Prevalence of intimate partner violence and health implications for women using emergency departments and primary care clinics.

OBJECTIVES

To determine prevalence of intimate partner violence (IPV) among women accessing health care, factors that influence rates of abuse, barriers to disclosure, and associated health problems and perceptions of safety.

METHODS

A convenience sample of women seeking health care completed 1268 anonymous surveys (75 in Spanish) while at 1 of 24 urban, suburban, or rural emergency departments or primary care clinics.

RESULTS

Of women in this study, 50-57% had experienced physical and/or emotional abuse and 26% reported sexual abuse in their lifetime. In the past year, 28% reported emotional abuse, 12% physical abuse, 6% severe physical abuse, and 4% sexual abuse. Logistic regression models found that younger, less-educated, less-affluent women presenting to urban emergency departments reported the highest rates of physical abuse. Although 83% welcomed abuse screening, only 25% ever had been asked and 86% would disclose abuse if asked directly, respectfully, and confidentially. Abused women reported significantly lower health status ratings than nonabused women (p < 0.001). Emotional abuse was as strongly associated with health problems as physical abuse. The majority (70-93%) of women with headaches, stomach problems, chronic pain, vaginal bleeding, substance abuse, depression, and suicidal thoughts had experienced lifetime physical/emotional abuse.

CONCLUSIONS

Women experience many forms of abuse and present to a wide range of health care settings. The striking prevalence of IPV and associated emotional/physical health problems challenges providers to routinely assess for abuse in ways that minimize barriers to disclosure and enhance the development of an effective plan of care based on a patient's abuse experience.