Intimate partner violence and sexually transmitted disease symptoms in a national sample of married Bangladeshi women

ArticleinInternational Journal of Gynecology & Obstetrics 100(1):18-23 · February 2008with6 Reads
DOI: 10.1016/j.ijgo.2007.06.045 · Source: PubMed
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.
    • "Intimate partner violence (IPV), here defined as physical abuse, is a complex global problem, not only because it is a human rights issue, but also because it is associated with chronic mental [1, 2] and physical34567 illnesses as well as proximate, acute health effects related to injuries for women [1, 8] and their children [5, 9, 10] . The proportion of partnered women who have ever experienced IPV varies widely across the developing world; with reported rates as low as 12 % in Haiti to as high as 71 % in Bangladesh [11], although differences in these rates may be the result of willingness to report. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Intimate partner violence (IPV) is a complex global problem, not only because it is a human rights issue, but also because it is associated with chronic mental and physical illnesses as well as acute health outcomes related to injuries for women and their children. Attitudes, beliefs, and norms regarding IPV are significantly associated with the likelihood of both IPV experience and perpetration. Methods We investigated whether IPV acceptance is correlated across socially connected individuals, whether these correlations differ across types of relationships, and whether social position is associated with the likelihood of accepting IPV. We used sociocentric network data from 831 individuals in rural Honduras to assess the association of IPV acceptance between socially connected individuals across 15 different types of relationships, both within and between households. We also investigated the association between network position and IPV acceptance. Results We found that having a social contact that accepts IPV is strongly associated with IPV acceptance among individuals. For women the clustering of IPV acceptance was not significant in between-household relationships, but was concentrated within households. For men, however, while IPV acceptance was strongly clustered within households, men’s acceptance of IPV was also correlated with people with whom they regularly converse, their mothers and their siblings, regardless of household. We also found that IPV was more likely to be accepted by less socially-central individuals, and that the correlation between a social contact’s IPV acceptance was stronger on the periphery, suggesting that, as a norm, it is held on the periphery of the community. Conclusion Our results show that differential targeting of individuals and relationships in order to reduce the acceptability and, subsequently, the prevalence of IPV may be most effective. Because IPV norms seem to be strongly held within households, the household is probably the most logical unit to target in order to implement change. This approach would include the possible benefit of a generational effect. Finally, in social contexts in which perpetration of IPV is not socially acceptable, the most effective strategy may be to implement change not at the center but at the periphery of the community. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2893-4) contains supplementary material, which is available to authorized users.
    Full-text · Article · Dec 2016
    • "Many married women feel that they cannot refuse to have sex with their husbands if their husbands have sexually transmitted infections (STIs; Jesmin & Cready, 2014 ). In a nationally representative sample of Bangladeshi married women, Decker et al. (2008) found that 38% women experienced some form of violence in the 12 months preceding the survey. Twenty percent of them experienced physical violence, 9.7% experienced sexual violence , and 8.4% experienced both sexual and physical violence. "
    [Show abstract] [Hide abstract] ABSTRACT: One-third of the women worldwide experience intimate partner violence (IPV) that increases their vulnerability to both short- and long-term physical, sexual, reproductive, and mental health problems. Surprisingly, IPV is justified by many women globally. Although the IPV literature to date is mostly focused on risk factors associated with actual occurrences, little is known on attitudinal acceptance of such violence. Also, despite the growing scholarship of community influence and health link, IPV research has relatively overlooked the effects of norms at the community level. Using a representative national sample of 13,611 married women in Bangladesh, this study examined the association of community attitudes and women's individual attitudes toward wife beating. The results revealed that women living in communities with permissive attitudes toward wife beating were more likely to justify husbands' beating (OR = 4.5). Women married at a younger age, who had less than primary-level education, lived in households categorized as poor or middle class, and did not consume media appeared to be at higher risk for justifying wife beating. This research adds to a growing research body on community influences on health by examining IPV attitudes and community norms link.
    Article · Oct 2015
    • "The adoption of effective and concrete measures to combat domestic and sexual violence against women, sensitization of society as a whole on these issues, prosecution of perpetrators, and provision of assistance and protection to victims are some of the measures proposed. The importance of women's protection and empowerment is premised on consistent findings from prior studies and the current study, which show that violence, particularly physical abuse, makes women susceptible to HIV infection and other STDs (Abuya et al., 2012; Decker et al., 2008; Dunkle et al., 2004; Fonck et al., 2005; Jewkes et al., 2003; Maman et al., 2002; Martin & Curtis, 2004; Silverman et al., 2008; van der Straten et al., 1998). Our study argues strongly for the immediate implementation of the proposals in the Sexual Offences Act of 2006. "
    [Show abstract] [Hide abstract] ABSTRACT: The prevalence of both domestic violence (DV) and HIV among Kenyan women is known to be high, but the relationship between them is unknown. Nationally representative cross-sectional data from married and formerly married (MFM) women responding to the Kenya Demographic and Health Survey 2008/2009 were analyzed adjusting for complex survey design. Multivariable logistic regressions were used to assess the covariate-adjusted associations between HIV serostatus and any reported DV as well as four constituent DV measures: physical, emotional, sexual, and aggravated bodily harm, adjusting for co-variates entered into each model using a forward stepwise selection process. Co-variates of a priori interest included those representing marriage history, risky sexual behavior, substance use, perceived HIV risk, and socio-demographic characteristics. The prevalence of HIV among MFM women was 10.7% (any DV: 13.1%, no DV: 8.6%); overall prevalence of DV was 43.4%. Among all DV measures, only physical DV was associated with HIV (11.9%; adjusted odds ratio: 2.01, p < 0.05). Efforts by the government and women's groups to monitor and improve policies to reduce DV, such as the Sexual Offences Act of 2006, are urgently needed to curb HIV, as are policies that seek to provide DV counseling and treatment to MFM women.
    Full-text · Article · Feb 2015
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