Violent contraceptive coercion, polyvictimization, and contraceptive outcomes among African American women receiving WIC services in Fulton County, Georgia Público
Bergenfeld, Irina (Spring 2018)
Abstract
Background: Women’s exposure to intimate partner violence and reproductive coercion is associated with negative reproductive health outcomes linked to reduced use of contraceptives, including unintended pregnancy and sexually transmitted infections. African American women have been found to be at higher risk of reproductive coercion by male partners and to have higher rates of unintended pregnancy and sexually transmitted infections than women of other race/ethnicities. Reproductive coercion may contribute to disparities in contraceptive use among African American women, who are less likely to use contraception and less likely to use effective methods. As low-income African American women may be uniquely vulnerable to threats on their reproductive agency, it critical to understand exposure to violent contraceptive coercion and polyvictimization as they relate to contraceptive choices in this group.
Objective: This study seeks to assess the relationship between violent contraceptive coercion and contraceptive behaviors influencing risk of UIP and STIs in AA women receiving care at Women, Infants, and Children (WIC) clinics in Fulton County, GA. We hypothesize that women exposed to past year violent contraceptive coercion and past year polyvictimization will be more likely to forgo contraception or to use ineffective methods, and more likely to use condoms inconsistently or not at all, than women not exposed to these domains of abuse in the past year.
Methods: A secondary analysis was performed using cross-sectional survey data collected between May and July of 2012 at two WIC clinics in Fulton County, GA. Participants completed survey questions involving several domains of health behaviors and experiences, including intimate partner violence and current contraceptive use. This analysis was restricted to African American women under 55 years old. Univariate and multivariate logistic or multinomial regression were used to calculate odds ratios and associated 95% confidence intervals describing the relationship between exposure to VCC and polyvictimization, and outcomes including consistency of condom use and contraceptive nonuse or ineffective use.
Results: Of 395 women interviewed, about 10% reported past year violent contraceptive coercion and 13% reported polyvictimization across at least two of four partner violence domains assessed. Exposure to violent contraceptive coercion in the past year was positively associated with consistent condom use versus nonuse. Polyvictimization showed no significant association with consistency of condom use in unadjusted or adjusted models.
Discussion: The association between violent contraceptive coercion and increased odds of consistent condom use has not been previously described and should be examined in greater depth within the context of African American women’s unique patterns of contraceptive use and exposure to male partner reproductive coercion. Strategies to conceal contraceptive use in women exposed to VCC and other IPV domains should be further explored and incorporated into postpartum family planning counseling.
Table of Contents
Table of Contents
Chapter 1: Review of the literature1
Definitions and prevalence 1
Demographic risk factors5
Sexual and Reproductive Health Outcomes 7
Current instruments14
Gaps and Areas for further study 16
Chapter 2: Introduction19
Chapter 3: Methods21
Chapter 4: Results28
Chapter 5: Discussion and Conclusions32
Chapter 6: Public Health Implications37
List of Abbreviations39
References40
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