Background Intimate partner violence (IPV) is a worldwide public health problem, especially in low- and middle-income countries. Increasingly, there is research investigating whether health literacy may be protective against certain health problems. We investigated whether health literacy may be protective against IPV, using Zambia as a case study.

Methods We accessed data for Zambia collected through the 2007 Demographic and Health Surveys Program administered by the United States Agency for International Development. We derived a dichotomous measure of health literacy that we have reported previously. Responses to questions regarding verbal, physical, and sexual abuse were used to derive a dichotomous outcome variable representing a history of any IPV. A second measure represented whether victims of IPV had ever sought help. Multivariate logistic regression was used to test the hypothesis that having high health literacy would be protective against IPV.

Results 4,229 respondents between the ages of 15–49 years participated in the survey. 54.1% had experienced some type of IPV and 17.2% of those had sought help. 24.3% had high health literacy. The odds of IPV were higher among: 20–29 year-olds (OR = 1.7, 95% CI: = 1.3, 2.3) and 30–39 year-olds (OR = 1.5, 95% CI: = 1.1, 2.0), women with less than secondary education (OR = 1.5, 95% CI: = 1.1, 2.2), formerly married women (OR = 1.7, 95% CI: = 1.4, 2.1), women living in urban areas (OR = 1.5, 95% CI: = 1.1, 2.0), and did not vary by level of income. After controlling for these characteristics, women with high health literacy were 19% less likely to have ever experienced IPV (OR = 0.81, 95% CI: = 0.6, 1.0). Health literacy and seeking help were not related.

Conclusions This is the first study to find that high health literacy as measured with a robust indicator in a large national sample was protective against IPV. Opportunities should be identified to improve health literacy in an attempt to prevent this global health problem.