Fonseka Ruvani W, McDougal Lotus, Raj Anita, Reed Elizabeth, Lundgren Rebecka, Urada Lianne, Silverman Jay G
Center on Gender Equity and Health (GEH), University of California San Diego School of Medicine, La Jolla, CA, USA.
Joint Doctoral Program in Public Health, San Diego State University and University of California San Diego, San Diego, CA, USA.
Confl Health. 2022 Feb 14;16(1):5. doi: 10.1186/s13031-022-00436-2.
Studies from many contexts indicate that proximity to conflict is associated with increased likelihood of intimate partner violence (IPV), and girl child marriage is associated with both proximity to conflict and increased IPV. In this study, we consider whether girl child marriage acts as a mediator of the association between proximity to conflict and IPV in the context of Sri Lanka, which sustained long-term conflict until 2009.
We analyzed responses of currently partnered women between ages 18 and 49 in the 2016 Sri Lankan Demographic and Health Survey (N = 13,691). Using logistic regression analyses, we measured associations between proximity to conflict (residence in districts which were central, proximal, or distal to the regions where the war occurred) and the outcomes of IPV and girl child marriage, and secondarily assessed girl child marriage as a possible mediator of the association between proximity to conflict and past year IPV.
Women residing in districts central to conflict, as compared to districts distal to conflict, had increased odds of past year sexual, physical, and emotional IPV, with the odds of sexual IPV increasing the most (adjusted odds ratio/aOR 4.19, 95% confidence interval/CI 2.08-8.41). Residing in districts proximal to conflict compared to those distal to conflict was associated with lower odds of past year physical and emotional IPV, with the greatest decrease in emotional IPV (aOR 0.31, CI 0.18-0.54). Girl child marriage was more likely in districts central to conflict as opposed to those distal to conflict (aOR 1.89, CI 1.22-2.93), and partially mediated the relationship between centrality to conflict and IPV.
Our findings demonstrate that residing in districts central to conflict compared to those distal to conflict is associated with greater odds of IPV and girl child marriage in post-conflict Sri Lanka, with girl child marriage partially mediating the association between centrality to conflict and IPV. Residence in districts proximal to conflict appears protective against IPV. Future research should investigate what factors are responsible for decreased IPV in districts proximal to violence, and whether these factors can be reproduced to mitigate the increased prevalence of IPV in districts central to conflict.
来自许多地区的研究表明，靠近冲突地区与亲密伴侣暴力（IPV）发生可能性增加有关，童婚则与靠近冲突地区以及IPV增加都有关联。在本研究中，我们探讨在2009年才结束长期冲突的斯里兰卡，童婚是否在靠近冲突地区与IPV之间的关联中起到中介作用。
我们分析了2016年斯里兰卡人口与健康调查中年龄在18至49岁之间、目前处于伴侣关系中的女性的回答（N = 13,691）。通过逻辑回归分析，我们测量了靠近冲突地区（居住在战争发生地区的中心、附近或偏远地区）与IPV及童婚结果之间的关联，并进一步评估童婚是否可能是靠近冲突地区与过去一年IPV之间关联的中介因素。
与居住在远离冲突地区的女性相比，居住在冲突中心地区的女性过去一年遭受性、身体和情感IPV的几率增加，其中性IPV的几率增加最多（调整后的优势比/aOR为4.19，95%置信区间/CI为2.08 - 8.41）。与居住在远离冲突地区的女性相比，居住在靠近冲突地区的女性过去一年遭受身体和情感IPV的几率较低，情感IPV的下降幅度最大（aOR为0.31，CI为0.18 - 0.54）。与远离冲突地区相比，冲突中心地区童婚的可能性更大（aOR为1.89，CI为1.22 - 2.93），并且部分介导了冲突中心地区与IPV之间的关系。
我们的研究结果表明，在冲突后的斯里兰卡，与居住在远离冲突地区的女性相比，居住在冲突中心地区的女性遭受IPV和童婚的几率更高，童婚部分介导了冲突中心地区与IPV之间的关联。居住在靠近冲突地区似乎对IPV有保护作用。未来的研究应调查哪些因素导致靠近暴力地区的IPV减少，以及这些因素是否可以被复制以减轻冲突中心地区IPV患病率的上升。
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