Prevalence of co-occurring forms of intimate partner violence against women aged 15–49 and the role of education-related inequalities: analysis of Demographic and Health Surveys across 49 low-income and middle-income countriesResearch in context
Summary: Background: Women experiencing co-occurring forms of intimate partner violence (IPV; ie, physical, sexual, and/or psychological) often face more severe psychological and health consequences than those experiencing a single form. However, research on IPV co-occurrence in low- and middle-inc...
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Elsevier
2025-04-01
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| author | Shuangyu Zhao Shan Liu Jiuxuan Gao Ning Ma Shaoru Chen Joht Singh Chandan Rockli Kim Peter Karoli John Lapah Niyi Jayalakshmi Rajeev Melkamu Aderajew Zemene Md Nuruzzaman Khan Hajirani M. Msuya Chunling Lu S.V. Subramanian Feng Cheng John S. Ji Kun Tang Pascal Geldsetzer Zhihui Li |
| author_facet | Shuangyu Zhao Shan Liu Jiuxuan Gao Ning Ma Shaoru Chen Joht Singh Chandan Rockli Kim Peter Karoli John Lapah Niyi Jayalakshmi Rajeev Melkamu Aderajew Zemene Md Nuruzzaman Khan Hajirani M. Msuya Chunling Lu S.V. Subramanian Feng Cheng John S. Ji Kun Tang Pascal Geldsetzer Zhihui Li |
| author_sort | Shuangyu Zhao |
| collection | DOAJ |
| description | Summary: Background: Women experiencing co-occurring forms of intimate partner violence (IPV; ie, physical, sexual, and/or psychological) often face more severe psychological and health consequences than those experiencing a single form. However, research on IPV co-occurrence in low- and middle-income countries (LMICs) remains limited. This study examines the prevalence of IPV co-occurrence in LMICs and its education-based inequalities. Methods: Data from the most recent Demographic and Health Surveys in 49 LMICs (2011–2023) were used. Our primary outcome was IPV co-occurrence, defined as a woman aged 15–49 ever experiencing any two or three forms of physical, sexual, or psychological IPV from her partner within the past year. We categorised IPV co-occurrence into four subtypes: co-occurrence of (1) physical and sexual IPV, (2) physical and psychological IPV, (3) sexual and psychological IPV, and (4) all three forms of IPV. We analysed the prevalence of IPV co-occurrence and its subtypes by women's education levels, calculating odds ratios to assess inequalities. Nonparametric restricted cubic splines were used to explore nonlinear relationships between education and IPV. Findings: The study included a total of 344,661 women. The weighted prevalence of IPV co-occurrence varied widely across countries—from 2.4% in Armenia to 38.9% in Papua New Guinea. Overall, women with no education were most at risk, experiencing an adjusted prevalence of 14.3% (95% CI: 13.3–15.2), compared to 11.8% (95% CI: 10.8–12.9) among those with primary education, 9.9% (95% CI: 9.3–10.6) for secondary education, and 5.3% (95% CI: 4.5–6.2) for higher education. The prevalence of IPV co-occurrence involving sexual IPV was highest among women with primary education, with 4.1% (95% CI: 3.4–4.8) reporting concurrent physical and sexual violence, compared to 1.5% (95% CI: 1.1–1.9) to 3.7% (95% CI: 3.2–4.1) among other education levels. Interpretation: IPV co-occurrence remains high, particularly among women with little or no education. Education-focused interventions are urgently needed to reduce IPV risk and its severe impact. However, the findings may be influenced by potential reporting biases and cross-country variability in IPV measurement methodologies, which may limit generalizability. Funding: The China National Natural Science Foundation (Grant numbers 72203119) and The Research Fund, Vanke School of Public Health, Tsinghua University. |
| format | Article |
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| issn | 2589-5370 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
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| series | EClinicalMedicine |
| spelling | doaj-art-c11bf783c14d49dfb2c585f2340fddc02025-08-20T01:49:30ZengElsevierEClinicalMedicine2589-53702025-04-018210315010.1016/j.eclinm.2025.103150Prevalence of co-occurring forms of intimate partner violence against women aged 15–49 and the role of education-related inequalities: analysis of Demographic and Health Surveys across 49 low-income and middle-income countriesResearch in contextShuangyu Zhao0Shan Liu1Jiuxuan Gao2Ning Ma3Shaoru Chen4Joht Singh Chandan5Rockli Kim6Peter Karoli7John Lapah Niyi8Jayalakshmi Rajeev9Melkamu Aderajew Zemene10Md Nuruzzaman Khan11Hajirani M. Msuya12Chunling Lu13S.V. Subramanian14Feng Cheng15John S. Ji16Kun Tang17Pascal Geldsetzer18Zhihui Li19Vanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, PR ChinaVanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, PR ChinaVanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, PR ChinaVanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, PR ChinaVanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, PR ChinaDepartment of Applied Health Sciences, University of Birmingham, Birmingham, United KingdomInterdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea; Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of KoreaNational Institute for Medical Research, Dar es Salaam, TanzaniaGhana Health Service, Gushegu Municipal Health Directorate, Gushegu, GhanaDepartment of Public Health and Community Medicine, Central University of Kerala, Kasaragod, IndiaDepartment of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaNossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaDepartment of Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, TanzaniaDivision of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United StatesDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, United States; Harvard Center for Population and Development Studies, Cambridge, MA, United StatesVanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, PR China; Institute for Healthy China, Tsinghua University, 100084, Beijing, ChinaVanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, PR ChinaVanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, PR ChinaDivision of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; Chan Zuckerberg Biohub – San Francisco, San Francisco, CA, USAVanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, PR China; Institute for Healthy China, Tsinghua University, 100084, Beijing, China; Corresponding author. Vanke School of Public Health, Tsinghua University, 100084, Beijing, China.Summary: Background: Women experiencing co-occurring forms of intimate partner violence (IPV; ie, physical, sexual, and/or psychological) often face more severe psychological and health consequences than those experiencing a single form. However, research on IPV co-occurrence in low- and middle-income countries (LMICs) remains limited. This study examines the prevalence of IPV co-occurrence in LMICs and its education-based inequalities. Methods: Data from the most recent Demographic and Health Surveys in 49 LMICs (2011–2023) were used. Our primary outcome was IPV co-occurrence, defined as a woman aged 15–49 ever experiencing any two or three forms of physical, sexual, or psychological IPV from her partner within the past year. We categorised IPV co-occurrence into four subtypes: co-occurrence of (1) physical and sexual IPV, (2) physical and psychological IPV, (3) sexual and psychological IPV, and (4) all three forms of IPV. We analysed the prevalence of IPV co-occurrence and its subtypes by women's education levels, calculating odds ratios to assess inequalities. Nonparametric restricted cubic splines were used to explore nonlinear relationships between education and IPV. Findings: The study included a total of 344,661 women. The weighted prevalence of IPV co-occurrence varied widely across countries—from 2.4% in Armenia to 38.9% in Papua New Guinea. Overall, women with no education were most at risk, experiencing an adjusted prevalence of 14.3% (95% CI: 13.3–15.2), compared to 11.8% (95% CI: 10.8–12.9) among those with primary education, 9.9% (95% CI: 9.3–10.6) for secondary education, and 5.3% (95% CI: 4.5–6.2) for higher education. The prevalence of IPV co-occurrence involving sexual IPV was highest among women with primary education, with 4.1% (95% CI: 3.4–4.8) reporting concurrent physical and sexual violence, compared to 1.5% (95% CI: 1.1–1.9) to 3.7% (95% CI: 3.2–4.1) among other education levels. Interpretation: IPV co-occurrence remains high, particularly among women with little or no education. Education-focused interventions are urgently needed to reduce IPV risk and its severe impact. However, the findings may be influenced by potential reporting biases and cross-country variability in IPV measurement methodologies, which may limit generalizability. Funding: The China National Natural Science Foundation (Grant numbers 72203119) and The Research Fund, Vanke School of Public Health, Tsinghua University.http://www.sciencedirect.com/science/article/pii/S2589537025000823Intimate partner violence co-occurrenceEducation-based inequalityLow- and middle-income countries |
| spellingShingle | Shuangyu Zhao Shan Liu Jiuxuan Gao Ning Ma Shaoru Chen Joht Singh Chandan Rockli Kim Peter Karoli John Lapah Niyi Jayalakshmi Rajeev Melkamu Aderajew Zemene Md Nuruzzaman Khan Hajirani M. Msuya Chunling Lu S.V. Subramanian Feng Cheng John S. Ji Kun Tang Pascal Geldsetzer Zhihui Li Prevalence of co-occurring forms of intimate partner violence against women aged 15–49 and the role of education-related inequalities: analysis of Demographic and Health Surveys across 49 low-income and middle-income countriesResearch in context EClinicalMedicine Intimate partner violence co-occurrence Education-based inequality Low- and middle-income countries |
| title | Prevalence of co-occurring forms of intimate partner violence against women aged 15–49 and the role of education-related inequalities: analysis of Demographic and Health Surveys across 49 low-income and middle-income countriesResearch in context |
| title_full | Prevalence of co-occurring forms of intimate partner violence against women aged 15–49 and the role of education-related inequalities: analysis of Demographic and Health Surveys across 49 low-income and middle-income countriesResearch in context |
| title_fullStr | Prevalence of co-occurring forms of intimate partner violence against women aged 15–49 and the role of education-related inequalities: analysis of Demographic and Health Surveys across 49 low-income and middle-income countriesResearch in context |
| title_full_unstemmed | Prevalence of co-occurring forms of intimate partner violence against women aged 15–49 and the role of education-related inequalities: analysis of Demographic and Health Surveys across 49 low-income and middle-income countriesResearch in context |
| title_short | Prevalence of co-occurring forms of intimate partner violence against women aged 15–49 and the role of education-related inequalities: analysis of Demographic and Health Surveys across 49 low-income and middle-income countriesResearch in context |
| title_sort | prevalence of co occurring forms of intimate partner violence against women aged 15 49 and the role of education related inequalities analysis of demographic and health surveys across 49 low income and middle income countriesresearch in context |
| topic | Intimate partner violence co-occurrence Education-based inequality Low- and middle-income countries |
| url | http://www.sciencedirect.com/science/article/pii/S2589537025000823 |
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