Song Yingda, Wang Juan, Wang Jiaxuan, Ren Yan, Ma Jun
Cardiac Center Department, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
Thoracic Surgery Department, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
Front Psychiatry. 2025 Aug 20;16:1515828. doi: 10.3389/fpsyt.2025.1515828. eCollection 2025.
Intimate Partner Violence (IPV) presents a significant global public health issue, particularly affecting women of childbearing age (WBCA). The COVID-19 pandemic has exacerbated the IPV globally. This study aimed to assess the global burden and health inequalities attributable to IPV among WBCA from 1990 to 2021.
We utilized data from the Global Burden of Disease (GBD) 2021 to assess the disease burden attributable to IPV among WBCA, by age group, GBD region, and country, measured using mortality, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR). Joinpoint regression was utilized to examine trends over time. To assess both absolute and relative health disparities, the Slope Index of Inequality (SII) and the Concentration Index were computed.
In 2021, global IPV-related mortality and DALYs among WBCA were 44,661 and 5.35 million, respectively. The IPV-attributable ASDR declined from 292.88 per 100,000 population in 1990 (95% uncertainty interval [UI]: 167.98 to 439.65) to 272.08 per 100,000 population in 2021 (95% UI: 148.65 to 422.82), with average annual percentage change (AAPC) of -0.19 (95% confidence interval [CI]: -0.39 to -0.10). Significant inflection points were identified in the years 2000 and 2019. In 2019, the IPV-attributable ASDR began to rise. This upward trend was primarily driven by IPV-related depressive disorders burden. The IPV-attributable ASMR decreased from 2.61 per 100,000 population in 1990 (95% UI: 1.73 to 3.71) to 2.26 per 100,000 population in 2021 (95% UI: 1.45 to 3.21), with AAPC of -0.46 (95% CI: -0.60 to -0.33). This downward trend was also observed in the burden caused by IPV-related HIV/AIDS and interpersonal violence. In 2021, the highest disease burden attributable to IPV was reported among the 30-34 age group, low and low-middle Socio-Demographic Index (SDI) regions, and Eastern Sub-Saharan Africa. The largest increase in disease burden attributable to IPV occurred in the 40-44 age group, Oceania, and low-middle SDI region. The absolute value of the SII for ASMR increased from 2.04 in 1990 to 4.59 in 2021, while that of the SII for ASDR decreased from 321 in 1990 to 190 in 2021. The relative Concentration Index for ASMR and ASDR dropped from -0.33 and -0.2 in 1990 to -0.46 and -0.26 in 2021, respectively. The worsening of health inequalities was mainly concentrated in low- and middle-income countries (LMICs) and IPV-related HIV/AIDS burden.
Since 1990, the burden attributable to IPV among WBCA has generally declined. However, the COVID-19 pandemic reversed this trend, particularly in IPV-related depressive disorders burden. Health inequalities have worsened, particularly in relation to IPV-related HIV/AIDS burden. Increased attention must be given to eliminating the preventable burden of IPV in LMICs, with coordinated global efforts required to mitigate its health impact.
亲密伴侣暴力（IPV）是一个重大的全球公共卫生问题，尤其影响育龄妇女（WBCA）。新冠疫情加剧了全球范围内的亲密伴侣暴力。本研究旨在评估1990年至2021年全球育龄妇女中亲密伴侣暴力所致的负担及健康不平等情况。
我们利用《2021年全球疾病负担》（GBD 2021）的数据，按年龄组、GBD区域和国家评估育龄妇女中亲密伴侣暴力所致的疾病负担，采用死亡率、伤残调整生命年（DALYs）、年龄标准化死亡率（ASMR）和年龄标准化DALY率（ASDR）进行衡量。采用Joinpoint回归分析随时间的趋势。为评估绝对和相对健康差距，计算了不平等斜率指数（SII）和集中指数。
2021年，全球育龄妇女中与亲密伴侣暴力相关的死亡率和伤残调整生命年分别为44,661例和535万。亲密伴侣暴力所致的年龄标准化DALY率从1990年的每10万人292.88例（95%不确定区间[UI]：167.98至439.65）降至2021年的每10万人272.08例（95% UI：148.65至422.82），平均年变化百分比（AAPC）为-0.19（95%置信区间[CI]：-0.39至-0.10）。在2000年和2019年发现了显著的拐点。2019年，亲密伴侣暴力所致的年龄标准化DALY率开始上升。这一上升趋势主要由与亲密伴侣暴力相关的抑郁症负担推动。亲密伴侣暴力所致的年龄标准化死亡率从1990年的每10万人2.61例（95% UI：1.73至3.71）降至2021年的每10万人2.26例（95% UI：1.45至3.21），AAPC为-0.46（95% CI：-0.60至-0.33）。在与亲密伴侣暴力相关的艾滋病毒/艾滋病和人际暴力造成的负担方面也观察到了这种下降趋势。2021年，30 - 34岁年龄组、社会人口指数（SDI）低和中低的地区以及东撒哈拉以南非洲报告的亲密伴侣暴力所致疾病负担最高。亲密伴侣暴力所致疾病负担增加最多的是40 - 44岁年龄组、大洋洲和中低SDI地区。ASMR的SII绝对值从1990年的2.04增加到2021年的4.59，而ASDR的SII绝对值从1990年的321降至2021年的190。ASMR和ASDR的相对集中指数分别从1990年的-0.33和-0.2降至2021年的-0.46和-0.26。健康不平等的加剧主要集中在低收入和中等收入国家（LMICs）以及与亲密伴侣暴力相关的艾滋病毒/艾滋病负担上。
自1990年以来，育龄妇女中亲密伴侣暴力所致的负担总体呈下降趋势。然而，新冠疫情扭转了这一趋势，特别是在与亲密伴侣暴力相关的抑郁症负担方面。健康不平等加剧，特别是在与亲密伴侣暴力相关的艾滋病毒/艾滋病负担方面。必须更加关注消除低收入和中等收入国家中亲密伴侣暴力可预防的负担，需要全球共同努力减轻其对健康的影响。
