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      Women’s and men’s reports of past-year prevalence of intimate partner violence and rape and women’s risk factors for intimate partner violence: A multicountry cross-sectional study in Asia and the Pacific

      research-article
      1 , * , 2 , 3 , 1 , 1 , 4 , 5 , on behalf of the UN Multi-country Study on Men and Violence Study Team
      PLoS Medicine
      Public Library of Science

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          Abstract

          Background

          Understanding the past-year prevalence of male-perpetrated intimate partner violence (IPV) and risk factors is essential for building evidence-based prevention and monitoring progress to Sustainable Development Goal (SDG) 5.2, but so far, population-based research on this remains very limited. The objective of this study is to compare the population prevalence rates of past-year male-perpetrated IPV and nonpartner rape from women’s and men’s reports across 4 countries in Asia and the Pacific. A further objective is to describe the risk factors associated with women’s experience of past-year physical or sexual IPV from women’s reports and factors driving women’s past-year experience of partner violence.

          Methods and findings

          This paper presents findings from the United Nations Multi-country Study on Men and Violence in Asia and the Pacific. In the course of this study, in population-based cross-sectional surveys, 5,206 men and 3,106 women aged 18–49 years were interviewed from 4 countries: Cambodia, China, Papua New Guinea (PNG), and Sri Lanka. To measure risk factors, we use logistic regression and structural equation modelling to show pathways and mediators. The analysis was not based on a written plan, and following a reviewer’s comments, some material was moved to supplementary files and the regression was performed without variable elimination. Men reported more lifetime perpetration of IPV (physical or sexual IPV range 32.5%–80%) than women did experience (physical or sexual IPV range 27.5%–67.4%), but women’s reports of past-year experience (physical or sexual IPV range 8.2%–32.1%) were not very clearly different from men’s (physical or sexual IPV range 10.1%–34.0%). Women reported much more emotional/economic abuse (past-year ranges 1.4%–5.7% for men and 4.1%–27.7% for women). Reports of nonpartner rape were similar for men (range 0.8%–1.9% in the past year) and women (range 0.4%–2.3% in past year), except in Bougainville, where they were higher for men (11.7% versus 5.7%). The risk factor modelling shows 4 groups of variables to be important in experience of past-year sexual and/or physical IPV: (1) poverty, (2) all childhood trauma, (3) quarrelling and women’s limited control in relationships, and (4) partner factors (substance abuse, unemployment, and infidelity). The population attributable fraction (PAF) was largest for quarrelling often, but the second greatest PAF was for the group related to exposure to violence in childhood. The relationship control variable group had the third highest PAF, followed by other partner factors. Currently married women were also more at risk. In the structural model, a resilience pathway showed less poverty, higher education, and more gender-equitable ideas were connected and conveyed protection from IPV. These are all amenable risk factors. This research was cross-sectional, so we cannot be sure of the temporal sequence of exposure, but the outcome being a past-year measure to some extent mitigates this problem.

          Conclusions

          Past-year IPV indicators based on women’s reported experience that were developed to track SDG 5 are probably reasonably reliable but will not always give the same prevalence as may be reported by men. Report validity requires further research. Interviews with men to track past-year nonpartner rape perpetration are feasible and important. The findings suggest a range of factors are associated with past-year physical and/or sexual IPV exposure; of particular interest is the resilience pathway suggested by the structural model, which is highly amenable to intervention and explains why combining economic empowerment of women and gender empowerment/relationship skills training has been successful. This study provides additional rationale for scaling up violence prevention interventions that combine economic and gender empowerment/relationship skills building of women, as well as the value of investing in girls’ education with a view to long-term violence reduction.

          Abstract

          In a cross-sectional analysis of survey data from Cambodia, China, Papua New Guinea, and Sri Lanka, Rachel Jewkes and colleagues compare women's and men's reports of past-year prevalence of intimate partner violence and rape.

          Author summary

          Why was the study done?
          • Understanding the past-year prevalence of physical and or sexual intimate partner violence (IPV) and risk factors is essential for building evidence-based prevention.

          • Previous studies have not compared men’s and women’s past-year prevalence reports and have been limited by a predominant focus on risk factors for lifetime exposure to IPV.

          • Monitoring SDG 5.2 and building evidence-based prevention require a relative understanding of the measures of past-year prevalence and the drivers of this violence.

          What did the authors do and find?
          • We use data from 4 countries of the UN Multi-country Study on Men and Violence in Asia and the Pacific to compare the population prevalence rates of past-year IPV and nonpartner rape from women’s and men’s reports and present an analysis of drivers of women’s experience of past-year physical or sexual IPV.

          • Women’s reports of past-year male-perpetrated IPV were similar to those from men.

          • Four groups of variables are important drivers of IPV: poverty, all childhood trauma, quarrelling and women’s limited control in the relationship, and partner factors (substance abuse, unemployment, and infidelity).

          What do these findings mean?
          • Past-year IPV indicators based on women’s reported experience that were developed to track SDG 5 are probably reasonably reliable.

          • Women appear to gain resilience to violence through combined economic power and understanding gender empowerment/relationship skills, as well as education; this is an important foundation for intervention.

          • Further research is needed on the validity of men’s and women’s reports of IPV, which could not be determined from these data.

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          Most cited references45

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          A simulation study of the number of events per variable in logistic regression analysis

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            • Article: not found

            Structural Model Evaluation and Modification: An Interval Estimation Approach.

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              A reliability coefficient for maximum likelihood factor analysis

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Academic Editor
                Journal
                PLoS Med
                PLoS Med
                plos
                plosmed
                PLoS Medicine
                Public Library of Science (San Francisco, CA USA )
                1549-1277
                1549-1676
                5 September 2017
                September 2017
                : 14
                : 9
                : e1002381
                Affiliations
                [1 ] Gender & Health Research Unit, Medical Research Council and School of Public Health, University of the Witwatersrand, Pretoria, South Africa
                [2 ] The Equality Institute, Melbourne, Australia
                [3 ] International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
                [4 ] Emory University, Atlanta, Georgia, United States of America
                [5 ] Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
                Massachusetts General Hospital, UNITED STATES
                Author notes

                I have read the journal's policy and the authors of this manuscript have the following competing interests: RJ is a member of the Editorial Board of PLOS Medicine.

                ¶ Membership of the UN Multi-country Study on Men and Violence Study Team is provided in the Acknowledgements.

                Author information
                http://orcid.org/0000-0002-4330-6267
                Article
                PMEDICINE-D-16-03259
                10.1371/journal.pmed.1002381
                5584751
                28873087
                1d1a0833-660a-4985-979c-2b4edd52e28d
                © 2017 Jewkes et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 7 October 2016
                : 31 July 2017
                Page count
                Figures: 1, Tables: 4, Pages: 20
                Funding
                Funded by: UK Aid from the UK Department for International Development (DFID)
                Award Recipient :
                Funded by: Partners for Prevention, a UNDP, UNFPA, UN Women and UNV regional joint programme for gender-based violence prevention in Asia and the Pacific
                Funded by: funder-id http://dx.doi.org/10.13039/100006661, United Nations Population Fund;
                Funded by: UN Women
                Award Recipient :
                Funded by: UNDP
                Funded by: CARE
                Funded by: Government of Australia
                Funded by: Government of Sweden
                Funded by: Government of Norway
                Funded by: funder-id http://dx.doi.org/10.13039/501100001322, South African Medical Research Council;
                Award Recipient :
                This document is an output from the What Works to Prevent Violence: a Global Programme that is funded by the UK Aid from the UK Department for International Development (DFID) for the benefit of developing countries. The primary research was funded by Partners for Prevention, a UNDP, UNFPA, UN Women and UNV regional joint programme for gender-based violence prevention in Asia and the Pacific. Funding was provided by UNFPA, UN Women, UNDP, CARE, the Government of Australia, the Government of Sweden, the Government of Norway, and South African Medical Research Council. No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Public and Occupational Health
                Traumatic Injury Risk Factors
                Violent Crime
                Intimate Partner Violence
                Social Sciences
                Sociology
                Criminology
                Crime
                Violent Crime
                Intimate Partner Violence
                Social Sciences
                Sociology
                Criminology
                Crime
                Rape and Sexual Assault
                Medicine and Health Sciences
                Public and Occupational Health
                Traumatic Injury Risk Factors
                Child Abuse
                Social Sciences
                Sociology
                Criminology
                Crime
                Child Abuse
                Medicine and Health Sciences
                Pediatrics
                Child Abuse
                People and Places
                Geographical Locations
                Asia
                Cambodia
                People and places
                Geographical locations
                Asia
                Sri Lanka
                Social Sciences
                Sociology
                Education
                Educational Attainment
                People and Places
                Geographical Locations
                Asia
                Medicine and Health Sciences
                Public and Occupational Health
                Traumatic Injury Risk Factors
                Violent Crime
                Social Sciences
                Sociology
                Criminology
                Crime
                Violent Crime
                Custom metadata
                The data are owned by Partners for Prevention. Requests for data access can be submitted to Kathy Taylor, Manager, Partners for Prevention by email: kathy.taylor@ 123456one.un.org .

                Medicine
                Medicine

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