Institut de Recherche interdisciplinaire sur les Enjeux Sociaux (IRIS), UMR 8156-997, CNRS U997 Inserm EHESS UFR SMBH, Université Sorbonne Paris Nord, 93300 Aubervilliers, France; UFR SMBH, Université Sorbonne Paris Nord, 93100 Bobigny, France; Direction de la protection maternelle et infantile et promotion de la santé, Conseil départemental du Val-de-Marne, 94000 Créteil, France.
Direction de la protection maternelle et infantile et promotion de la santé, Conseil départemental du Val-de-Marne, 94000 Créteil, France.
Eur J Obstet Gynecol Reprod Biol. 2024 Dec;303:22-27. doi: 10.1016/j.ejogrb.2024.10.016. Epub 2024 Oct 9.
The aim of this study was to determine the prevalence of domestic and sexual violence and to characterize the association between exposure to domestic and sexual violence and low uptake of gynecological care, in the context of induced abortion.
We conducted a case-control study among women seeking abortion care, in mother and child centers and sexual health centers in the Paris, France area (April 2022-March 2023).
A total of 103 women were included in the study during induced abortion care. Physical, psychological or sexual domestic violence was reported by 48.5 % and sexual violence, whoever the perpetrator, was reported by 23.3 %. In the bivariate analysis, a history of physical, psychological or sexual domestic violence was not associated with the absence of a gynecological consultation in the past two years, compared with no history of intimate partner violence (p = 0.09). After adjustment for regular pelvic pain, dysmenorrhea, vulvodynia and dyspareunia, there was no association between a history of sexual violence and the absence of a gynecological consultation in the past two years (OR 1.05; CI95% 0.27-4.13, p = 0.93).
Violence was a common finding among women seeking abortion care. We did not find any association between a history of sexual violence and the absence of a gynecological consultation in the past two years. We suggest investigating multiple or frequent use of gynecological care following violence. The combination of ethical, moral, and psychological constraints associated with violence screening and abortion care is a challenge to patient recruitment in future studies.
本研究旨在确定家庭暴力和性暴力的流行情况，并在人工流产背景下，分析遭受家庭暴力和性暴力与接受妇科保健服务率低之间的关系。
我们在法国巴黎地区的母婴中心和性健康中心进行了一项病例对照研究，纳入了正在寻求人工流产的女性（2022 年 4 月至 2023 年 3 月）。
在人工流产期间，共有 103 名女性参与了这项研究。48.5%的女性报告曾遭受过身体、心理或性方面的家庭暴力，23.3%的女性报告曾遭受过任何施暴者实施的性暴力。在单因素分析中，与无亲密伴侣暴力史相比，有身体、心理或性方面的家庭暴力史与过去两年内未进行妇科咨询之间并无关联（p=0.09）。在校正了常规盆腔疼痛、痛经、外阴痛和性交困难后，性暴力史与过去两年内未进行妇科咨询之间也无关联（OR 1.05；95%CI95% 0.27-4.13，p=0.93）。
暴力是寻求人工流产的女性中常见的问题。我们没有发现性暴力史与过去两年内未进行妇科咨询之间存在关联。我们建议调查在遭受暴力后是否存在多次或频繁使用妇科保健服务的情况。在未来的研究中，与暴力筛查和流产护理相关的伦理、道德和心理限制的结合，对患者招募构成了挑战。
