Ethnic-specific prevalence rates of intimate partner violence against women in New Zealand.

OBJECTIVE: This study presents age-standardised ethnic-specific prevalence rates of intimate partner violence against women in New Zealand, by physical and/or sexual intimate partner violence, psychological intimate partner violence, controlling behaviours and economic abuse. METHODS: Data are from 1,431 ever-partnered women in the representative and cross-sectional He Koiora Matapopore, the 2019 New Zealand Family Violence Study. RESULTS: High lifetime prevalence of intimate partner violence is present across all ethnic groups in NZ, with over half of all women reporting any intimate partner violence (55.8%). Substantial ethnic disparities exist in intimate partner violence rates, with Maori women reporting the highest prevalence of intimate partner violence (64.6%), followed by NZ European women (61.6%). CONCLUSIONS: Intimate partner violence prevention and intervention services are needed at the population-level, and services must be culturally responsive and attuned to the needs of communities that bear the greatest burden. IMPLICATIONS FOR PUBLIC HEALTH: Ethnic differences in intimate partner violence prevalence likely contribute to health disparities at the population-level, reinforcing calls for prevention and necessitating healthcare systems to be culturally informed and mobilised to address intimate partner violence as a priority health issue.

Evidence of Gender Asymmetry in Intimate Partner Violence Experience at the Population-Level.

Claims of "gender symmetry" in intimate partner violence (IPV) prevalence are contested, with resolution of the issue complicated by methodological and measurement challenges. This study explores gendered differences in the distribution of IPV exposure at the population-level, considering multiple types of IPV exposure. The subjects comprised of 1,431 ever-partnered women and 1,355 ever-partnered men. Data from a nationally representative population-based cross-sectional survey were used to compare men and women's IPV experiences. Twenty-three IPV acts were assessed across IPV types (moderate physical, severe physical, sexual, psychological, controlling behaviors, economic). Proportions were presented by gender for the number of individual IPV acts experienced per IPV type, and the frequency of these acts (none, once, few times, or many times). A composite exposure score was developed to assess the number of acts and their frequency within types by comparing scores in tertiles and across types by correlations. Women reported greater overall prevalence of 20 of the 23 individual IPV acts assessed. Across all assessed acts, women comprised a substantially greater proportion of those who reported experiencing individual acts "many times." Women experienced more severe and more frequent IPV than men based on self-reported experience of IPV acts, and by the frequency with which acts were experienced. Significant differences between men and women's exposure scores were observed for all six assessed types, with greater proportions of women scoring in the upper tertiles. This study provides evidence of gender asymmetry in experiences of IPV at the population level. While men do experience IPV victimization, there remains need for directed and substantial resource allocation for intervention and therapeutic responses to women's exposure to IPV, and for primary prevention with men. Going forward, IPV measurement tools that consider frequency, severity, or co-occurring types of IPV are needed.

Association Between Women's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand.

Importance: Intimate partner violence (IPV) is increasingly recognized as a contributing factor for long-term health problems; however, few studies have assessed these health outcomes using consistent and comprehensive IPV measures or representative population-based samples. Objective: To examine associations between women's lifetime IPV exposure and self-reported health outcomes. Design, Setting, and Participants: The cross-sectional, retrospective 2019 New Zealand Family Violence Study, adapted from the World Health Organization's Multi-Country Study on Violence Against Women, assessed data from 1431 ever-partnered women (63.7% of eligible women contacted) in New Zealand. The survey was conducted from March 2017 to March 2019, across 3 regions, which accounted for approximately 40% of the New Zealand population. Data analysis was performed from March to June 2022. Exposures: Exposures were lifetime IPV by types (physical [severe/any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types. Main Outcomes and Measures: Outcome measures were poor general health, recent pain or discomfort, recent pain medication use, frequent pain medication use, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition. Weighted proportions were used to describe the prevalence of IPV by sociodemographic characteristics; bivariate and multivariable logistic regressions were used for the odds of experiencing health outcomes by IPV exposure. Results: The sample comprised 1431 ever-partnered women (mean [SD] age, 52.2 [17.1] years). The sample was closely comparable with New Zealand's ethnic and area deprivation composition, although younger women were slightly underrepresented. More than half of the women (54.7%) reported any lifetime IPV exposure, of whom 58.8% experienced 2 or more IPV types. Compared with all other sociodemographic subgroups, women who reported food insecurity had the highest IPV prevalence for any IPV (69.9%) and all specific types. Exposure to any IPV and specific IPV types was significantly associated with increased likelihood of reporting adverse health outcomes. Compared with those unexposed to IPV, women who experienced any IPV were more likely to report poor general health (adjusted odds ratio [AOR], 2.02; 95% CI, 1.46-2.78), recent pain or discomfort (AOR, 1.81; 95% CI, 1.34-2.46), recent health care consultation (AOR, 1.29; 95% CI, 1.01-1.65), any diagnosed physical health condition (AOR, 1.49; 95% CI, 1.13-1.96), and any mental health condition (AOR, 2.78; 95% CI, 2.05-3.77). Findings suggested a cumulative or dose-response association because women who experienced multiple IPV types were more likely to report poorer health outcomes. Conclusions and Relevance: In this cross-sectional study of women in New Zealand, IPV exposure was prevalent and associated with an increased likelihood of experiencing adverse health. Health care systems need to be mobilized to address IPV as a priority health issue.

Association Between Men's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand.

Importance: Health implications of intimate partner violence (IPV) against men is relatively underexplored, although substantial evidence has identified associations between IPV and long-term physical health problems for women. Given the gendered differences in IPV exposure patterns, exploration of men's IPV exposure and health outcomes using population-based samples is needed. Objective: To assess the association between men's lifetime IPV exposure and self-reported health outcomes. Design, Setting, and Participants: This cross-sectional study analyzed data from the 2019 New Zealand Family Violence Study, which was conducted across 3 regions of New Zealand. The representative sample included ever-partnered men aged 16 years or older. Data analysis was performed between May and September 2022. Exposures: Lifetime IPV against men by types (physical [severe or any], sexual, psychological, controlling behaviors, and economic abuse), any IPV (at least 1 type), and number of IPV types experienced. Main Outcomes and Measures: The 7 health outcomes were poor general health, recent pain or discomfort, recent use of pain medication, frequent use of pain medication, recent health care consultation, any diagnosed physical health condition, and any diagnosed mental health condition. Results: The sample comprised 1355 ever-partnered men (mean [SD] age, 51.3 [16.9] years), who predominantly identified as heterosexual (96.9%; 95% CI, 95.7%-97.8%). Half of the sample (49.9%) reported experiencing any lifetime IPV, of whom 62.1% reported at least 2 types. Of all sociodemographic subgroups, unemployed men had the greatest prevalence of reporting exposure to any IPV (69.2%) and all IPV types. After adjustment for sociodemographic factors, men's exposure to any lifetime IPV was associated with an increased likelihood of reporting 4 of the 7 assessed health outcomes: poor general health (adjusted odds ratio [AOR], 1.78; 95% CI, 1.34-2.38), recent pain or discomfort (AOR, 1.65; 95% CI, 1.21-2.25), recent use of pain medication (AOR, 1.27; 95% CI, 1.00-1.62), and any diagnosed mental health condition (AOR, 1.66; 95% CI, 1.11-2.49). Specific IPV types were inconsistently associated with poor health outcomes. Any physical IPV exposure was associated with poor general health (AOR, 1.80; 95% CI, 1.33-2.43), recent pain or discomfort (AOR, 2.23; 95% CI, 1.64-3.04), and frequent use of pain medication (AOR, 1.69; 95% CI, 1.08-2.63), which appeared to be associated with exposure to severe physical IPV. Exposure to sexual IPV, controlling behaviors, and economic abuse was not associated with any assessed outcomes after sociodemographic adjustment. Experience of a higher number of IPV types did not show a clear stepwise association with number of health outcomes. Conclusions and Relevance: Results of this study indicate that exposure to IPV can adversely affect men's health but is not consistently a factor in men's poor health at the population level. These findings do not warrant routine inquiry for IPV against men in clinical settings, although appropriate care is needed if IPV against men is identified.

Gender Patterns in the Use of Physical Violence Against a Violent Partner: Results of a Cross-Sectional Population-Based Study in New Zealand.

We examine gendered patterns in the use of violence in response to the partner's violence ("fighting back"). Within each gender, we examined if socio-demographic differences in prevalence were present, and if contextual factors influenced the use of violence against a violent partner. Data from a large, population-based sample of New Zealand adults was used to identify ever-partnered respondents who had experienced physical IPV (n = 407 women, and n = 391 men). Weighted percentages and 95% confidence intervals (95%CIs) were calculated for the use of violence against a violent partner, stratified by gender. Multivariable logistic regression was used to assess the association between each contextual risk factors and the use of violence against a violent partner. For both men and women, at the multivariable level, use of violence against a violent partner was associated with contextual factors related to the abuse. However, for almost all of these variables a higher proportion of women than men experienced the risk factor; for example, a higher proportion of women than men reported having experienced severe IPV (57.6% women; 43.7% men), injuries resulting from IPV (44.5% women, 15.0% men), and fear of a partner (22.7% women, 4.9% men). Women were also more likely to report experiencing other types of IPV (particularly sexual IPV) and were more likely to report that their children were present at the time of violence. These factors contributed to the higher proportion of women who reported fighting back at least once (53.4% of women and 22.3% of men). Health, social, and legal services need to conduct appropriate and thorough assessment of nature and context (current and historical) of the violence that individuals have been exposed to as part of service provision. Assessments need to be carried out with a gender-lens in order to provide comprehensive and appropriate responses.

Prevalence of interpersonal violence against women and men in New Zealand: results of a cross-sectional study.

OBJECTIVE: To determine prevalence rates of non-partner and partner violence (IPV) in men and women from a population-based study. METHODS: We recruited 2,887 randomly selected respondents (1,464 women and 1,423 men) from three regions of New Zealand between 2017 and 2019. Face-to-face interviews using a questionnaire adapted from the WHO multi-country study on violence against women was used for data collection. RESULTS: Physical violence by non-partners was most commonly experienced by men (39.9% lifetime exposure) compared with 11.9% of women. More women (8.2%) experienced lifetime non-partner sexual violence compared with men (2.2%). About 29% of men and women reported at least one act of physical-IPV in their lifetime, and about 12.4% of women and 2.1% of men reported at least one act of lifetime sexual IPV. More women than men reported serious injuries, fear, and physical and mental health impacts following IPV experience. CONCLUSIONS: These findings indicate high prevalence of interpersonal violence exposure in the population, with marked gender differences in the types and impacts of violence reported. IMPLICATIONS FOR PUBLIC HEALTH: Study results call for the urgent implementation of violence prevention programs, and funding for both services to rehabilitate people who have perpetrated violence and services to support recovery of those affected.

Relational Mobility and Other Contributors to Decline in Intimate Partner Violence.

This study explored whether changes in risk and protective factors of intimate partner violence (IPV) can account for the noted reduction in 12-month IPV prevalence in New Zealand between 2003 and 2019. Changes in relational mobility over time were also explored. Data from two population-based surveys of 18-64 year-old ever-partnered women in New Zealand that were conducted according to identical procedures in 2003 (n=2764) and 2019 (n=944) were used. Changes in a variety of potential risk and protective factors over time and their possible contribution to IPV reduction were assessed. The findings indicated that there was no change in the prevalence of the strongest risk and protective factors of IPV victimisation and perpetration over time (e.g. partner concurrent relationship, previous exposure to violence for both respondent and partner, and partner's problematic alcohol/drug use). However, a combination of factors including decline in women's problematic alcohol or drug use, decline in the number of children within families, and increases in the proportion of women and partners with a qualification higher than secondary education are likely to be associated with the reduction in IPV prevalence. A greater degree of relational mobility, demonstrated through a greater proportion of women who left their abusive partner permanently and increased numbers of relationships that women had, was also observed between two study years. Overall, these results indicate that changes in 12-month IPV prevalence over time are likely to be linked with changes that increase women's autonomy and ability to move out of violent relationships. To achieve sustained reductions in IPV, more comprehensive and planned efforts are needed to address other underlying and exacerbating causes, including problematic alcohol/drug use and previous exposure to violence during childhood and adulthood.

Factors influencing help-seeking by those who have experienced intimate partner violence: Results from a New Zealand population-based study.

BACKGROUND: There is limited information about what influences help-seeking following experience of intimate partner violence (IPV). This study investigated determinants of formal and informal help-seeking by those who had experienced lifetime physical, sexual or psychological IPV. METHODS: A cross-sectional population-based New Zealand study conducted from 2017 to 2019 recruited 2,887 participants (1,464 women and 1,423 men) aged 16 years and older. Face-to-face interviews were conducted. Of these, 1,373 participants experienced physical, sexual or psychological IPV. Two series of logistic regressions were conducted: 1) comparing those who sought help with those who did not, and 2) comparing those who had not sought help with those who sought informal help only, or with those who also sought formal help. RESULTS: Of the 1,373 participants who reported experience of physical, sexual or psychological IPV 835 participants (71.3% of women and 49.0% of men) sought some form of help. In both genders self-reported physical and mental health or work-related IPV impacts were significantly associated with help-seeking. Experiencing only one form of IPV was associated with lower odds of seeking formal help by women (Adjusted odds ratio = 0.38; 95%CI = 0.15, 0.92 for physical/sexual only and AOR = 0.37, 95%CI = 0.22, 0.64 for psychological only) compared to those experiencing concurrent types of IPV. CONCLUSION AND IMPLICATIONS: Although there were gender differences in help-seeking, for both women and men the experience of greater impacts associated with IPV exposure increased the likelihood of help-seeking. Agencies providing services for people who are experiencing IPV need to be equipped to identify and respond to multiple forms of IPV, and prepared to address the suite of impacts experienced.

Lifetime Prevalence of Intimate Partner Violence and Disability: Results From a Population-Based Study in New Zealand.

INTRODUCTION: There is no population-based study on prevalence rates for all forms of intimate partner violence experienced by people with different types of disabilities in New Zealand. This study compares the reported lifetime prevalence of intimate partner violence (physical, sexual, psychological, controlling behaviors, and economic abuse) for people with different types of disabilities with that reported by those without disabilities and tests whether there is a gender difference. METHODS: From March 2017 to March 2019, a total of 2,888 women and men aged ≥16 years participated in a cross-sectional study in New Zealand using a cluster random sampling method. Face-to-face interviews were used for data collection. The WHO Multi-country Study questionnaire was employed as the data collection tool. Logistic regression was conducted, and AORs were reported. RESULTS: Those with any disability reported significantly higher rates of most forms of intimate partner violence than those without disabilities, among both genders, including physical intimate partner violence (AOR=1.80, 95% CI=1.32, 2.47 for women, AOR=2.44, 95% CI=1.72, 3.45 for men) and psychological and economic abuse. Women with disabilities were more likely to report experiences of sexual intimate partner violence than men (range =13.5-17.1% vs 4.0%-21.2% in men). Men with intellectual disability were more likely to report physical intimate partner violence than women with intellectual disability (60.5% in men and 36.0% in women). CONCLUSIONS: People with disabilities report experiencing a significantly high lifetime prevalence of intimate partner violence compared with people without disabilities. The results warrant policy and practice changes to identify early signs of abuse and intervene accordingly and warrant an investment in targeted violence prevention programs.

Prevalence of Nonpartner Physical and Sexual Violence Against People With Disabilities.

INTRODUCTION: This study aims to determine the prevalence rates of nonpartner physical and sexual violence in men and women with different disabilities compared with those in people without disabilities. METHODS: Face-to-face interviews were conducted in 3 regions of New Zealand (2017-2019), and 2,887 randomly selected respondents participated (1,464 women, 1,423 men). Respondents provided information on the disability types (physical, intellectual, psychological, none) experienced and on the experience of physical and sexual violence since age 15 years. Analysis was conducted in 2020-2021. RESULTS: More people with disabilities reported nonpartner physical and sexual violence experience than those without disabilities. For women, 15.4% of those with disabilities experienced lifetime nonpartner physical violence, and 11.1% experienced lifetime nonpartner sexual violence. For men with disabilities, 56.2% experienced lifetime nonpartner physical violence, and 5.6% experienced lifetime nonpartner sexual violence. Women and men with psychological disabilities reported the highest prevalence rates of nonpartner physical and sexual violence. The main perpetrators of nonpartner physical violence for women with disabilities were parents and relatives (59.7%), whereas for men with disabilities, strangers (59.3%) were the main perpetrators. Among people with disabilities who reported nonpartner sexual violence, 43.5% of women and 60.0% of men never sought help. CONCLUSIONS: This is one of the few studies globally reporting on the prevalence of nonpartner violence in both men and women with different disability types. It contributes information on the gender and relationships of those who perpetrated the violence. Findings highlight the need for violence prevention and intervention programs that are inclusive of and responsive to those with different disability types.

Women's Initiation of Physical Violence Against an Abusive Partner Outside of a Violent Episode.

This article explores women's use of physical violence against an abusive male partner, outside of the context of a violence episode. Data were drawn from the New Zealand Violence Against Women Study, a cross-sectional household survey conducted using a population-based cluster-sampling scheme. Logistic regression analysis was used to identify factors associated with women initiating physical violence against their male partners. Of the 845 women who had experienced physical violence perpetrated by their intimate partner, 19% reported physically mistreating their partner at least once outside of a male initiated violent episode, while 81% never initiated violence against their partner. Analyses showed that women's initiation of violence under these circumstances was strongly associated with either or both partners having alcohol problems, her recreational drug use, her number of violent partners, and her mother being hit or beaten by her father when she was a child.

Hitting Back: Women's Use of Physical Violence Against Violent Male Partners, in the Context of a Violent Episode.

This article explores women's use of physical violence in the context of experiencing intimate partner violence (IPV). Data were drawn from the New Zealand Violence Against Women Study, a cross-sectional household survey conducted using a population-based cluster-sampling scheme. Multinomial logistic regression was used to identify factors associated with women's use of physical violence against their partners when they were being physically hurt. Of the 843 women who had experienced physical violence perpetrated by an intimate partner, 64% reported fighting back at least once or twice whereas 36% never fought back. Analyses showed that women's use of violence more than once or twice was associated with experience of severe IPV, IPV that had "a lot of effect" on their mental health, and with children being present when the woman was being physically abused. Women's use of physical violence only once or twice was associated with both partners having alcohol problems and both having been exposed to violence as a child. Of the women who fought back, 66% reported that this did not result in the violence stopping.

Physical injuries resulting from intimate partner violence and disclosure to healthcare providers: results from a New Zealand population-based study.

BACKGROUND: Few studies document the health burden attributable to intimate partner violence (IPV) at the population level. OBJECTIVES: To document injuries resulting from IPV and women's use of healthcare for treatment of IPV injuries using the New Zealand Violence Against Women Study. METHODS: A cross-sectional household survey was conducted using a population-based cluster sampling scheme. In total, 2855 women aged 18-64 years were interviewed about their experience of IPV, injuries resulting from violence, and their use of healthcare services. RESULTS: Of the 956 women who had experienced physical and/or sexual IPV in their lifetime, half were injured at least once as a result of the violence. The most common injuries were abrasions and bruises; followed by cuts, punctures, bites; and injuries to the eye or ear. Many women reported that they needed healthcare for treatment of IPV injuries, yet most (86%) did not receive healthcare on all occasions it was needed. Half of ever-injured women who received treatment told a healthcare provider the reason for their injury. Among those who did not disclose, shame was the most frequent reason for not telling, followed by fear of further violence. CONCLUSIONS: This population-based study documents the injury-burden created by IPV, to individuals, healthcare systems, and the population. Implications include supporting healthcare providers to respond to victims of violence and the need for prevention strategies at the population level.

Help-seeking behaviors and reasons for help seeking reported by a representative sample of women victims of intimate partner violence in New Zealand.

Efforts to understand and support the process of help seeking by victims of intimate partner violence are of considerable urgency if we are to design systems and responses that are capable of actively and appropriately meeting the needs of victims. Using data from the New Zealand Violence Against Women Study, which drew from a representative general population sample of women aged 18 to 64 years, the authors report on the help-seeking behaviors of the women who had ever in their lifetime experienced physical and/or sexual violence by an intimate partner (n = 956). More than 75% of respondents reported that they had told someone about the violence, indicating that it is not necessarily a "secret and private" problem. However, more than 40% of women indicated that no one had helped them. Informal sources of support (family and friends) were most frequently told about the violence but not all provided helpful responses. Fewer women told formal sources of help such as police, health care providers, and not all provided helpful responses. Women's reasons for seeking help and for leaving violent relationships were similar and included "could not endure more," being badly injured, fear or threat of death, and concern for children. Women's reasons for staying in or returning to violent relationships included perception of the violence as "normal/not serious," her emotional investment in the relationship, or staying for the sake of the children. The findings suggest that broader community outreach is required to ensure that family and friends are able to provide appropriate support for women in abusive relationships who are seeking help. Continued improvement in institutional responses is also required.

Prevalence of child sexual abuse reported by a cross-sectional sample of New Zealand women.

OBJECTIVE: The objective is to describe the prevalence of child sexual abuse (CSA) among women in New Zealand, document ethnic specific rates, and outline the frequency of abuse experienced and the most commonly identified perpetrators. Associations between CSA and later adverse consequences were also explored. METHODS: Retrospective report from a random sample of 2,855 women aged 18-64 years old in two regions in New Zealand. Face-to-face interviews with one randomly selected woman from each household were conducted. RESULTS: The overall prevalence rates for CSA were 23.5% for women from the urban region and 28.2% from the rural region. In both urban and rural regions, Maori women more frequently reported experiences of CSA than women from European and other ethnic groups (urban: 30.5% vs. 17.0% and rural: 35.1% vs. 20.7%). The median age of onset of the abuse was 9 years, and the median estimated age of the abuser was 30 years. Half of those who experienced CSA reported that it occurred once or twice, 27% "a few times," and 23% "multiple times." Sole perpetrators were involved in 83% of cases. The majority of cases were perpetrated by a family member, most frequently male. Compared with non-victims, victims of CSA were twice as likely to experience later intimate partner violence and violence by others. CONCLUSIONS: This study reports on a large, population-based sample in an ethnically diverse population in New Zealand, providing the first ethnic-specific rates of CSA available. Findings suggest important priorities for prevention and intervention activities.