Intimate partner violence and sexually transmitted disease symptoms in a national sample of married Bangladeshi women
ABSTRACT To assess associations of intimate partner violence (IPV) with women's sexually transmitted disease (STD) symptoms, and to clarify biological and behavioral mechanisms underpinning heightened STD rates among abused women.
A cross-sectional investigation of married couples (n=2865) sampled via the Bangladesh Demographic Health Survey.
Over one third (38%) of married Bangladeshi women experienced physical or sexual IPV in the 12 months preceding the survey. Victimization was bivariately associated with vaginal irritation/discharge, pelvic pain during intercourse, genital sores/ulcers, and vaginal discharge with odor (OR 1.39-2.09). IPV demonstrated an independent effect on vaginal irritation with discharge (adjusted OR 1.34) and vaginal discharge with odor (adjusted OR 2.08) after accounting for STD exposure (i.e., husbands' recent STD).
IPV elevates married Bangladeshi women's STD symptoms beyond the risk represented by husbands' STD alone, suggesting that high rates of STD among abusive men and the context of violence itself both relate to abused women's STD risk.
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ABSTRACT: The notion of preconception care aims to target the existing risks before pregnancy, whereby resources may be used to improve reproductive health and optimize knowledge before conceiving. The preconception period provides an opportunity to intervene earlier to optimize the health of potential mothers (and fathers) and to prevent harmful exposures from affecting the developing fetus. These interventions include birth spacing and preventing teenage pregnancy, promotion of contraceptive use, optimization of weight and micronutrient status, prevention and management of infectious diseases, and screening for and managing chronic conditions. Given existing interventions and the need to organize services to optimize delivery of care in a logical and effective manner, interventions are frequently co-packaged or bundled together. This paper highlights packages of preconception interventions that can be combined and co-delivered to women through various delivery channels and provides a logical framework for development of such packages in varying contexts.Reproductive Health 09/2014; 11 Suppl 3:S7. DOI:10.1186/1742-4755-11-S3-S7 · 1.62 Impact Factor
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ABSTRACT: Background While the majority of research in Bangladesh has focused on intimate partner violence (IPV) against women, less is known about the correlates of physical violence against unmarried female adolescents, particularly community-level characteristics that may increase their risk of experiencing violence. Methods We used multilevel logistic regression analysis to assess the variability in physical violence against unmarried female adolescents at the community level and to explore the role of community-level characteristics in explaining this variability. The data for this analysis were taken from a 2005 nationally representative survey of 20,000 adolescents aged 10 to 24 living in Bangladesh. Data from 4,370 unmarried female adolescents were included in the final model. Results Communities in Bangladesh have, on average, high levels of physical violence against unmarried female adolescents, and these levels vary widely across communities. Community-level acceptance of physical punishment against adolescents was related to unmarried female adolescents’ risk of experiencing physical violence. Conclusions It is important to find and target communities in which unmarried adolescent girls are at higher risk of experiencing physical violence. Programs and policies must focus specifically on changing attitudes regarding treatment of women and girls. As these attitudes accepting of physical violence are found in adolescents aged 10 to 19, school and community-based programs should particularly target this age group.BMC Public Health 10/2014; 14(1):1027. DOI:10.1186/1471-2458-14-1027 · 2.32 Impact Factor
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ABSTRACT: A large proportion of women around the world suffer from chronic diseases including mental health diseases. In the United States alone, over 12% of women of reproductive age suffer from a chronic medical condition, especially diabetes and hypertension. Chronic diseases significantly increase the odds for poor maternal and newborn outcomes in pregnant women. A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for preventing and managing chronic diseases and promoting psychological health on maternal, newborn and child health outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. Maternal prepregnancy diabetic care is a significant intervention that reduces the occurrence of congenital malformations by 70% (95% Confidence Interval (CI): 59-78%) and perinatal mortality by 69% (95% CI: 47-81%). Furthermore, preconception management of epilepsy and phenylketonuria are essential and can optimize maternal, fetal and neonatal outcomes if given before conception. Ideally changes in antiepileptic drug therapy should be made at least 6 months before planned conception. Interventions specifically targeting women of reproductive age suffering from a psychiatric condition show that group-counseling and interventions leading to empowerment of women have reported non-significant reduction in depression (economic skill building: Mean Difference (MD) -7.53; 95% CI: -17.24, 2.18; counseling: MD-2.92; 95% CI: -13.17, 7.33). While prevention and management of the chronic diseases like diabetes and hypertension, through counseling, and other dietary and pharmacological intervention, is important, delivering solutions to prevent and respond to women's psychological health problems are urgently needed to combat this leading cause of morbidity.Reproductive Health 09/2014; 11 Suppl 3:S5. DOI:10.1186/1742-4755-11-S3-S5 · 1.62 Impact Factor