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Prevalence of Intimate Partner Violence in Urban Young Women. Leslie Davidson, MD, MSc, E. Carolyn Olson MPH, Leslie Rottenberg CSW, Vicki Breitbart CSW EdD, Lynne Stevens CSW BCD, Vaughn Rickert, PsyD. Columbia University, Joseph L. Mailman School of Public Health
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Prevalence of Intimate Partner Violence in Urban Young Women Leslie Davidson, MD, MSc, E. Carolyn Olson MPH, Leslie Rottenberg CSW, Vicki Breitbart CSW EdD, Lynne Stevens CSW BCD, Vaughn Rickert, PsyD Columbia University, Joseph L. Mailman School of Public Health Planned Parenthood of New York City Funded by the CDC through the Center for Youth Violence Prevention at Columbia University
Intimate Partner Violence “…is a pattern of assaultive and coercive behaviors that may include inflicted physical injury, psychological abuse, sexual assault, progressive social isolation, stalking, deprivation, intimidation and threats. These behaviors are perpetrated by someone who is, was, or wishes to be involved in an intimate or dating relationship with an adult or adolescent, and are aimed at establishing control by one partner over the other.”- FVPF
Objectives • Prevalence of violence in young women seeking family planning services • Impact of violence on contraceptive use • Views of younger women re health sector & IPV
Procedures • 645 Young women aged 15-24 recruited at Margaret Sanger Clinic of PPNYC • Anonymous computer-assisted audio interview (CASI-A) • Compensated $10 gift certificate • Offered assistance, referral and handouts: • Healthy relationships • Information card about agencies and support
Age of Participants • Adolescent (15-18): 37% • Young Adult (19-21): 41% • Adult (22-23): 22% N=638
Ethnicity of Participants • 33% Hispanic • 28% Black • 23% White • 12% Asian • 5% Other N=638
Reproductive History: Pregnancy and Childbirth • Pregnancy • 44% have been pregnant 284 • 23% pregnant once 145 • 10% pregnant twice • 11% pregnant three or more times • Children • 10% have had children 573 9% have had one baby 1% have had two or three babies 6
Prevalence: Violence in Last Year 1 1 • Physical Violence1 (4 questions) • 22% 136/617 • Sexual Violence1 (4 questions) • 37% 229/616 • Controlling Behavior (7 questions) • 67% 419/617 1CADRI
Sexual Violence Experience of Violence(in last yr)1 None = 25% Controlling Behavior Phys/Sex = 46% N=618 27% 8% 20% 12% 1% 4% Physical Violence 1% 1CADRI and controlling Q’s
Results: Lifetime “Abuse”1 • Physical (one question) • 16% • Sexual (one question) • 9% 56 • Verbal/Emotional (one question) • 39% 251 N=630-634 1 Initial Survey Questions (abused)
Lifetime Dating Violence • Physical (10 questions) • 66% 417 • 16% “abuse” • Sexual (2 questions) • 29% 184 • 9% “abuse” • Verbal/Emotional (11 questions) • 93% 587 • 39% “abuse” N=630-634
Comparing Sexual “Abuse” Question with DVI Sexual Violence Questions • Raped, forced into sex by partner • 29% of women • Missed 2% of women who said they had been “sexually abused” • “Sexually abused” by partner • 9% of women • Missed 59% of the women who had been forced into sex or raped by partner • Unsure about 15% of women who had been forced into sex or raped by partner
What are the view of young women ? Their expectations and experiences of the health care sector
Focus Group Results1 • Women do not want to be talked down to by a provider. • Providers should ask about the relationship before launching into questions about violence (i.e., “How is your relationship going?”). • Providers should not use terms “violence” or “abuse,” but descriptions of behaviors. • Providers should normalize screening questions. • Providers must be clear about limits of confidentiality and of intervention. 1 12 young women
Disclosure • Only 11% of the 321 who identified themselves as “abused” had previously talked to a provider about it1 • 53% of the whole sample had already been asked about violence by a provider 1Initial questions
Recommendations from women who had disclosed abuse • What would make women more likely to disclose in the future? • Confidentiality assured • Clinic environment is friendly and understanding • Comfort with provider, harder if it is a man1 • Provider wouldn’t take any action without patient’s permission 164% 15-19, 26% 20-24 – p<07
Screening: Recommendations1 from the women surveyed • 87% would not mind being asked22,3 • 73% felt they could be honest • 90% of women feel screening all women is a good or a very good idea2 • 74% of women would find it easier if the provider were a woman3 1 Whole sample of 645 women 2 Varies by violence experience 3 Varies by age or ethnicity
Participants’ views: Who Should Be Asking them? • Parents • 90% mom • 73% dad • 65% stepmom • 57% stepdad • Professionals • 95% health care professional • 89% counselor or social worker • 58% coach
Survey Conclusions • High prevalence rates in young women • Many young women are exposed to several types of violence in their relationships, and rarely are they exposed to ONLY one. • Violence affects women’s contraceptive use • Young women support being asked about IPV, particularly by their health care provider • Many women who consider themselves abused are not disclosing IPV to their providers.