Statement of purpose This study aims to investigate associations between intimate partner violence (IPV), reproductive coercion (RC), and contraception, and to understand IPV and RC intervention preferences, barriers to uptake, and implementation issues. Past work suggests that fear of violence/sabotage of contraceptives may explain contraceptive choice and utilisation.
Methods/approach Utilising an explanatory mixed methods design, quantitative data about IPV, RC, and contraception were first collected via web-based survey from 194 English-speaking adult-women in a reproductive healthcare setting. Subsequently, qualitative data were collected via semi-structured interviews with fourteen clinic patients with experiences of IPV and RC to elucidate the quantitative findings and assess intervention preferences and barriers. Associations between IPV, RC, and contraception were estimated with bivariate and multivariate analyses.
Results Almost 38% of patients experienced IPV and over 25% experienced RC in their current relationship. Further, 34% of those experiencing IPV experienced RC, and 50% of those experiencing RC experienced IPV. Women experiencing IPV or RC were more likely to depend on withdrawal or condoms. Over 90% of patients who experienced IPV reported they had not discussed these experiences with a healthcare professional. Patients expressed strong desire for providers to regularly ask about their relationships, including experiences of IPV and RC, using open-ended questions that probe beyond physical well-being. For an intervention, patients wanted a ‘human connexion,’ to feel empowered to recognise signs of unhealthy relationships.
Conclusions The prevalence of IPV and RC among patients in this setting, corroborated by interviews with patients, suggests that an intervention within a reproductive health setting is warranted.
Significance/Contribution to Injury and Violence Prevention Science IPV and RC are significant public health problems. This work suggests that a reproductive health clinic would be an acceptable setting for an intervention to address the effects of IPV and RC on contraceptive use and patient well-being.
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