Greene M Claire, Heise Lori, Musci Rashelle J, Wirtz Andrea L, Johnson Renee, Leoutsakos Jeannie-Marie, Wainberg Milton L, Tol Wietse A
Psychiatry, Columbia University, New York, New York, USA
Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Inj Prev. 2020 May 5. doi: 10.1136/injuryprev-2019-043433.
Alcohol use is a consistent correlate of intimate partner violence (IPV) in low-income and middle-income countries (LMICs). However, the magnitude of this association differs across studies, which may be due to contextual and methodological factors. This study aims to estimate and explore sources of heterogeneity in the association between alcohol use and IPV in 28 LMICs (n=109 700 couples).
In nationally representative surveys, partnered women reported on IPV victimisation and male partner's alcohol use. We estimated the relationship between alcohol use and IPV using logistic regression and full propensity score matching to account for confounding. Country-specific ORs were combined using a random-effects model. Country-level indicators of health and development were regressed on ORs to examine sources of variability in these estimates.
Partner alcohol use was associated with a 2.55-fold increase in the odds of past-year IPV victimisation (95% CI 2.27 to 2.86) with substantial variability between regions (I=70.0%). Countries with a low (<50%) prevalence of past-year alcohol use among men displayed larger associations between alcohol use and IPV. Exploratory analyses revealed that colonisation history, religion, female literacy levels and substance use treatment availability may explain some of the remaining heterogeneity observed in the strength of the association between alcohol use and IPV across countries.
Partner alcohol use is associated with increased odds of IPV victimisation in LMICs, but to varying degrees across countries. Prevalences of male alcohol use and cultural factors were related to heterogeneity in these estimates between countries.
在低收入和中等收入国家（LMICs），饮酒是亲密伴侣暴力（IPV）的一个持续相关因素。然而，不同研究中这种关联的程度有所不同，这可能是由于背景和方法学因素所致。本研究旨在估计并探索28个低收入和中等收入国家（n = 109 700对夫妇）中饮酒与亲密伴侣暴力之间关联的异质性来源。
在具有全国代表性的调查中，有伴侣的女性报告亲密伴侣暴力受害情况以及男性伴侣的饮酒情况。我们使用逻辑回归和完全倾向得分匹配来估计饮酒与亲密伴侣暴力之间的关系，以控制混杂因素。使用随机效应模型合并各国的比值比（OR）。将国家层面的健康和发展指标对OR进行回归分析，以检验这些估计值变异性的来源。
伴侣饮酒与过去一年亲密伴侣暴力受害几率增加2.55倍相关（95%置信区间2.27至2.86），各地区之间存在很大差异（I = 70.0%）。男性过去一年饮酒患病率低（<50%）的国家，饮酒与亲密伴侣暴力之间的关联更大。探索性分析表明，殖民历史、宗教、女性识字水平和物质使用治疗可及性可能解释了各国饮酒与亲密伴侣暴力之间关联强度中观察到的一些剩余异质性。
在低收入和中等收入国家，伴侣饮酒与亲密伴侣暴力受害几率增加相关，但各国程度不同。男性饮酒患病率和文化因素与各国这些估计值的异质性有关。
