Intimate partner violence in older South African women: An analysis of the 2016 Demographic and Health Survey.

BACKGROUND: South Africa (SA) has one of the highest rates of intimate partner violence (IPV) in the world. It is also in the midst of a demographic transition in which the number of people aged >60 years is expected to double by mid-century. Despite the confluence of these two public health issues, there are no published studies on the epidemiology and risk factors for IPV in older SA women. OBJECTIVES: To provide a foundational understanding of IPV among women aged ≥50 years in SA. METHODS: This study used the first-ever nationally representative sample of women aged >49 (N=2 265) that includes data on physical, sexual, and emotional IPV. Both lifetime experience of IPV and IPV within the past 12 months were reported, as was the presence of controlling behaviours by the partner. Four multilevel logistic models and one multilevel linear regression model were fit to examine the demographic, developmental and structural correlates of IPV in women aged 50 - 95. RESULTS: The lifetime prevalence rates for all types of IPV were slightly higher among older women than among women aged 15 - 49. Nine percent of respondents reported IPV in the past 12 months, and 35% reported at least one persistent controlling behaviour. Divorced/separated women and those who had witnessed IPV as a child had greater odds of reporting IPV. In contrast to the literature on younger women, education, race and wealth were not strong predictors of IPV in this sample of older women. CONCLUSIONS: This study is the first of its kind in the SA context, and shows that IPV is a persistent threat for women across the lifespan. It suggests that IPV may manifest differently in older women compared with women of reproductive age, necessitating future qualitative and quantitative studies that examine the correlates, causes and points of intervention unique to this growing population.

Facilitating access to adolescent sexual and reproductive health services through legislative reform: Lessons from the South African experience.

South Africa (SA) has progressive legislation enabling adolescents to access various sexual- and reproductive-health services (SRH) independently, without consent from parents or legal guardians. This article reviews the SA legislative framework for adolescent access to SRH interventions. It outlines the five approaches adopted in current legislation to address adolescents' capacity to independently consent to specified health interventions, based on age, capacity and public policy requirements, or combinations thereof. Rather than subsume various health interventions under the umbrella of medical treatment, SA has separately legislated on many SRH interventions (e.g. HIV testing, contraceptives and terminations of pregnancy, among others). We identify strengths and weaknesses of the SA approach, and conclude with lessons learned from the SA experience which could inform discussion and debate on the most appropriate ways for countries to consider law reform that facilitates adolescent access to SRH services.