Measuring attitudes about intimate partner violence against women: the ATT-IPV scale.

In lower-income settings, women more often than men justify intimate partner violence (IPV). Yet, the role of measurement invariance across gender is unstudied. We developed the ATT-IPV scale to measure attitudes about physical violence against wives in 1,055 married men and women ages 18-50 in My Hao district, Vietnam. Across 10 items about transgressions of the wife, women more often than men agreed that a man had good reason to hit his wife (3 % to 92 %; 0 % to 67 %). In random split-half samples, one-factor exploratory factor analysis (EFA) (N 1 = 527) and confirmatory factor analysis (CFA) (N 2 = 528) models for nine items with sufficient variability had significant loadings (0.575-0.883; 0.502-0.897) and good fit (RMSEA = 0.068, 0.048; CFI = 0.951, 0.978, TLI = 0.935, 0.970). Three items had significant uniform differential item functioning (DIF) by gender, and adjustment for DIF revealed that measurement noninvariance was partially masking men's lower propensity than women to justify IPV. A CFA model for the six items without DIF had excellent fit (RMSEA = 0.019, CFI = 0.994, TLI = 0.991) and an attitudinal gender gap similar to the DIF-adjusted nine-item model, suggesting that the six-item scale reliably measures attitudes about IPV across gender. Researchers should validate the scale in urban Vietnam and elsewhere and decompose DIF-adjusted gender attitudinal gaps.

Violence in childhood, attitudes about partner violence, and partner violence perpetration among men in Vietnam.

PURPOSE: We assess the association of men's exposure to violence in childhood-witnessing physical violence against one's mother and being hit or beaten by a parent or adult relative-with their attitudes about intimate partner violence (IPV) against women. We explore whether men's perpetration of IPV mediates this relationship and whether men's attitudes about IPV mediate any relationship of exposure to violence in childhood with perpetration of IPV. METHODS: Five hundred twenty-two married men 18-51 years in Vietnam were interviewed. Multivariate regressions for ordinal and binary responses were estimated to assess these relationships. RESULTS: Compared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of reporting more reasons to hit a wife (aOR, 1.43; 95% CI, 1.03-2.00 and aOR, 1.66; 95% CI, 1.05-2.64, respectively). Men's lifetime perpetration of IPV accounted fully for these associations. Compared with men experiencing neither form of violence in childhood, men experiencing either or both had higher adjusted odds of ever perpetrating IPV (aOR, 3.28; 95% CI, 2.15-4.99 and aOR, 4.56; 95% CI, 2.90-7.17, respectively). Attitudes about IPV modestly attenuated these associations. CONCLUSIONS: Addressing violence in childhood is needed to change men's risk of perpetrating IPV and greater subsequent justification of it.

Measuring attitudes about women's recourse after exposure to intimate partner violence: the ATT-RECOURSE scale.

Attitudes about intimate partner violence (IPV) against women are widely surveyed, but attitudes about women's recourse after exposure to IPV are understudied, despite their importance for intervention. Designed through qualitative research and administered in a probability sample of 1,054 married men and women 18 to 50 years in My Hao District, Vietnam, the ATT-RECOURSE scale measures men's and women's attitudes about a wife's recourse after exposure to physical IPV. Data were initially collected for nine items. Exploratory factor analysis (EFA) with one random split-half sample (N 1 = 526) revealed a one-factor model with significant loadings (0.316-0.686) for six items capturing a wife's silence, informal recourse, and formal recourse. A confirmatory factor analysis (CFA) with the other random split-half sample (N 2 = 528) showed adequate fit for the six-item model and significant factor loadings of similar magnitude to the EFA results (0.412-0.669). For the six items retained, men consistently favored recourse more often than did women (52.4%-66.0% of men vs. 41.9%-55.2% of women). Tests for uniform differential item functioning (DIF) by gender revealed one item with significant uniform DIF, and adjusting for this revealed an even larger gap in men's and women's attitudes, with men favoring recourse, on average, more than women. The six-item ATT-RECOURSE scale is reliable across independent samples and exhibits little uniform DIF by gender, supporting its use in surveys of men and women. Further methodological research is discussed. Research is needed in Vietnam about why women report less favorable attitudes than men regarding women's recourse after physical IPV.

'Many people know the law, but also many people violate it': discrimination experienced by people living with HIV/AIDS in Vietnam--results of a national study.

In Vietnam, discrimination against people living with HIV/AIDS (PLHIV) is defined within and prohibited by the 2007 national HIV/AIDS law. Despite the law, PLHIV face discrimination in health care, employment, education and other spheres. This study presents the first national estimates of the levels and types of discrimination that are defined in Vietnamese law and experienced by PLHIV in Vietnam. A nationally representative sample of 1200 PLHIV was surveyed, and 129 PLHIV participated in focus group discussions (FGDs). In the last 12 months, nearly half of the survey population experienced at least one form of discrimination and many experienced up to six different types of discrimination. The most common forms of discrimination included disclosure of HIV status without consent; denial of access to education for children; loss of employment; advice, primarily from health care providers, to abstain from sex; and physical and emotional harm. In logistic regression analysis, the experience of discrimination differed by gender, region of residence and membership status in a PLHIV support group. The logistic regression and FGD results indicate that disclosure of HIV status without consent was associated with experiencing other forms of discrimination. Key programme and policy recommendations are discussed.

Qualitative study of an operations research project to engage abused women, health providers, and communities in responding to gender-based violence in Vietnam.

This article describes an action research project designed to engage women, health providers, and communities to respond to gender-based violence (GBV) in Vietnam. Based on results from in-depth interviews and group discussions, it considers the extent to which the project approaches were empowering for abused women. The results underscore the problems entailed in introducing systematic screening for gender-based violence into government health facilities in the low-resource setting of Vietnam, the importance of combining ideational change and rights components with support for abused women, and the difficulty of engaging male perpetrators.