-related factors on suicide attempt in married women.

BACKGROUND

Suicide is a global public health concern that poses significant burden on individuals, families and communities. There is limited research on factors predicting suicide attempt in women.

DESIGN

A retrospective case-control design was adopted.

METHODS

Using a convenience sampling method, 610 participants, admitted to a teaching referral hospital in Northwest of Iran, were recruited to the study and assigned to case or control groups based on whether or not they had attempted suicide. The participants in two groups were matched in the terms of important demographic characteristics. Domestic violence-related factors were considered as independent variables and suicide attempt as dependent variable. Descriptive statistics, and simple and multivariate logistic regression analysis were used to analyse the data. Odds ratios (OR) of domestic violence-related factors were compared between the groups. We used STROBE checklist as an EQUATOR in this study.

RESULTS

The mean age of participants in the case and control groups was 28.4 and 29.45 years, respectively. The infidelity was the strongest predictor of suicide attempt in women (OR 44.57, 95%CI 6.08-326. 63, p < 0.001), followed by being threatened to physical assault by husband (OR 37.01, 95%CI 11.54-118.67, p < 0.001), jealousy of husband (OR 23.46, 95%CI 11.63-47.30, p < 0.001), and previous attempts to divorce (OR 16.55, 95%CI 5.91-46.31, p < 0.001). Suicide attempt was significantly lower in women who reported a sense of peace in life or lived with their mother or father-in-law (p < 0.001).

CONCLUSIONS

To reduce the risk of suicide in women, violence against women should be condemned and appropriate prevention measures be taken by health professionals.

RELEVANCE TO CLINICAL PRACTICE

Recognising risk, assessment and referral of victims of domestic violence should be an integral part of healthcare systems.

Epidemiological and spatial characteristics of interpersonal physical violence in a Brazilian city: A comparative study of violent injury hotspots in familial versus non-familial settings, 2012-2014

This study explores both epidemiological and spatial characteristics of domestic and community interpersonal violence. We evaluated three years of violent trauma data in the medium-sized city of Campina Grande in North-Eastern Brazil. 3559 medical and police records were analysed and 2563 cases were included to identify socioeconomic and geographic patterns. The associations between sociodemographic, temporal, and incident characteristics and domestic violence were evaluated using logistic regression. Using Geographical Information Systems (GIS), we mapped victims' household addresses to identify spatial patterns. We observed a higher incidence of domestic violence among female, divorced, or co-habitant persons when the violent event was perpetrated by males. There was only a minor chance of occurrence of domestic violence involving firearms. 8 out of 10 victims of domestic violence were women and the female/male ratio was 3.3 times greater than that of community violence (violence not occurring in the home). Unmarried couples were twice as likely to have a victim in the family unit (OR = 2.03), compared to married couples. Seven geographical hotspots were identified. The greatest density of hotspots was found in the East side of the study area and was spatially coincident with the lowest average family income. Aggressor sex, marital status, and mechanism of injury were most associated with domestic violence, and low-income neighbourhoods were coincident with both domestic and non-domestic violence hotspots. These results provide further evidence that economic poverty may play a significant role in interpersonal, and particularly domestic violence.

Performance of Healthcare Providers Regarding Iranian Women Experiencing Physical Domestic Violence in Isfahan

Background:

Domestic violence (DV) can threaten women's health. Healthcare providers (HCPs) may be the first to come into contact with a victim of DV. Their appropriate performance regarding a DV victim can decrease its complications. The aim of the present study was to investigate HCPs' performance regarding women experiencing DV in emergency and maternity wards of hospitals in Isfahan, Iran.

Materials and Methods:

The present descriptive, cross-sectional study was conducted among 300 HCPs working in emergency and maternity wards in hospitals in Isfahan. The participants were selected using quota random sampling from February to May 2016. A researcher-made questionnaire containing the five items of HCPs performance regarding DV (assessment, intervention, documentation, reference, and follow-up) was used to collect data. The reliability and validity of the questionnaire were confirmed, and the collected data were analyzed using SPSS software. Cronbach's alpha was used to assess the reliability of the questionnaires. To present a general description of the data (variables, mean, and standard deviation), the table of frequencies was designed.

Results:

The performance of the participants regarding DV in the assessment (mean = 64.22), intervention (mean = 68.55), and reference stages (mean = 68.32) were average. However, in the documentation (mean = 72.55) and follow-up stages (mean = 23.10), their performance was good and weak respectively (criterion from 100).

Conclusions:

Based on the results, because of defects in providing services for women experiencing DV, a practical indigenous guideline should be provided to treat and support these women.

The prevalence of violence against women and some related factors in Sanandaj city (Iran) in 2015

Background and aim

Violence against women is considered as one of the social problems of all countries in the world. The aim of this study was to determine the prevalence of violence against married women referring to health centers, and determining its related factors in Sanandaj, Iran, in 2015.

Methods

This cross-sectional study was conducted on 700 married women referred to health centers in Sanandaj, Iran in 2015. A researcher made questionnaire was used to collect data. To perform sampling, the city was divided into 5 regions and from each region, one health center was selected randomly. Data were analyzed by SPSS 18 and using descriptive statistics, independent-samples t-test, chi-square test and ANOVA. Significance level of .05 was considered.

Results

The results of this study showed that all women in the study had been subjected to violence at least once. In 11.7% of cases, the violence was moderate and severe. A total of 9.6% had been subjected to physical violence, 42.2% to verbal and psychological violence, 52.4% to sexual violence and 53.4% to economic violence. It was a statistically significant correlation between violence and following variables; education (p=0.0001), occupation (p=0.0001), history of domestic violence in family (p=0.0001), and having a boy in the family (p=0.0001). There was no statistically significant relationship between the number of girls in the family and violence against women (p=0.19).

Conclusion

Although Physical violence against women has decreased, other forms of violence including; verbal, sexual and economic were used against women. It seems that the problem of violence against women would not be solved without improving women’s socio-economic status.

Factors Associated With Domestic Violence Against Women in Iran: An Exploratory Multicenter Community-Based Study

Domestic violence against women committed by intimate partners is a worldwide concern especially in developing countries. The aim of this study was to assess the problem among Iranian women and identify associated risk factors. Using a cross-sectional multicenter design, 1,600 women in six different areas of Iran were surveyed. A measure of domestic violence against women was administered and demographic information collected. Logistic regression models were used to identify factors associated with domestic violence. The prevalence of domestic violence among participants were emotional (64%), physical (28%), and sexual (18%). Higher education (both women and their partners), employment status of partner (being employed), and lower number of children lowered the risk, whereas history of previous marriage (for either women or their partners), unstable marriage, substance abuse, crowded family situation, and lower socioeconomic status increased the risk of domestic violence. There is a high prevalence of domestic violence, particularly emotional, against women by their partners. Preventive measures are recommended such as increasing public awareness, improving in socioeconomic status of families, educating women about what they can do, and encouraging counseling for the couple or the woman alone.