Socioeconomic Inequalities in Intimate Partner Violence: Evidence from Vietnam.

Although socioeconomic inequality has been identified as a significant factor for violence against women, the connection between these two variables has not been widely recognized and addressed in many countries. This study aims to quantify the degree of socioeconomic inequalities in intimate partner violence (IPV) in Vietnam and investigate the contribution of each determinant factor that contributes to the observed inequality. We utilized the Vietnamese National Survey on Domestic Violence against Women (N = 4,019) for the analysis. Household wealth was used as a proxy for socioeconomic status. We used a concentration index to quantify the degree of socioeconomic inequality in emotional, physical, or sexual violence and a combination of these three types of violence. We further decomposed the concentration index to identify the contribution of each determinant to the observed inequality in IPV. We found that the prevalence of IPV was significantly concentrated among the worse-off across all types of IPV and that disparities in husband's occupation (48%), women's education (39%), husband's education (38%), and class (34%) were the primary factors contributing to increased inequalities in IPV. Our results indicated that higher education and engagement in skilled jobs were highly concentrated among the better-off, creating unequal distribution of these variables across wealth. Policy could mitigate the inequality in IPV by expanding women's access to education and economic opportunities. However, interventions should target both men and women and within couples because husband's characteristics also play an important role in explaining socioeconomic inequalities in IPV.

The Effect of Economic Reliance, Stress, and Women's Employment Status on Intimate Partner Violence Risk Among Partnered Women in Burkina Faso and Kenya.

Economic factors, such as economic reliance on male partners, and economic stressors such as household income or employment loss, play an important role in the risk of intimate partner violence (IPV) within romantic partnerships. To investigate these relationships, we used survey data from IPUMS Performance Monitoring for Action that were collected in 2020 and 2021. We assessed the relationship between several economic factors-(1) women's economic reliance on their partners, (2) household income loss, and (3) respondent's employment status over the past year-and experience of IPV in the past year in Burkina Faso (N = 2,646) and Kenya (N = 3,416). Women who reported being economically reliant on their partners were less likely to experience physical or psychological violence in Burkina Faso (Prevalence ratio [PR]: 0.41, 95% confidence interval [CI]: 0.26-0.64 and PR: 0.75, 95% CI: 0.59-0.94, respectively), and physical violence in Kenya (PR: 0.69, 95% CI: 0.52-0.90) compared to women who reported not being economically reliant. In Kenya, women in households that experienced a complete loss of income were more likely to experience IPV compared to households that did not experience income loss-1.9 times more likely to experience psychological violence, and three times more likely to experience sexual violence. In Burkina Faso, no significant relationship was found between household income loss and IPV. Our findings indicate that both relative economic empowerment and overall economic stress may act as important risk factors for IPV, particularly where patriarchal and gender inequitable norms are relevant. These findings reinforce the need for a nuanced and intersectional understanding of IPV risk and intervention development, with the relationships between economic dynamics and IPV varying across countries and contexts.

Characteristics of physical violence against pregnant women - analysis of medico-legal data and literature review.

Pregnancy is a period which is especially sensitive to physical violence and its aftermath. Subjecting a pregnant woman to violence can have negative effects on both the mother as well as the child. In Poland, there are programs, such as the Blue Card, aimed at protection against violence, however the phenomenon is underestimated. Documentation covering forensic examinations carried out at the request of the police or privately at the Department of Forensic Medicine in Poznan in the years 2015-2020 was analyzed. Out of 7,689 cases, 22 were concluded to meet the criteria of violence against pregnant women. The cases were then further analyzed, consideration of the victim's age, professional status, relations with the perpetrator, form of physical violence, and medical assistance. The average age of the women at the time of the incident was 31.1 years. In 90.1% of the cases, the perpetrator was a known man, usually a current or former partner. The most common injuries were abrasions and bruises, while the most common locations of injuries were the head, neck, and arms. The most common forms of violence were grappling, kicking, and hitting with an open hand. Over 72% of the women sought medical attention after the incident. There is a need for educational programs concerning the effects of violence during pregnancy and ways to help. Gynecologists and midwives play an especially important role, by having direct contact with the patient, thus being able to quickly identify victims of violence and take actions to secure safe environment for the woman and the child.

Exploring the Interplay of Intergenerational Transmission, Structural Inequalities, and Relative Resources in Domestic Violence: Evidence From a Nationally Representative Dataset.

Domestic violence persists as a significant social challenge affecting a considerable number of women globally. Some scholars have ascribed the inclination toward domestic violence to a "cycle of violence" spanning generations, while others have pointed out structural inequalities. Feminist researchers contend that a comprehensive understanding necessitates exploration within the social and institutional realms of gender inequality. While each of these perspectives contributes significantly to comprehending domestic violence, individually, they might not unveil the complete causal narrative. This study endeavors to address this gap by proposing an integrated model to elucidate domestic violence in the context of Türkiye, examining (a) the correlation between growing up in a violent household and the susceptibility to domestic violence, (b) the interrelation between structural factors and the vulnerability to domestic violence, and (c) the connection between a woman's advantageous position in terms of the couple's relative resources and the likelihood of experiencing domestic violence. To achieve this objective, multivariate micro-level analyses were conducted using nationally representative data from the 2014 Research on Domestic Violence Against Women in Türkiye. The outcomes affirm the significance of all three approaches, highlighting the value of integrated methodologies for a more profound comprehension of the etiology of domestic violence. This insight is crucial for the development of effective prevention programs. Furthermore, the findings highlight intra-parental violence exposure as the most robust risk factor or predictor for subsequent involvement in violent intimate relationships. As the initial study in Türkiye encompasses early-life experiences, structural inequalities, and the relative resources of couples, this research is poised to contribute significantly to the existing body of literature on domestic violence.

The Failure to Recognize Continuing Harm: Post-Separation Domestic Abuse in Child Contact Cases.

This article presents findings from a case file review of post-separation parenting cases in England and Wales. It first outlines that jurisdiction's legal framework relevant to these cases, before providing an overview of the findings relating to the profile of the cases and their outcomes. It then describes the types of abuse most frequently encountered in these cases, and examines the attitude of the courts to post-separation abuse by looking at both interim and final court orders. The study finds that key legal provisions governing these cases are not being followed, with little understanding shown for the nature of post-separation abuse.

College Faculty Experiences With Student Disclosures of Victimization.

Victimization of college students is widespread, and it is not uncommon for students to disclose these experiences to faculty. Given that how faculty respond to disclosures may have implications for students' psychosocial and academic outcomes, it is key to know more about disclosures to help faculty prepare a supportive response. This study used data from an online survey of members of two U.S.-based professional scholarly associations for criminal justice and criminology (N = 637) to look at the nature of student disclosure of victimization and which faculty are more likely to receive such disclosures. Disclosure to faculty was widespread (87% of faculty had received at least one disclosure of victimization from a student), and disclosures were mostly made in person. Over half the time (52.3%), participants thought the disclosure was prompted by an incident in class or another aspect of the course, and more than a quarter of the time (28.8%), the disclosure came from a student in a course that utilized trigger warnings. A faculty member's individual identities, such as gender or race and ethnicity, did not appear to render them more or less likely to receive student disclosures. However, faculty with victimization experiences who had links to victim services organizations, who were teaching in a Sociology department, or who had been teaching longer were more likely to have received a disclosure. Graduate student instructors were less likely to have received a disclosure, even controlling for years of teaching. This suggests widespread training of college-level instructors in how to respond to a student's disclosure of victimization may be warranted, at least for faculty teaching courses focusing on criminology and criminal justice.

Intimate Partner Violence During Lockdown: The Potent Influence of Stress and Authoritarian Beliefs.

COVID-19 pandemic caused several lockdowns in most countries, enclosing together perpetrators and victims of intimate partner violence (IPV). Our study investigates psychological mechanisms associated with IPV. We supposed that stress provoked by the pandemic, as well as adhering to authoritarian beliefs will be a predictor of IPV. Using an online questionnaire, 1,659 individuals indicated whether they had been victim or witnessed IPV at home and filled a perceived stress scale, anxiety, depression, and aggressiveness scales. They were also asked to fill an authoritarianism scale, how they cope with the lockdown situations, and some demographical information. We found that individuals who were victims or witnesses of IPV during the COVID-19 lockdowns tended to have more difficulty isolating at home or to hold stronger authoritarian beliefs. Importantly, the association between authoritarian beliefs and IPV was moderated by perceived stress, suggesting that individuals who hold authoritarian views may be more affected by stress, which could increase the risk of experiencing or witnessing IPV. IPV incidents during the pandemic lockdowns may be partially explained by perceived stress, which is amplified by authoritarian attitudes. Further discussions on the causes of IPV and interventions are suggested.

An Exploration of Geographic Access to Substance Use Treatment Programs and Violence Against Women.

Violence against women (VAW) is a significant public health and human rights issue, with an estimated 736 million women globally experiencing VAW. Consistent evidence demonstrates that substance use is associated with VAW and that participation in substance use treatment programs is associated with reduction in substance use-related violence. While evidence demonstrates the ability to address VAW through substance use treatment programs, less attention has been paid to geographic access to substance use programs. If these programs are geographically inaccessible, particularly to marginalized populations, many people will not get the help they need. This study seeks to explore the relationship between geographic access to substance use treatment programs on VAW. Using data from the HIV Prevention Trials Network (HPTN) 064 study, longitudinal multilevel models were used to assess the relationship between neighborhood-level social determinants, with a specific focus on geographic access to Substance Abuse and Mental Health Services Administration (SAMHSA) certified drug and alcohol treatment programs and VAW. The study included 1910 women, ages 18 to 44, living in select geographic areas with high-ranked prevalence of HIV and poverty. The findings of this study indicate that among women who reside in census tracts with high prevalence rates of HIV: (1) substance use increases VAW; (2) VAW decreases as geographic access to SAMHSA-certified drug and alcohol treatment facilities increases; and (3) when looking at specific types of VAW, emotional and physical abuse decreases as geographic access to substance use treatment increases. Policies and programs to increase access to substance use treatment should be explored and evaluated, and more programs are needed that address the intersectionality of substance use and VAW.

The experiences and perceptions of campus resource utilization by college students with childhood domestic violence exposure histories.

Objective: The purpose of this study was to examine the campus resource utilization experiences of university students with childhood domestic violence exposure (CDV) histories. Participants: 368 students attending a large, flagship, land-grant, predominantly White university in the Southeastern United States. Methods: Participants completed a web-based survey with variables including CDV, campus resource utilization and perceptions of said resources, and participant resource suggestions. Results: Most students utilized at least one health-related campus resource, with the student health and counseling centers being the most common and helpful. Suggested areas for institutional and service provider growth include enhanced advertisement and accessibility for existing resources and added support groups. Conclusions: College campuses provide unique opportunities to support young adults with CDV histories. Tailoring programming to students with CDV histories has the potential to improve student's success in and beyond college.

Explosive and Harmful Impulses: A Subset of Child and Adolescent-to-Parent Violence and Abuse.

"Filial harm" refers to harms experienced by a parent and caused by their child, with increasing umbrella terminology developing to capture all forms of harm despite differing experiences and contexts. In this paper, based on a Glaserian Grounded Theory study underpinned by participatory research principles, this work utilized diaries and interactive interviews with 34 parents and arts-based workshops with 21 children to develop a new terminology and approach to child and adolescent-to-parent violence and abuse when harm does not have a clear intent. Explosive and harmful impulses refer to preadolescents experiencing proactive, reactive, affective, and relational harms and needs. These specific forms of filial harm are based upon underlying needs, and the maladaptive ways children may attempt to meet their needs result in filial harm as an unintended consequence rather than being a form of harm with intent. Using an approach that captures subsections of filial harm, there is opportunity to better represent the nuance of individual family experiences and could provide more appropriate language and interventions that better represent the language used by families themselves. Future interventions, support pathways, and research with families living with explosive and harmful impulses could use the provided framework to understand why children are attempting to meet their needs in harmful ways and to consider less harmful methods of support.

Association of Daily Activities With Maternal-Child Bonding, Parenting Self-Efficacy, Social Support, and Parenting Behaviors Among Survivors Living in an Intimate Partner Violence Shelter: A Daily Diary Study.

Following a traumatic event such as intimate partner violence (IPV), survivors often experience stress related to the violence. These high levels of stress related to IPV can be associated with the daily activities of survivors and their relationships with their children, such as maternal-child bonding. The purpose of the current study is to explore the relationship between daily activities, daily stress levels, parenting self-efficacy and behaviors, and maternal-child bonding among survivors living in an IPV shelter using an ecological momentary assessment (EMA) methodology. Twenty-five mothers living in an IPV shelter in two states in the Southern United States completed a baseline survey and completed electronic daily diaries for 14 days. Higher daily stress was associated with the number of times the mothers met with the case manager. Higher daily stress was also related to lower parenting self-efficacy. The number of case management appointments and legal appointments were positively correlated with a higher bonding score. More social support was associated with more positive parenting. IPV and post-traumatic stress disorder symptoms were not significantly associated with maternal-child bonding, parenting behaviors, or parenting self-efficacy. Findings suggest that screening for maternal support may be particularly important for positive bonding and positive parenting. Findings also lend preliminary insight into practical places where service providers could act to protect the bonding process or mitigate risks to impede it. Future research should include objective data about the mother's emotions and her interactive behavior with her child. There is also a need to consider how federal programs fund and incentivize service providers to focus on mother-child dyads and how they can tailor services that promote bonding.

The Uptake and Measurement of Alternative Approaches to Domestic Violence Intervention Programs: A Scoping Review.

This scoping review explores the breadth and depth to which Domestic Violence Intervention Programs (DVIPs) in the United States and globally: (a) incorporate components that address the relationship between intimate partner violence (IPV) and social injustice, racism, economic inequality, and adverse childhood experiences (ACEs); (b) use restorative (RJ)/transformative justice (TJ) practices, individualized case management, partnerships with social justice actors, and strengths-based parenting training in current programming; and (c) measure effectiveness. In 2021, we searched 12 academic databases using a combination of search terms and Medical Subject Headings. In all, 27 articles that discussed at least one key concept relative to DVIP curricula were included in the final review. Findings suggest that very few DVIPs address ACEs and/or the relationship between structural violence, social inequality, and IPV perpetration. Even fewer programs use restorative practices including RJ or TJ. Furthermore, DVIPs use inconsistent methods and measures to evaluate effectiveness. To respond to IPV perpetration more effectively and create lasting change, DVIPs must adopt evidence-informed approaches that prioritize social and structural determinants of violence, trauma-informed care, and restoration.

Violencia en pareja en personas seropositivas: una revisión sistemática / Violência por parceiro íntimo em pessoas soropositivas: uma revisão sistemática / Partner violence in HIV-positive people: a systematic review

El presente trabajo tiene como objetivo, caracterizar la violenciaen pareja en personas con seropositividad (prevalencia,tipos de acciones violentas, variables de riesgo/ protectorasy consecuencias), para lo cual se realizó una revisión sistemáticaa través del protocolo PRISMA. La búsqueda de artículos serealizó en Scopus, Web of Science, Eric, Scielo y Pubmedpublicados hasta 2021. Se encontraron 113 artículos, de loscuales 22 cumplieron con los criterios de elegibilidad. Losresultados indican que la violencia en pareja en personasseropositivas, además de manifestarse de manera física,psicológica, patrimonial, sexual y verbal, se puede presentar através del uso del VIH para ejercer la violencia. La prevalenciavaría en función del contexto geográfico en un intervalo del19,6% al 43,1%; la cual es superior en población migrantey en hombres que tienen sexo con hombres (HSH) mujeresseropositivas, parejas no heterosexuales y en parejas en la queambos miembros son seropositivos. Las variables de riesgo/protectoras identificadas se asociaron con las dimensiones:informativas, motivacionales, de habilidades conductuales,sociodemográficas, culturales, de salud, sociofamiliares ypolíticas. Asimismo, se evidenciaron consecuencias sociales,económicas y de salud.(AU)

The objective of this work is to characterize partner violencein people with seropositivity (prevalence, types of violentactions, risk/protective variables, and consequences), for whicha systematic review was carried out through the PRISMAprotocol. The search for articles was carried out in Scopus,Web of Science, Eric, Scielo and Pubmed published up to 2021. 113 articles were found, of which 22 met the eligibilitycriteria. The results indicate that intimate partner violencein seropositive people, in addition to manifesting itself ina physical, psychological, patrimonial, sexual, and verbalway, can be presented using HIV to exercise violence. Theprevalence varies depending on the geographical contextin a range from 19.6% to 43.1%, which is higher in themigrant population and in men who have sex with men(MSM), seropositive women, non-heterosexual couples andin couples in which both members are seropositive. Therisk/protective variables identified were associated with thedimensions: informational, motivational, behavioral skills,sociodemographic, cultural, health, socio-family and political.Likewise, social, economic and health consequences wereevidenced.(AU)

O objetivo deste trabalho é caracterizar a violência conjugalem pessoas com soropositividade (prevalência, tipos de açõesviolentas, variáveis de risco/proteção e consequências), paraa qual foi realizada uma revisão sistemática por meio doprotocolo PRISMA. A busca de artigos foi realizada no Scopus,Web of Science, Eric, Scielo e Pubmed publicados até 2021.Foram encontrados 113 artigos, dos quais 22 atenderamaos critérios de elegibilidade. Os resultados indicam que aviolência por parceiro íntimo em pessoas soropositivas, alémde se manifestar de forma física, psicológica, patrimonial,sexual e verbal, pode se apresentar por meio do uso do HIVpara exercer a violência. A prevalência varia de acordo como contexto geográfico em uma faixa de 19,6% a 43,1%; queé maior na população migrante e em homens que fazemsexo com homens (HSH), mulheres soropositivas, casais nãoheterossexuais e em casais em que ambos os membros sãosoropositivos. As variáveis de risco/proteção identificadasforam associadas às dimensões: informacional, motivacional,habilidades comportamentais, sociodemográficas, culturais,de saúde, sociofamiliares e políticas. Da mesma forma, foramevidenciadas consequências sociais, econômicas e de saúde.(AU)

Child-to-Parent Violence ­ Der Blinde Fleck in der Forschung zur familiären Gewalt? Ein Systematic Review / Child-to-Parent Violence ­The Blind Spot in Research on Family Violence? A Systematic Review.

Child-to-Parent Violence -The Blind Spot in Research on Family Violence? A Systematic Review Child-to-parent violence (CPV) is a phenomenon that has received little attention in the German scientific community. With this paper, the authors present the international state of research in the context of a systematic review. By means of a search a dataset of 317 scientific publications for the period 2012-2022 was identified at August 2022. After applying the inclusion and exclusion criteria, 14 studies were finally defined and analyzed in detail. Based on the analysis, the following variables are highlighted as outcomes: Forms of CPV, prevalence, age and gender of individuals performing CPV, risk and protective factors, the direction of CPV within family constellations as well as external conditioning factors of CPV.The results show that there are some concrete findings in research regarding these variables, particularly in the area of risk and protective factors. An initial systematization of violent behaviour in the context of CPV can also be derived fromthe current state of research. At the same time, however, there are still clear gaps in research, e. g. in terms of prevalence, which is mainly due to very different definitions of "violence". This applies both with regard to the international state of research, but especially with regard to the situation in German-speaking countries.

A descriptive study of domestic and family violence presentations to an emergency department in the Northern Territory.

OBJECTIVE: Examine the nature of domestic and family violence (DFV) presentations to an ED in the Northern Territory and identify potential gaps in service delivery. METHODS: Prospective descriptive study of DFV presentations in November 2021. RESULTS: A total of 70 presentations were identified, representing 1.2% of all presentations aged 16 years and older. Disproportionately impacted were First Nations people (90%), women (77.1%) and those aged less than 40 years (67.1%). Most (81.4%) arrived outside of business hours and only 37.1% were assessed by the social worker. Case complexity was increased by high rates of homelessness (30%), concurrent alcohol consumption (44.3%) and pregnancy (11.1% of females). More than a third (37.1%) had attended on one to four occasions in the previous 6 months with a DFV-related injury. Compared to non-DFV attendances, the median ED length of stay was approximately twice as long (456 vs 210 min), admissions rates to the ED short stay unit five times higher (25.7% vs 5.7%; P < 0.01, odds ratio [OR] = 5.7 and 95% confidence interval [CI] = 3.3-9.8) and rates of self-discharge prior to completion of care 9 times higher (12.9% vs 1.5%; P < 0.01, OR = 9.5 and 95% CI = 4.6-19.7). CONCLUSION: The data highlights the need for a 24 h trauma-informed, culturally safe and integrated service to support people experiencing DFV. This could be achieved by a specialist unit designed and staffed by First Nations health practitioners.

Attitude Is Everything: Examining Acceptance of Violence Items for Differential Item Functioning Across Heterosexual and Sexual Minority Youth.

Acceptance of dating violence (ADV) is a cognitive risk factor for violence perpetration and a common target of prevention programs. However, frequently used items assessing ADV are characterized by heteronormative item wording, and limited research has evaluated the degree to which ADV items function equivalently for both heterosexual and sexual minority youth (SMY). The current study sought to determine if there are differences in the way heterosexual and SMY respond to ADV survey items. Secondary data from a total of 2,014 adolescents (Mage = 16.78) were used to examine differences in ADV. Results of differential item functioning analysis indicated nonuniform differential item functioning for two of eight ADV items, with heterosexual youth being more likely to express strong levels of agreements with (a) female-perpetrated physical violence in response to male-perpetrated violence and (b) female-perpetrated violence against males broadly, relative to SMY. Although these differences were of negligible magnitude and only resulted in minimal differences in overall expected average scores, heterosexual youth were more likely to strongly accept female-perpetrated dating violence compared to SMY. Findings highlight differences in ADV item response patterns across heterosexual and sexual minority identifying youth and provide preliminary evidence for group differences in acceptance of female-perpetrated dating violence. Implications for prevention programming based on current findings include greater focus on measure adaptation and development as well as more consensus on the necessity of preventing female-perpetrated violence.

Barriers and facilitators of the reporting by family doctors of cases of domestic violence - a qualitative study across Portugal.

BACKGROUND: Domestic violence (DV) is a serious and prevalent public health problem with devastating consequences for the victims and their families. Whilst the number of cases reported to the authorities has risen in recent years, many victims still chose not to present a complaint. In Portugal, to address this, DV became a public crime. As victims of DV present multiple health problems and frequently seek professional help, family doctors are in a privileged position to detect and report cases of DV to the authorities. However, little is known about what motivates these professionals to report or not the DV cases they encounter in their practice to the authorities. METHODS: We conducted semi-structured interviews with family doctors from all regional health administrations of continental Portugal. Interviews occurred between July 2020 and September 2022, were conducted in person or remotely, audio recorded, transcribed, and analysed using thematic analysis. Content analysis was conducted to assess the agreement or disagreement regarding mandatory reporting in each of the themes and subthemes. RESULTS: Fifty-four family doctors took part in this study (n = 39 women, n = 15 men). The main themes that arose from the analysis were: "Barriers related to the physician's activity," "Barriers related to the victim or aggressor," "Facilitators related to the physician's activity," "Facilitators related to the victim or aggressor." Although different barriers were described, most doctors agreed with the mandatory reporting of DV cases. CONCLUSIONS: Family doctors encounter multiple barriers and facilitators when considering reporting a DV case to the authorities. The results of this study can help develop new interventions to address the barriers described by the doctors, increasing their compliance with mandatory reporting, the protection of victims and the just persecution of the aggressor.

Training Australian general practitioners to counsel women experiencing intimate partner abuse (WEAVE): a pre-post training analysis.

BACKGROUND: Evaluations of Intimate Partner Abuse training for general practitioners is limited. The Women's Evaluation of Abuse and Violence Care study trialled in Australia was a primary care intervention that included delivering the Health Relationships training, a program that educates practitioners on how to provide supportive counselling and assistance to women afraid of an intimate partner. We report on effectiveness of the Healthy Relationships training program within a cluster-randomised controlled trial. METHODS: General practitioners filled out a baseline survey and surveys before and after training, including quantitative and open-text questions on barriers and enablers to supporting victim-survivors. The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool, a validated measure, was included to assess practitioner knowledge, skills, confidence, and attitudes. General linear model repeated analysis of variance tested the difference between trial groups over time. RESULTS: Fifty-two general practitioners completed the baseline demographic survey, with 65% (19 intervention, 18 comparison) completing both pre-and-post-training surveys. There were no between-group differences in baseline characteristics. Post-training, the intervention group had significantly higher average scores than the comparison on perceived preparation to address abuse (p = .000), perceived knowledge (p = .000), actual knowledge (p = .03), and greater awareness of practice-related issues (p = .000). There were no between-group differences in PREMIS opinion domain scores on workplace issues, self-efficacy and understanding of victims. Post-training, the qualitative data indicated that the intervention practitioners (n = 24) reported increased knowledge, awareness, and confidence, while time pressures and lack of referral options impeded addressing abuse. CONCLUSION: The Healthy Relationships Training program for general practitioners increased aspects of practitioner knowledge, skills, and confidence. However, more support is needed to change opinions and support victim-survivors sustainably. TRIAL REGISTRATION: The WEAVE trial was registered on 21/01/2008 with the Australian New Zealand Clinical Trial Registry, number ACTRN12608000032358.

Exclusive breastfeeding and its association with intimate partner violence during pregnancy: analysis from Pakistan demographic and health survey.

BACKGROUND: Intimate partner violence (IPV) is a global social issue and increasingly asks for the attention of policymakers. IPV is one of the main factors that affect the health of pregnant women and their infants during pregnancy and after childbirth; it will not only cause direct harm to women themselves but also reduce women's exclusive breastfeeding (EBF) behavior and pose a threat to newborn health. Existing facts on the association between IPV and EBF in the Pakistani context are negligible and incomplete to an enduring measure of IPV practice. To this effect, the present study aims to investigate the relationship between EBF and IPV practiced during the prenatal period and post-delivery. METHODS: The statistics study has drawn from the Pakistan Demographic and Health Survey (PDHS) 2018. A total of 1191 breastfeeding females aged 15-49 with children under 6 months were selected for the present study. T-test or chi-square test of Univariate test of hypothesis; Logistic regression model was utilized to explore the potential impact of IPV on female exclusive breastfeeding from three dimensions of physical, sexual and psychological violence, to provide data support for the Pakistani government to formulate policies to promote female EBF. All investigations have been performed in STATA software 16.0 (Stata Corp, College Station, TX, USA) at 95% confidence interval. RESULTS: Among the 1191 participants, 43.6% (520 / 1191) of the females were EBF, while the rates of physical, sexual, and emotional IPV were 47.44%, 30.23%, and 51.72%, respectively. Logistic regression analysis showed that females who have experienced physical IPV were 32% less likely to be exclusively breastfed (aOR = 0.68; 95% CI; 0.490, 0.980; P < 0.05), the chances of EBF were reduced by 22% in women who experienced IPV (aOR = 0.78; 95 CI; 0.55, 1.00; P < 0.05), females who experienced emotional IPV were 31% less probable to exclusively breastfed (aOR = 0.69; 95% CI; 0.47, 0.92; P < 0.05). CONCLUSIONS: This study determines the adverse effects of sexual and psychological violence on EBF practices in women. Policymakers in Pakistan should actively implement assistance programs to reduce IPV, emphasize monitoring women's experiences of IPV before and after giving birth, and encourage women to break the "culture of silence" when they experience IPV to maximize their access to assistance.