Chen Grace L, Silverman Jay G, Dixit Anvita, Begum Shahina, Ghule Mohan, Battala Madhusudana, Johns Nicole E, Raj Anita, Averbach Sarah
University of California San Diego School of Medicine, 9500 Gilman Drive #0606, La Jolla, CA 92093, United States.
Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive #0507, La Jolla, CA, 92093, United States.
EClinicalMedicine. 2020 Apr 18;21:100318. doi: 10.1016/j.eclinm.2020.100318. eCollection 2020 Apr.
Intimate partner violence (IPV) has been shown to be associated differentially with contraceptive use based on type, with IPV more likely among pill users and less likely among condom users. Recent increases in IUD uptake allow consideration of this type of contraceptive. We assessed the association between self-reported IPV and self-reported contraceptive use, by type, among non-pregnant married women in rural India in a region with higher than average IUD use.
We assessed the association between past 12-month IPV (physical, sexual, or any) and past 3-month contraceptive use (condom, pill, IUD, or any modern method) using crude and adjusted multinomial logistic regression models.
Among the 1001 women included, 109 (10·9%) reported experiencing physical IPV and 27 (2·7%) reported experiencing sexual IPV in the past 12 months. Women experiencing physical IPV were significantly less likely to use condoms (adjusted relative risk ratio [RRR]: 0·54, 95% confidence interval [CI]: 0·30-0·98, = 0·042) than women not experiencing violence. There was a trend towards increased IUD use among women experiencing physical IPV (adjusted RRR: 1·78, 95% CI: 0·91-3·41, = 0·091) compared to those not experiencing physical IPV, but this did not reach statistical significance.
Our findings suggest that women who experience physical IPV in India are less likely to use condoms and may be more likely to use IUDs than women without exposure to IPV. This research expands on prior findings suggesting higher uptake of women-controlled contraceptives among women contending with IPV in India.
亲密伴侣暴力（IPV）已被证明根据避孕方式的不同与避孕措施的使用存在差异关联，使用避孕药的人群遭受IPV的可能性更大，而使用避孕套的人群遭受IPV的可能性较小。近期宫内节育器（IUD）的使用增加，使得对这类避孕方式的考虑成为可能。我们在印度农村地区一个宫内节育器使用高于平均水平的地区，评估了非怀孕已婚妇女中自我报告的IPV与自我报告的不同类型避孕措施使用之间的关联。
我们使用粗率和调整后的多项逻辑回归模型，评估过去12个月的IPV（身体暴力、性暴力或任何一种）与过去3个月的避孕措施使用（避孕套、避孕药、宫内节育器或任何现代避孕方法）之间的关联。
在纳入的1001名妇女中，109名（10.9%）报告在过去12个月中遭受过身体暴力，27名（2.7%）报告遭受过性暴力。遭受身体暴力的妇女使用避孕套的可能性显著低于未遭受暴力的妇女（调整后的相对风险比[RRR]：0.54，95%置信区间[CI]：0.30 - 0.98，P = 0.042）。与未遭受身体暴力的妇女相比，遭受身体暴力的妇女使用宫内节育器的比例有增加的趋势（调整后的RRR：1.78，95% CI：0.91 - 3.41，P = 0.091），但未达到统计学显著性。
我们的研究结果表明，在印度，遭受身体暴力的妇女使用避孕套可能性较小，且与未遭受IPV的妇女相比，使用宫内节育器的可能性可能更大。这项研究扩展了先前的研究结果，表明在印度应对IPV的妇女中，对女性可控避孕措施的采用率更高。
