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      What factors are associated with recent intimate partner violence? findings from the WHO multi-country study on women's health and domestic violence

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          Abstract

          Background

          Intimate partner violence (IPV) against women is a global public health and human rights concern. Despite a growing body of research into risk factors for IPV, methodological differences limit the extent to which comparisons can be made between studies. We used data from ten countries included in the WHO Multi-country Study on Women's Health and Domestic Violence to identify factors that are consistently associated with abuse across sites, in order to inform the design of IPV prevention programs.

          Methods

          Standardised population-based household surveys were done between 2000 and 2003. One woman aged 15-49 years was randomly selected from each sampled household. Those who had ever had a male partner were asked about their experiences of physically and sexually violent acts. We performed multivariate logistic regression to identify predictors of physical and/or sexual partner violence within the past 12 months.

          Results

          Despite wide variations in the prevalence of IPV, many factors affected IPV risk similarly across sites. Secondary education, high SES, and formal marriage offered protection, while alcohol abuse, cohabitation, young age, attitudes supportive of wife beating, having outside sexual partners, experiencing childhood abuse, growing up with domestic violence, and experiencing or perpetrating other forms of violence in adulthood, increased the risk of IPV. The strength of the association was greatest when both the woman and her partner had the risk factor.

          Conclusions

          IPV prevention programs should increase focus on transforming gender norms and attitudes, addressing childhood abuse, and reducing harmful drinking. Development initiatives to improve access to education for girls and boys may also have an important role in violence prevention.

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          Most cited references22

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          Violence against women: an integrated, ecological framework.

          This article encourages the widespread adoption of an integrated, ecological framework for understanding the origins of gender-based violence. An ecological approach to abuse conceptualizes violence as a multifaceted phenomenon grounded in an interplay among personal, situational, and sociocultural factors. Although drawing on the conceptual advances of earlier theorists, this article goes beyond their work in three significant ways. First, it uses the ecological framework as a heuristic tool to organize the existing research base into an intelligible whole. Whereas other theorists present the framework as a way to think about violence, few have attempted to establish what factors emerge as predictive of abuse at each level of the social ecology. Second, this article integrates results from international and cross-cultural research together with findings from North American social science. And finally, the framework draws from findings related to all types of physical and sexual abuse of women to encourage a more integrated approach to theory building regarding gender-based abuse.
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            Multilevel Analysis

            Joop Hox (2002)
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              Intimate partner violence and physical health consequences.

              Domestic violence results in long-term and immediate health problems. This study compared selected physical health problems of abused and never abused women with similar access to health care. A case-control study of enrollees in a multisite metropolitan health maintenance organization sampled 2535 women enrollees aged 21 to 55 years who responded to an invitation to participate; 447 (18%) could not be contacted, 7 (0.3%) were ineligible, and 76 (3%) refused, yielding a sample of 2005. The Abuse Assessment Screen identified women physically and/or sexually abused between January 1, 1989, and December 31, 1997, resulting in 201 cases. The 240 controls were a random sample of never abused women. The general health perceptions subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey measured general health. The Miller Abuse Physical Symptom and Injury Scale measured abuse-specific health problems. Cases and controls differed in ethnicity, marital status, educational level, and income. Direct weights were used to standardize for comparisons. Significance was tested using logistic and negative binomial regressions. Abused women had more (P<.05) headaches, back pain, sexually transmitted diseases, vaginal bleeding, vaginal infections, pelvic pain, painful intercourse, urinary tract infections, appetite loss, abdominal pain, and digestive problems. Abused women also had more (P< or =.001) gynecological, chronic stress-related, central nervous system, and total health problems. Abused women have a 50% to 70% increase in gynecological, central nervous system, and stress-related problems, with women sexually and physically abused most likely to report problems. Routine universal screening and sensitive in-depth assessment of women presenting with frequent gynecological, chronic stress-related, or central nervous system complaints are needed to support disclosure of domestic violence.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2011
                16 February 2011
                : 11
                : 109
                Affiliations
                [1 ]London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
                [2 ]WHO, Avenue Appia 20, 1211 Geneva 27, Switzerland
                [3 ]International Centre for Research on Women, 1120 20thSt NW, Suite 500 North, Washington D.C. 20036, USA
                [4 ]Geneva, Switzerland
                Article
                1471-2458-11-109
                10.1186/1471-2458-11-109
                3049145
                21324186
                22d622a6-a8a9-4c47-a81b-b3c9e2fd197a
                Copyright ©2011 Abramsky et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 October 2010
                : 16 February 2011
                Categories
                Research Article

                Public health
                Public health

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