Delkhosh Marjan, Ardalan Ali, Rahimiforoushani Abbas, Salehpoor-Emran Mohammad, Merghati-Khoei Effat
Department of Community Health & Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Department of health in Emergency and Disaster, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2025 May 16;25(1):1803. doi: 10.1186/s12889-024-21239-5.
Partner violence suffered by refugee women is a topic of debate. Symptoms of sexually transmitted infections (STIs) and reproductive tract infections (RTIs) may be a consequence of this violence. This study aimed to determine the possible associations between partner violence and the appearance of symptoms of STIs/RTIs among Afghan women in Iran.
This cross-sectional population-based household survey was conducted with 188 reproductive-age Afghan refugee women residing in a refugee settlement in a selected city of Iran in 2016-17. Data were collected using four self-report instruments: A Socio-demographic characteristics form, the Assessment of Intimate Partner Violence, Women's self-reported STIs/RTIs-associated symptoms, and the Multi-Country Study on Women's Health and Domestic Violence against Women. The SPSS software version 22 was used for data analysis and comparisons between variables, and the significance level was established at P < 0.05. Also, the bivariate logistic regression model evaluated odds ratios (OR) with a 95% confidence interval (CI).
Most women reported at least one symptom related to STIs/RTIs (70.7%) during the last year. 'No condom use' (P = 0.015) (OR = 3.25; 95% CI = 1.26-8.39) and 'having unusual sex' (P = 0.009) (OR = 3.75; 95% CI = 1.26-15.49) were found to be a statistically related significant relationship with the reported STIs/RTIs-associated symptoms. Most women (66.9%) neither sought help for their STI/RTI symptoms by healthcare nor received treatment. IPV was positively associated with STIs/RTIs-associated symptoms (P < 0.001), having a history of STIs/RTIs diagnosis (P < 0.001), and experiencing at least one of the most specific STIs/RTIs-associated symptoms (vaginal discharge and genital ulcers) (P < 0.001). Women who had experienced any STIs/RTIs-associated symptoms experienced more sexual abuse from their spouses compared to women without any history of STIs/RTIs-reported symptoms (P < 0.001).
Based on the results, self-perception of the presence of STIs/RTIs-associated symptoms among the Afghan refugee population is considerable. Moreover, the high prevalence of IPV and its strong links with the self-perception of the presence of STIs/RTIs-associated symptoms underline the urgent need for developing, testing, and implementing appropriate and timely interventions for managing STIs/RTIs and IPV simultaneously in refugee camps/settlements to tackle both violence and STIs/RTIs among refugee couples.
难民妇女遭受的伴侣暴力是一个备受争议的话题。性传播感染（STIs）和生殖道感染（RTIs）的症状可能是这种暴力行为的后果。本研究旨在确定伊朗阿富汗妇女中伴侣暴力与STIs/RTIs症状出现之间的可能关联。
2016 - 17年，对居住在伊朗某选定城市一个难民定居点的188名育龄阿富汗难民妇女进行了这项基于人群的横断面家庭调查。使用四种自我报告工具收集数据：一份社会人口学特征表格、亲密伴侣暴力评估、妇女自我报告的与STIs/RTIs相关的症状，以及妇女健康与针对妇女的家庭暴力多国研究。使用SPSS软件22版进行数据分析和变量间比较，显著性水平设定为P < 0.05。此外，双变量逻辑回归模型评估了具有95%置信区间（CI）的比值比（OR）。
大多数妇女报告在过去一年中至少出现一种与STIs/RTIs相关的症状（70.7%）。“未使用避孕套”（P = 0.015）（OR = 3.25；95% CI = 1.26 - 8.39）和“进行异常性行为”（P = 0.009）（OR = 3.75；95% CI = 1.26 - 15.49）被发现与报告的STIs/RTIs相关症状存在统计学上的显著关联。大多数妇女（66.9%）既没有因STI/RTI症状寻求医疗帮助，也没有接受治疗。亲密伴侣暴力与STIs/RTIs相关症状呈正相关（P < 0.001），有STIs/RTIs诊断史（P < 0.001），以及经历至少一种最具特异性的STIs/RTIs相关症状（阴道分泌物和生殖器溃疡）（P < 0.001）。与没有任何STIs/RTIs报告症状史的妇女相比，经历过任何STIs/RTIs相关症状的妇女遭受配偶性虐待的情况更多（P < 0.001）。
基于研究结果，阿富汗难民人群中对STIs/RTIs相关症状存在情况的自我认知程度较高。此外，亲密伴侣暴力的高发生率及其与STIs/RTIs相关症状存在情况的自我认知之间的紧密联系，凸显了迫切需要在难民营/定居点同时制定、测试和实施适当且及时的干预措施，以同时应对STIs/RTIs和亲密伴侣暴力问题，解决难民夫妇中的暴力行为和STIs/RTIs问题。
