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      Does domestic violence legislation reduce permissive attitudes about intimate partner violence? Longitudinal evidence from men and women from 61 countries

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          Abstract

          Background:

          Intimate partner violence (IPV) is highly prevalent and has substantial implications for women’s health. Changing IPV attitudes is one pathway to reduce IPV. While evidence suggests that interventions targeting individuals may change IPV attitudes, the effect of wider-scale interventions, such as legislation, remain unknown.

          Methods:

          We used individual-level IPV attitudes information collected between 1997 and 2020 by the Demographic and Health Surveys (DHS) and the Multiple Indicator Cluster Surveys (MICS), which we linked with national-level domestic violence (DV) legislation information. We evaluated the effect of adoption of DV legislation on changes in IPV attitudes using a difference-in-differences study design that controlled for time-varying country-level confounding and accounted for staggered timing of legislation adoption.

          Findings:

          Our sample included 2,184,047 women from 60 countries and 390,877 men from 40 countries. After controlling for country-level confounders, adoption of DV legislation reduced IPV acceptability among women (average treatment effect among treated (ATT) = −0.07, 95% CI: −0.16, 0.06) and men (ATT = −0.11, 95% CI: −0.22, 0.03) although estimates were imprecise and included the null.

          Interpretation:

          DV legislation may reduce permissive IPV attitudes, especially among men, although conclusions should be interpreted cautiously due to imprecise estimates.

          Funding:

          Eunice Kennedy Shriver National Institute of Child Health and Human Development (5R00HD104896).

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          Most cited references28

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          Global health. The global prevalence of intimate partner violence against women.

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            What factors are associated with recent intimate partner violence? findings from the WHO multi-country study on women's health and domestic violence

            Background Intimate partner violence (IPV) against women is a global public health and human rights concern. Despite a growing body of research into risk factors for IPV, methodological differences limit the extent to which comparisons can be made between studies. We used data from ten countries included in the WHO Multi-country Study on Women's Health and Domestic Violence to identify factors that are consistently associated with abuse across sites, in order to inform the design of IPV prevention programs. Methods Standardised population-based household surveys were done between 2000 and 2003. One woman aged 15-49 years was randomly selected from each sampled household. Those who had ever had a male partner were asked about their experiences of physically and sexually violent acts. We performed multivariate logistic regression to identify predictors of physical and/or sexual partner violence within the past 12 months. Results Despite wide variations in the prevalence of IPV, many factors affected IPV risk similarly across sites. Secondary education, high SES, and formal marriage offered protection, while alcohol abuse, cohabitation, young age, attitudes supportive of wife beating, having outside sexual partners, experiencing childhood abuse, growing up with domestic violence, and experiencing or perpetrating other forms of violence in adulthood, increased the risk of IPV. The strength of the association was greatest when both the woman and her partner had the risk factor. Conclusions IPV prevention programs should increase focus on transforming gender norms and attitudes, addressing childhood abuse, and reducing harmful drinking. Development initiatives to improve access to education for girls and boys may also have an important role in violence prevention.
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              Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial.

              HIV infection and intimate-partner violence share a common risk environment in much of southern Africa. The aim of the Intervention with Microfinance for AIDS and Gender Equity (IMAGE) study was to assess a structural intervention that combined a microfinance programme with a gender and HIV training curriculum. Villages in the rural Limpopo province of South Africa were pair-matched and randomly allocated to receive the intervention at study onset (intervention group, n=4) or 3 years later (comparison group, n=4). Loans were provided to poor women who enrolled in the intervention group. A participatory learning and action curriculum was integrated into loan meetings, which took place every 2 weeks. Both arms of the trial were divided into three groups: direct programme participants or matched controls (cohort one), randomly selected 14-35-year-old household co-residents (cohort two), and randomly selected community members (cohort three). Primary outcomes were experience of intimate-partner violence--either physical or sexual--in the past 12 months by a spouse or other sexual intimate (cohort one), unprotected sexual intercourse at last occurrence with a non-spousal partner in the past 12 months (cohorts two and three), and HIV incidence (cohort three). Analyses were done on a per-protocol basis. This trial is registered with ClinicalTrials.gov, number NCT00242957. In cohort one, experience of intimate-partner violence was reduced by 55% (adjusted risk ratio [aRR] 0.45, 95% CI 0.23-0.91; adjusted risk difference -7.3%, -16.2 to 1.5). The intervention did not affect the rate of unprotected sexual intercourse with a non-spousal partner in cohort two (aRR 1.02, 0.85-1.23), and there was no effect on the rate of unprotected sexual intercourse at last occurrence with a non-spousal partner (0.89, 0.66-1.19) or HIV incidence (1.06, 0.66-1.69) in cohort three. A combined microfinance and training intervention can lead to reductions in levels of intimate-partner violence in programme participants. Social and economic development interventions have the potential to alter risk environments for HIV and intimate-partner violence in southern Africa.
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                Author and article information

                Journal
                medRxiv
                MEDRXIV
                medRxiv
                Cold Spring Harbor Laboratory
                24 October 2023
                : 2023.10.23.23297413
                Affiliations
                [1 ]Department of Epidemiology, Rollins School of Public Health, Emory University
                [2 ]Hubert Department of Global Health, Rollins School of Public Health, Emory University
                [3 ]City University of New York (CUNY), Queens College
                [4 ]Department of Epidemiology, Mailman School of Public Health, Columbia University
                [5 ]Scripps Institution of Oceanography, University of California San Diego
                Author notes

                Contributors

                RAR conceptualized the study and wrote the first draft of the report.

                RAR, NRP, and TB contributed to the study design.

                ARH, KW, and RAR constructed harmonized datasets.

                ARH and RAR conducted statistical analysis.

                ARH, RAR, CJC, and NRP contributed to the interpretation of results.

                FJ and RAR conducted the literature review.

                FJ and ARH contributed to the writing of the report.

                All authors provided critical feedback of manuscript drafts, and reviewed and approved the final manuscript.

                Article
                10.1101/2023.10.23.23297413
                10635179
                37961711
                af89c369-ce1e-4efd-91d4-b8691e4a4db5

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows reusers to copy and distribute the material in any medium or format in unadapted form only, for noncommercial purposes only, and only so long as attribution is given to the creator.

                History
                Categories
                Article

                domestic violence legislation,attitudes about intimate partner violence,gender-based violence,difference-in-differences,policy evaluation,demographic and health surveys,women, business, and the law database

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