Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 35, Number 2, March/April 2003
DIGEST

Women Have Different Risk Factors for Verbal, Physical Partner Abuse

Women who are physically abused by their partners and women who are verbally abused have different profiles, suggesting differing risk factors for these two types of violence.1 Of women surveyed at two family planning clinics in Texas, 43% and 73% reported physical and verbal partner abuse, respectively. Most women reporting physical assault also reported verbal abuse (95%), and the two forms of violence were strongly correlated with each other. A woman's employment status, age at first intercourse and at first birth, and contraceptive use at last intercourse were associated with both types of abuse. However, some factors--race or ethnicity, previous childbearing, education and lifetime history of sexual abuse--were linked with only physical abuse.

To examine characteristics associated with victimization of women by their male partners, researchers recruited sexually active women who visited either of two community-based family planning clinics in Galveston, Texas, between April 1997 and January 1998. Participants were aged 14-26, had a current partner or spouse, were not pregnant or postpartum and were not mentally impaired. The self-administered questionnaire asked about women's demographic and reproductive background, as well as frequency of physical and verbal abuse in the current relationship, partner's age and the duration of the relationship. Physical abuse was defined as physically aggressive threats or behaviors (e.g., pushing, slapping, choking or punching), and verbal abuse was defined as critical or insulting behavior.

Of the 727 women who completed the questionnaire, 61% were 19-26 and the remainder were 14-18; mean ages of partners of women in these two age-groups were 25 and 20, respectively. Respondents were distributed about equally among three racial and ethnic groups: white, black and Mexican American. Roughly one-half of respondents had been in their current relationship for more than one year, and three in 10 had been involved with their partner for 1-6 months.

Some 43% and 73% of respondents indicated that they had experienced physical and verbal abuse, respectively; they reported, on average, that three episodes of physical aggression and nine of verbal abuse had occurred during their current relationship. Furthermore, 16% of respondents reported at least one case of severe physical abuse (i.e., they had been choked, strangled, punched or threatened with a knife or gun). Women who had been physically abused were significantly more likely than those who had not to have experienced verbal abuse (95% vs. 5%). In addition, an analysis of reported frequencies of abuse showed that the two types of violence were strongly correlated with each other (r=.7).

Chi-square analyses revealed that women who had been physically attacked were more likely than those who had not to be younger than 19, marginally less likely to be white or have at least a high school diploma and marginally more likely to have had at least one child. On average, they were younger at first intercourse (15.0 vs. 15.7 years) and at first birth (17.2 vs. 18.0); they were less likely to have used a condom, hormonal contraceptive or both at last intercourse and to have used a condom consistently in the previous year. Compared with women who had not been verbally victimized, those who had were significantly younger at first sex (15.2 vs. 15.8) and at first birth (17.5 vs. 17.9); they also were marginally less likely to have used condoms consistently in the previous year. Respondents who reported either form of abuse were more likely than those who did not to have a lifetime history of sexual abuse and to have been in their current relationship for more than six months.

The researchers used multivariate logistic regression analysis to determine which demographic and reproductive characteristics were independently associated with physical and verbal abuse. They entered into the model only factors that were at least marginally related to partner violence (i.e., at p<.10) in the chi-square tests, plus employment status (as a control for possible confounding of ethnicity and income). After adjustment for relationship length, these analyses showed that the odds of having encountered physical and verbal abuse were elevated among women who were employed (odds ratios, 1.6 and 1.4, respectively) and among those who had ever been sexually abused (2.2 for each). In contrast, the likelihood of partner violence was reduced among women who were older at first intercourse (odds ratio, 0.9 for either form of abuse) or at first birth (0.9) and among women who had used hormonal contraceptives (0.5), condoms (0.5-0.6) or both (0.4) at last intercourse. Additionally, the odds of physical assault were elevated among Mexican Americans and blacks (2.4-3.0) and women who had previously given birth (4.0), whereas odds were reduced among respondents who had at least a high school diploma (0.5-0.6).

Noting that partner violence is the main cause of serious injury among women aged 16-24, the investigators suggest that verbal abuse precedes or accompanies physical abuse and that limited education, early sexual debut, early motherhood and contraceptive nonuse at last sex predict physical violence. Despite three limitations of their study--the assessment of only male-inflicted violence and of only current relationships, and the nongeneralizability of the findings because of the low socioeconomic level of women recruited--the researchers conclude that "commonly collected demographic and reproductive health characteristics may assist the gynecologist to tailor his or her individual screening methods [for intimate partner violence]." Furthermore, they recommend that all women, including adolescents, be screened for both physical and verbal abuse.--T. Lane

REFERENCE

1. Rickert VI et al., The relationship among demographics, reproductive characteristics, and intimate partner violence, American Journal of Obstetrics and Gynecology, 2002, 187(4):1002-1007.