Armed conflicts and experience of intimate partner violence among women in Afghanistan: analysis of the 2015 Afghanistan DHS data.

OBJECTIVE: Armed conflicts and intimate partner violence (IPV) impose a burden on individual and societal well-being. Given the history of armed conflict in Afghanistan and the high prevalence of IPV, this study aims to examine the influence of armed conflicts on IPV among Afghan women. METHODS: Multilevel logistic regression models were applied to the 2015 Afghanistan Demographic and Health Survey (N=10 414 women aged 15-49). Armed conflict severity was measured using the conflict index issued by the Office for the Coordination of Humanitarian Affairs, IPV was measured by three types of violence, including emotional, physical and sexual violence. All analyses were conducted by using STATA V.15.1. RESULTS: Over 52% of women experienced at least one type of IPV, with 33.01%, 49.07%, and 8.99% experiencing emotional, physical, and sexual violence, respectively. The regression results show that armed conflicts were significantly and positively associated with the experience of all types of IPV. In addition, the association between armed conflicts and the experience of emotional IPV was positively moderated by women's attitudes towards IPV. CONCLUSION: Our findings suggest that women living in high-conflict regions were more prone to experience IPV, particularly women with positive attitudes towards IPV. Promoting progressive gender roles, women's empowerment, awareness of IPV and inclusion of women in conflict resolution will help deal with the issue of IPV.

Examining the relationship between intimate partner violence and child development program attendance in young children: A cross-sectional study.

The aim of the present study was to determine the association between different types of intimate partner violence against women and nonattendance at the Growth and Development Control Program (CRED or well-child visits) of their children under 5 years of age. This was an analytical cross-sectional study that comprised a secondary analysis of data from the Demographic and Family Health Survey (ENDES in Spanish) of Peru, 2019. Data from 19,647 mothers (aged 15-49 years) and their children under 5 years were analyzed. The independent variables were the types of intimate partner violence = emotional, physical, and sexual. The outcome variable was nonattendance at CRED in the last 6 months. The mean maternal age was 30.47 ±â€…6.66 years; 66.1% of children were between 25 and 60 months of age; the prevalence of nonattendance at CRED was 29.9%. A relationship was found between partner violence against the mother and nonattendance at CRED. Specifically, there was a higher probability of nonattendance in the children of women who experienced partner violence (sexual = aPR = 1.25 [95% CI = 1.07-1.44]; physical = aPR = 1.17 [95% CI = 1.08-1.26]; emotional = aPR = 1.12 [95% CI = 1.03-1.21]). This study showed an association indicating that children born to mothers experiencing intimate partner violence exhibit an elevated likelihood of nonattendance at CRED when compared to children of mothers not subjected to such violence. Therefore, emphasizing the promotion and monitoring of child development, especially for those with a history of maternal violence, should be a primary priority, particularly in primary care.

Prevalence, Correlates, and Trends of Intimate Partner Violence Against Women in Cambodia: Findings From 2014 and 2021-22 Cross-Sectional Demographic and Health Surveys.

Intimate partner violence (IPV) is globally endemic and a gross violation of human rights, in addition to abuse of intimacy by some men against their female intimate partners. Based on literature review, attitudinal, socio-demographic, and experiential attributes of 15 to 49 year old ever partnered women in the heterosexual relationships were identified. This study used the anonymized 2020-21Cambodia Demographic and Health Survey (CDHS) data to compute the IPV prevalence and its correlates, in addition to computing the changes in IPV prevalence at the urban, rural, and at the national levels using data from the 2014 CDHS. Identified attitudinal, socio-demographic, and experiential attributes were used in the bivariate and multivariable analysis. Simple and multiple logistic regression models were used for computing the bivariate and multivariate associations with IPV; additionally, trend analysis was done to compute changes in IPV prevalence between the 2 surveys. Lifetime prevalence of IPV was 20.70%, while the most common subtype was emotional IPV at 18.70%. Ten out of 12 correlates studied were found to be statistically significantly associated with IPV in the bivariate analysis. These were added in the multivariable model and 7 were found to be statistically significantly associated with IPV. Which included educational attainment of women and their intimate partners, number of living children, women's IPV acceptance, male partner's alcohol use, knowledge of physical beating of mother by one's father, and controlling behavior exercised by partner. During the intervening period between the 2 CDHSs, IPV and its subtypes were decreased in both urban and rural areas, as well as nationally. IPV decrease between the 2 DHSs and lower IPV rates in 2021-22 augur well for the health and human rights of Cambodian women. However, the ultimate target of eliminating IPV against women, will require measures that ensure economic and gender empowerment, and gender equality.

Reproductive coercion and abuse in intimate relationships: Women's perceptions of perpetrator motivations.

Reproductive coercion and abuse is a hidden and poorly recognised form of violence against women. It refers broadly to behaviours that interfere with or undermine a person's reproductive autonomy, specifically to promote or prevent pregnancy. Reproductive coercion and abuse can involve physical, sexual, financial or psychological abuse in order to achieve these aims, and is overwhelmingly perpetrated by men against women. As an emerging field of scholarship, conceptual understanding of reproductive coercion and abuse is still in its infancy; however, it is often described as being linked to coercive control. In this article, we seek to highlight the complexity of this relationship through qualitative analysis of in-depth interviews with 30 victim/survivors in Australia recruited from the community, focusing on their perceptions of the perpetrator's motivations. We developed four themes from our analysis: 1) His needs came first; 2) The illusion of a perfect father; 3) Creating a weapon of control; and 4) My body was his. Perceived perpetrator motivations ranged from entitlement and self-interest to a deep desire for domination and entrapment. Pregnancy preventing behaviour was more likely to be linked with entitlement and self-interest, whereas pregnancy promoting behaviour tended to be described by participants in relationships where there was a broader pattern of ongoing control and entrapment. Thus, we suggest that coercive control is a motivating factor for some, but not all men who perpetrate reproductive coercion and abuse. A greater understanding perpetrator motivations may be important for practitioners, particularly those working in sexual and reproductive health services, since it could be relevant to women's level of risk for coercive controlling behaviour or more extreme forms of physical or sexual violence.

Development and validation of the relational behavior interactions scale for couples.

In this research, we developed and validated a measure of couple-based reported behavior interactions (RBI). Specifically, Study 1 was designed to describe the development of the scale and to examine its reliability; Study 2 (N = 222), was designed to examine factors that could differentiate men and women. Additionally, we tested if women's behaviors could predict their partner's behavior. Results from the exploratory factor analysis (EFA) revealed a three-factor structure for couples' RBI which were labelled: Social Companionship and Affective Behavior Interactions (SAI) (Factor 1), Fulfilling Obligations and Duties of the Partner (FOD) (Factor 2) and Openness in the Relationship (OR) (Factor 3). In linear regression analyses, there was a significant difference between men and women in the second factor, which represents behaviors associated with fulfilling the responsibilities of a partner. On the other hand, neither the SAI factor nor the OR factor showed any distinct gender differences. The SPSS PROCESS analysis revealed that women's Social Companionship and Affective Behavior Interactions (Factor 1), and Openness in the Relationship (Factor 3) significantly predicted their male partner's behaviors. The relationship duration significantly moderated the association between women's and men's behaviors for both factors. Results are discussed in light of the need for a broader understanding of romantic behavioral interactions.

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.

Help-seeking experiences and intimate partner support in vulvodynia: A qualitative exploration.

BACKGROUND: Vulvodynia is a poorly understood chronic pain condition characterized by persistent and unexplained pain in the vulva. Given the intimate nature of the pain, partners may play an important role in promoting self-management and help-seeking behaviours among women with vulvodynia. OBJECTIVES: The current study aimed to explore the role of partner support in pain experiences and help-seeking behaviours among women with vulvodynia. DESIGN: A qualitative interpretive design was used. METHODS: Ten women with vulvodynia (M age = 37.9 years) were interviewed using a semi-structured non-directive topic guide. Data were analysed using reflexive thematic analysis. RESULTS: Three themes around help-seeking experiences were constructed from the data: (1) 'It's Been a Battle' - Failed by the Healthcare System; (2) 'It's Just the Vulva' - Dismissed by Healthcare Professionals; and (3) 'I Diagnosed Myself' - The Patient Becomes the Expert. Participants described negative help-seeking experiences characterized by long delays to diagnosis, lack of awareness and understanding from healthcare professionals, minimization of symptoms, and having to advocate for and demand care. A further three themes pertaining to partner support were also developed: (1) 'That Person to Listen to You' - Source of Emotional Support; (2) 'Why Don't You Try This?' - Finding Solutions Together; and (3) 'He Forgets that it's Still There' - Vulvodynia is a Foreign Concept. Partners provided emotional support and showed empathy and understanding, and practical support by accompanying women to medical appointments and help with pain management. However, participants felt partners' understanding of vulvodynia was limited and that this impacted their relationships. CONCLUSIONS: Findings highlight a lack of continuity of care and multidisciplinary approach to treatment, with help-seeking experiences being mainly negative in this sample. Increasing public awareness of vulvodynia and improving healthcare access is crucial to improving physical and psychological outcomes for this group. Partners can play an important role in supporting people with vulvodynia; however, other outlets of support should be further explored.

Understanding How Women with Vulvodynia Seek Help and Get Support from Their PartnersVulvodynia is a condition where women experience persistent and unexplained pain in the vulva. This pain can be quite personal and difficult to deal with. In this study, we wanted to understand how partners of women with vulvodynia help them cope with the pain and seek medical help. We interviewed 10 women with vulvodynia about their experiences of accessing healthcare for their symptoms, and how their partners affected these experiences. Many women faced challenges when seeking medical help, like delays in getting a diagnosis, healthcare professionals not understanding their condition, and their symptoms being downplayed. Women often had to be their own experts and advocate for their care. Partners of these women provided emotional and practical support, like going with them to medical appointments and helping them to manage the pain. However, some women felt their partners did not fully understand vulvodynia, and their worries sometimes strained their relationships. In conclusion, the study showed that there is a need for better healthcare for women with vulvodynia, including more awareness and easier access to treatment. Partners can be supportive, but other forms of support, for example, from friends, family, and other people with experience of vulva pain, should also be explored.

Long-Term Psychological and Physiological Effects of Male Sexual Trauma.

Male sexual trauma presents multiple clinical challenges. Although the topic has received increased attention in the last couple decades, male sexual trauma continues to be underreported and underrecognized. This study aimed to investigate the long-term effects of sexual trauma for men who were victimized within an institutional environment by a person in a position of power. This study included data from 47 adult men who were victims of sexual abuse or misconduct by an assigned physician at a higher education academic institution between 1966 and 2003. A primary finding was elevated rates of intimacy and sexual problems and erectile dysfunction, which started shortly after the abuse and persisted over time. We found that there was an association between intimacy and sexual problems and difficulty maintaining employment, drug addiction, erectile dysfunction, and loss of meaningful and romantic relationships. Levels of potential psychopathology were prominently linked to loss of sexual interest or pleasure, intimacy concerns, and loss of intimate and other personal relationships. Men who experienced sexual abuse as adults within an institutional environment developed long-standing patterns of interpersonal and professional problems. This study emphasizes the need for nuanced screening, evaluation, and treatment for male sexual trauma.

Being a Surrogate Partner: The Challenges of Fragile Boundaries.

Surrogate partner therapy is a type of treatment in which the surrogate partner (SP) works in a triadic setting with a sex therapist and a patient. At the same time, the SP acts as an intimate surrogate partner to the patient. The SP treatment includes a range of therapeutic experiences such as relaxation, intimate communication, sensual and sexual contact, and training for the acquisition of social skills. In the current study, we ask what and how SPs experience, understand, and construct boundaries in their work. We used Winnicott's therapeutic conceptualization of psychotherapy as a mode of playing and Goffman's dramaturgical role theory as the theoretical framework for our exploration. Applying a phenomenological and empathic approach, we analyzed 13 in-depth interviews with Israeli SP. It appears that SP's transitions from one performance to another are dramatic, in that their role requires the involvement of sexual and emotional helping relations with their patients. Moreover, SPs are obliged to have secrecy at all levels and in various relationships in their lives. We uncovered various complexities that SPs experience, such as a lack of clarity about their role, which creates challenges for building their professional and personal identity and affects their family and social relationships.

Support, not blame: safe partner disclosure among women diagnosed with HIV late in pregnancy in South Africa and Uganda.

BACKGROUND: HIV partner disclosure rates remain low among pregnant women living with HIV in many African countries despite potential benefits for women and their families. Partner disclosure can trigger negative responses like blame, violence, and separation. Women diagnosed with HIV late in pregnancy have limited time to prepare for partner disclosure. We sought to understand challenges around partner disclosure and non-disclosure faced by women diagnosed with HIV late in pregnancy in South Africa and Uganda and to explore pathways to safe partner disclosure. METHODS: We conducted in-depth interviews and focus group discussions with pregnant women and lactating mothers living with HIV (n = 109), disaggregated by antenatal care (ANC) initiation before and after 20 weeks of gestation, male partners (n = 87), and health workers (n = 53). All participants were recruited from DolPHIN2 trial sites in Kampala (Uganda) and Gugulethu (South Africa). Topic guides explored barriers to partner disclosure, effects of non-disclosure, strategies for safe disclosure. Using the framework analysis approach, we coded and summarised data based on a socio-ecological model, topic guides, and emerging issues from the data. Data was analysed in NVivo software. RESULTS: Our findings illustrate pregnant women who initiate ANC late experience many difficulties which are compounded by the late HIV diagnosis. Various individual, interpersonal, community, and health system factors complicate partner disclosure among these women. They postpone or decide against partner disclosure mainly for own and baby's safety. Women experience stress and poor mental health because of non-disclosure while demonstrating agency and resilience. We found many similarities and some differences around preferred approaches to safe partner disclosure among female and male participants across countries. Women and male partners preferred healthcare workers to assist with disclosure by identifying the 'right' time to disclose, mentoring women to enhance their confidence and communication skills, and providing professional mediation for partner disclosure and couple testing. Increasing the number of counsellors and training them on safe partner disclosure was deemed necessary for strengthening local health services to improve safe partner disclosure. CONCLUSION: HIV diagnosis late in pregnancy amplifies existing difficulties among pregnant women. Late ANC initiation is an indicator for the likelihood that a pregnant woman is highly vulnerable and needs safeguarding. Respective health programmes should be prepared to offer women initiating ANC late in pregnancy additional support and referral to complementary programmes to achieve safe partner disclosure and good health.

Prevalence, correlates, and trends of intimate partner violence against women in Pakistan: Results from Pakistan Demographic and Health surveys 2012-13 and 2017-18.

BACKGROUND: Intimate partner violence (IPV) is a global public health problem. The objectives of this study were to analyze the prevalence and correlates of IPV perpetrated by men against women from the recent nationally representative Pakistan Demographic and Health Survey (PDHS) 2017-18, and to analyze levels and trends of IPV perpetrated by current/former husbands from PDHS conducted in 2012-13, in the four provinces and the capital city. METHODS: Association of having ever experienced IPV, defined as either emotional, physical and/or sexual violence, by ever married women aged 15-49, with 12 explanatory socio-demographic, attitudinal, and experiences were analyzed using simple and multiple logistic regression models. RESULTS: The prevalence of having ever experienced IPV was 33.48% (95% CI: 30.76-36.32). In the final multivariable model, number of living children, having knowledge of parental physical IPV, husband's use of alcohol, and marital control were statistically significantly associated with IPV. Proportions and trend analysis of emotional and physical IPV between the PDHS 2017-18 and PDHS 2012-13, showed that in general, rural areas of provinces reported higher prevalence of emotional and physical IPV, compared with urban areas, and in general, emotional, and physical IPV prevalence declined from PDHS2012-13 to PDHS2017-18. CONCLUSIONS: The prevalence of having experienced physical and/or sexual intimate partner violence in Pakistan was lower than the prevalence for the WHO Eastern Mediterranean region. However, IPV burden at the provincial urban-rural residency status underscore the need for location specific strategies to effectively address IPV in Pakistan.

Intimate partner violence, suicide and self-harm in Sri Lanka: Analysis of national data.

There is increasing evidence from South Asia and internationally that intimate partner violence (IPV) is strongly associated with self-harm, however its association with suicide and self-harm has not been extensively examined, nor has this relationship been explored at a national level. Using national datasets, area-level variation in IPV, suicide and self-harm in Sri Lanka were examined. In addition, the association between individual level exposure to past-year IPV and non-fatal self-harm by any household member were explored in a series of multi-level logistic regression models, adjusting for age. Similar patterns in the distribution of suicide and IPV were found, with higher rates evident in post-conflict districts, specifically Batticaloa, Kilinochchi, and Mullaitivu. Experience of past year IPV and its various forms were strongly associated with household-level self-harm in the past year (adjusted odds ratio [AOR] = 3.83 95% CI 2.27-6.46). A similar magnitude was found for physical/sexual abuse (AOR 5.17 95% CI 2.95-9.05) and psychological abuse (AOR 4.64 95% CI 2.50-7.00). A dose-response association was also evident for frequency of abuse, with an increasing risk of household-level self-harm for women reporting abuse 'less often' (AOR 2.95 95% CI 1.46-5.92), and abuse experienced 'daily, weekly, or monthly' (AOR 4.83 95% CI 2.59-9.00), compared to no abuse. This study contributes to a growing body of evidence on the relationship between IPV and suicidal behaviour in South Asia. Addressing IPV and its various forms should be a priority for suicide prevention in Sri Lanka, alongside trauma-informed approaches in post-conflict settings.

The Effect of Irrational Relationship Beliefs on Attitudes Toward Intimate Partner Violence in Emerging Adults: Moderating Effect of Gender.

Attitudes toward intimate partner violence (IPVA) can be considered as approval/acceptance or disapproval/nonacceptance of physical violence against the intimate partner, psychological abuse, and control of the intimate partner. Individual (such as antisocial tendencies and irrational relationship beliefs [IRB]) and social factors (such as traditional norms and beliefs) shape IPVA. Studies on intimate partner violence (IPV) have revealed a significant relationship between IPVA and IPV. For this reason, IPVA is key to understanding IPV. This study was conducted to examine the effect of IRB on IPVA in Turkish emerging adults and the moderating effect of gender. Participants consisted of 551 students studying at a university in Central Anatolia. Of the participants, 374 were female, and the remaining 177 were male. All participants had at least one previous relationship experience. In the preliminary analysis performed, males' IPVA scores were higher than those of females. The study findings revealed that IRB and gender positively and significantly predicted IPV attitudes. Another important finding showed that the effect of IRB on IPVA was stronger for females. The results highlighted the importance of working on transforming irrational beliefs into rational beliefs in women's acceptance of IPV.

Influence of type of violence on women's help-seeking behaviour: Evidence from 10 countries in sub-Saharan Africa.

BACKGROUND: Intimate partner violence (IPV) is a major public health concern that mostly impacts women's health and social well-being. This study explored how the various types of IPV (physical, sexual, and emotional) including women's experience of childhood violence influence their help-seeking behavior in sub-Saharan Africa (SSA). METHODS: We analyzed data from the most recent Demographic and Health Surveys (DHS), carried out between 2018 and 2021. The outcome variable was help-seeking behavior. Descriptive and inferential analyses were carried out. The descriptive analysis looked at the bivariate analysis between the country and outcome variables. Using a binary logistic regression model, a multivariate analysis was utilized to determine the association between the outcome variable and the explanatory variables. Binary logistic regression modelling was used based on the dichotomous nature of the outcome variable. The results were sample-weighted to account for any under- or over-sampling in the sample. RESULTS: The proportion of women who sought help for intimate partner violence was 36.1 percent. This ranged from 19.2 percent in Mali to 49.6 percent in Rwanda. Women who experienced violence in childhood (OR = 0.75, CI = 0.69, 0.82) have a lower likelihood of seeking help compared to those who did not experience violence in their childhood. Women who had experienced emotional violence (OR = 1.94, CI = 1.80, 2.08), and physical violence (OR = 1.37, CI = 1.26, 1.48) have a higher likelihood of seeking help compared to those who have not. Women with secondary educational levels (aOR = 1.13, CI = = 1.02, 1.24) have a higher likelihood of seeking help compared to those with no education. Cohabiting women have a higher likelihood (aOR = 1.22, CI = 1.10, 1.35) of seeking help compared to married women. CONCLUSION: The study highlights the importance of early identification of IPV and fit-for-purpose interventions to demystify IPV normalization to enhance women's willingness to seek help. The study's findings suggest that education is crucial for increasing women's awareness of the legalities surrounding IPV and available structures and institutions for seeking help.

Intimate partner violence influences modern family planning use among married women in Tanzania: cross-sectional study.

BACKGROUND: Married women who experience intimate partner violence (IPV) are less likely to negotiate with their partners on modern family planning (FP) use. This study aimed to determine the influence of intimate partner violence and sociodemographics on modern family planning use. METHODS: A community-based cross-sectional study was conducted in the Mara region, Tanzania from April to July 2020. A total of 366 married women were interviewed. Data were collected using a structured interviewer-administered questionnaire. Analysis was done using SPSS version 25, and a binary logistic regression model was used to determine the predictors of modern FP use. The significance level was set at a p-value less than 0.05. RESULTS: The overall prevalence of IPV was 73% with 54.1% physical, 36.3% psychological, and 25.4%, sexual violence. The prevalence of modern FP use was 62%, and the most (49.1%) common method practiced by married women was injection (Depo Provera). Physical violence (AOR = 0.32, p = 0.0056), and psychological violence (AOR = 0.22, p = 0.0022) had significantly reduced odds of modern FP use. Religion (AOR = 4.6, p = 0.0085), and availability of preferred modern FP methods (AOR = 9.27, p < 0.0001) had significantly increased odds of modern FP use. CONCLUSION: In this study, there is a positive association between the use of modern FP methods and IPV. To prevent IPV and its negative health consequences, it is crucial to involve community leaders and primary healthcare workers. They can help in identifying the best strategies to prevent IPV and promote the use of modern FP methods. It is equally important to involve male partners in reproductive health decisions, including the use of modern FP methods. This approach will help reduce reproductive coercion.

Reducing Barriers for Expedited Partner Treatment in Adolescents and Young Adults: A Quality Improvement Initiative.

BACKGROUND: Adolescents and young adults (AYAs) face significant barriers to screening, testing, and treatment of sexually transmitted infections (STIs). Expedited partner therapy (EPT) streamlines partner treatment of STIs, but use among adolescents is low. We aimed to increase EPT offering and provision at 2 adolescent medicine clinics (AMCs) and the emergency department (ED) in an urban children's hospital. We addressed barriers at provider, pharmacy, and patient levels. We compared EPT offering and provision for chlamydia ( Chlamydia trachomatis [CT]) and trichomonas ( Trichomonas vaginalis [TV]) infection at baseline and across 2 intervention cycles. METHODS: Baseline data were collected from July 2019 to March 2020 and our intervention time frame spanned from April 2020 to October 2021. Laboratory codes identified patients with CT or TV infections. Cycle 1 allowed providers to order EPT within a patient's chart. The second cycle targeted education and standardization for STI/EPT notification and counseling. During this cycle, notification of ED patients was centralized to the AMC nurses. RESULTS: A total of 747 CT and TV cases were identified. In the AMC, EPT offering increased from 77.3% to 87.7% ( P = 0.01). Expedited partner therapy provision increased from 32.3% to 69.9% ( P < 0.001). Expedited partner therapy offering for ED patients increased by 82.3%. Retesting rates remained consistent, with a significant drop in reinfection rates ( P = 0.003) within patients seen in the AMC. CONCLUSIONS: This quality improvement initiative successfully increased EPT offering and provision among the cases identified. Future cycles may include longer-term follow-up to confirm partner treatment and testing per guidelines.

The Moderating Effects of HIV Relevant Factors on the Relationship Between Intimate Partner Violence and Intention to Start HIV Pre-exposure Prophylaxis (PrEP) Among Cisgender Women.

Intimate partner violence (IPV) and HIV are serious and related public health problems that detrimentally impact women's health. Because women who experience IPV are more likely to acquire HIV, it is critical to promote HIV prevention strategies, such as HIV pre-exposure prophylaxis (PrEP), that increase autonomy. This study of cisgender women eligible for HIV PrEP took place between 2017 and 2019 in Philadelphia and New York City. This study aimed to examine the relationship between four types of IPV (control, psychological, physical, sexual) and intention to start PrEP among PrEP-eligible cisgender women and assess the extent to which HIV relevant factors moderated the association between IPV experience and intention to start PrEP. In this sample of PrEP-eligible women (n = 214), 68.7% indicated intention to start PrEP in the next 3 months. Ethnicity was strongly associated with intention to start PrEP, with Hispanic women having the highest odds of intending to start PrEP in the next 3 months. Having a controlling partner significantly predicted intention to start PrEP. Women with more than one sex partner and a controlling partner had higher odds of intending to start PrEP as compared with those who had one or no partners and had no IPV control. These findings point to a need for patient-centered interventions that address the need for safety and autonomy among cisgender, PrEP-eligible women.

What Do Different People Look for in a Partner? Effects of Sex, Sexual Orientation, and Mating Strategies on Partner Preferences.

Partner preferences are an important differential in relationship formation and evolutionary fitness, and vary according to individual, ecological, and social factors. In this study, we evaluated the variation in preference for intelligence, kindness, physical attractiveness, health, and socioeconomic level among individuals of different sexes and sexual orientations in a Brazilian sample. We analyzed the preference scores of 778 heterosexual, bisexual, and homosexual men and women in three budgeted mate design tasks (low vs. medium vs. high budget) and their association with sociosexuality, attachment styles, homogamy, and willingness to engage in short- and long-term relationships. Results indicated a global trait preference order, with intelligence ranking first, followed by kindness, physical attractiveness, health, and lastly by socioeconomic status. Typical sex differences were observed mostly within the heterosexual group, and specific combinations of sex and sexual orientation were linked to variation in preference for physical attractiveness, kindness, and socioeconomic status. We also found unique associations of the other variables with partner preferences and with willingness to engage in short- or long-term relationships. By exploring the partner preferences of non-heterosexual individuals from a Latin American country, an underrepresented group in evolutionary psychology research, our results help understand the universal and specific factors that guide partner preferences and human sexual behavior.

Association between intimate partner violence and pregnancy intention: evidence from the Peruvian demographic and health survey.

BACKGROUND: Intimate partner violence (IPV) in Peru represents a significant public health challenge. IPV can influence women's reproductive and social behaviors, undermining fertility control, and exacerbating unintended pregnancies. Our objective was to assess the association between IPV and pregnancy intention among Peruvian women of reproductive age. METHODS: We conducted a secondary analysis of Peru's 2020 Demographic and Family Health Survey data. The independent variable in this study was IPV against women, which includes psychological IPV, sexual IPV, and physical IPV. If a respondent experienced any of these three forms of IPV, the IPV variable was labeled as "yes"; if none were present, it was labeled as "no". The dependent variable was pregnancy intention (no vs. yes). We utilized a generalized linear model (GLM) from the Poisson family with a log link function to assess the relationship between IPV occurrences (total and each IPV type) and pregnancy intention. We report crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI). RESULTS: We analyzed data from 8466 women aged 15 to 49. The prevalence of any IPV was 49.6% (psychological IPV: 45.8%; physical IPV: 22.2%; and sexual IPV: 4.3%). Exposure to physical IPV (aPR: 1.05; 95% CI: 1.03-1.07), psychological IPV (aPR: 1.04; 95% CI: 1.02-1.06), and sexual IPV (aPR: 1.09; 95% CI: 1.04-1.13), as well as a history of any IPV (aPR: 1.05; 95% CI: 1.02-1.07), were associated with a higher probability of not intending to become pregnant. This association persisted after adjusting for confounders like age, marital status, educational attainment, education level of the child's father, place of residence, wealth, ethnicity, and parity. CONCLUSION: One in two Peruvian women reported experiencing IPV. An association was observed between IPV exposure and a higher probability of not holding an intention to become pregnant.

The impacts of violence among women in intimate relationships: an integrative literature review. / Os impactos da violência entre mulheres em relação íntima: uma revisão integrativa da literatura.

The aim is to identify cultural, social and health impacts caused by intimate partner violence (IPV) in homoaffective (MOH) and biaffective (MOB) women. This is an integrative literature review that sought and analyzed studies indexed in the PubMed and Lilacs databases, considering the following languages. The study sought to answer the following research question: "What impacts does IPV bring to MOB and MOH?". Forty two studies were found and after applying the exclusion criteria, 19 went into the final sample. Data were analyzed using the content analysis methodology, Bardin's thematic analysis modality (2009). The full analysis of the articles revealed two categories: 1) Intimate partner violence and sociocultural impacts; and 2) Intimate partner violence and health impacts. The experience of situations of violence in intimate partnerships between homo and/or biaffective women affect their sociocultural and health dimensions, since they are under the bias of double vulnerability: women in homo/biaffective relationships. There is also an invisibility of the phenomenon in health services, since professionals are not trained to address the different sexual orientations among women and even less the situations of violence resulting from these relationships.

O objetivo é identificar impactos culturais, sociais e de saúde causadas pela violência na parceria íntima (VPI) em mulheres homoafetivas (MOH) e biafetivas (MOB). Estudo de revisão integrativa da literatura que buscou e analisou estudos indexados nas bases de dados PubMed e Lilacs, sendo considerados os idiomas: inglês, português e espanhol. O estudo buscou responder a seguinte pergunta de pesquisa: "Quais impactos a VPI traz para as MOB e MOH?". Foram encontrados 42 estudos e após aplicado os critérios de exclusão, 19 compuseram a amostra final. Os dados foram analisados a partir da metodologia de análise de conteúdo, modalidade análise temática de Bardin (2009). A análise na íntegra dos artigos revelou duas categorias: 1) A violência na parceria íntima e os impactos socioculturais; e 2) A violência na parceira íntima e os impactos na saúde. A vivência de situações de violência na parceria íntima entre mulheres homo e/ou biafetivas afeta suas dimensões socioculturais e de saúde, já que elas estão sob o viés da dupla vulnerabilidade: mulher em relações homo/biafetivas. Existe também invisibilidade do fenômeno nos serviços de saúde já que os profissionais não são formados para abordar as diferentes orientações sexuais entre mulheres e menos ainda as situações de violência advindas dessas relações.