Intimate Partner Violence Around the Time of Pregnancy and Utilization of WIC Services.

OBJECTIVES: Intimate partner violence (IPV) around the time of pregnancy is a risk factor for adverse pregnancy and birth outcomes. The supplemental nutrition program for women, infants, and children (WIC), available to low income pregnant women, may provide an opportunity to identify victims of IPV and refer them to services. This cross-sectional study aims to determine whether WIC participants are more likely than non-WIC participants to have reported IPV before or during pregnancy in the United States. METHODS: The 2004-2011 National Pregnancy Risk Assessment Monitoring System (PRAMS) survey (n = 319,689) was analyzed in 2015. Self-reported WIC participation, pre-pregnancy IPV, and IPV during pregnancy were examined. The associations between IPV and WIC participation were analyzed using multiple logistic regression and adjusted odds ratios with corresponding 95% confidence intervals were calculated. Subpopulation analysis was conducted, stratified by race/ethnicity. RESULTS: Nearly half of the study sample received WIC (48.1%), approximately 4% of women reported physical abuse 12 months before their most recent pregnancy, and 3% reported abuse during pregnancy. After adjusting for confounders, women who reported IPV before and during pregnancy had significantly higher odds of WIC utilization compared to women who did not report IPV. However, when stratified by race, the association was only significant for non-Hispanic White women (pre-pregnancy AOR 1.47, 95% CI [1.17, 1.85]; during pregnancy AOR 1.47, 95% CI [1.14, 1.88]). CONCLUSIONS FOR PRACTICE: There is an association between IPV before and during pregnancy and utilization of WIC. Public health professionals and policy makers should be aware of this association and use this opportunity to screen and address the needs of WIC recipients.

Associations of Partner Age Gap at Sexual Debut with Teenage Parenthood and Lifetime Number of Partners.

CONTEXT: Age at sexual debut and age gap between partners at debut are modifiable characteristics that may be related to risky sexual behaviors. Understanding any such relationships is a necessary first step toward strengthening risk interventions. METHODS: Age at sexual debut and partner age gap were examined for 3,154 female and 2,713 male respondents to the 2011-2013 National Survey of Family Growth who first had intercourse before age 18. Multivariable logistic regression was used to assess associations between these measures and teenage parenthood and reporting a high lifetime number of partners (i.e., a number above the sample median). RESULTS: Females' odds of teenage parenthood were elevated if sexual debut occurred at ages 15-17 and involved a partner age gap of 3-4 years (odds ratio, 1.8) or more (2.0); they were reduced if debut occurred before age 15 and the gap was 3-4 years (0.8). Females' likelihood of reporting a high lifetime number of partners was negatively associated with age gap (0.4-0.7, depending on age at debut and length of age gap). Males' likelihood of reporting a large number of partners was positively associated with age gap if sexual debut was before age 15 and the gap was five or more years (1.7) or if debut was at ages 15-17 and involved a 3-4-year gap (2.0). CONCLUSION: Identifying the mechanisms underlying these associations could inform program design and implementation.

Intimate partner violence, consenting to HIV testing and HIV status among Zambian women.

Sub-Saharan African countries are heavily burdened with HIV, which disproportionately affects women of reproductive age. Extant literature is inconsistent regarding the link between intimate partner violence and HIV. Data from the 2007 Zambian Demographic Health Survey of women aged 15-49 (n = 5014) were analysed. The influence of abuse by a current or former husband on consent to HIV testing and HIV positivity were evaluated. The unadjusted analysis showed a statistically significant association between intimate partner violence and consent to testing for HIV. Stratified analysis showed that there was a statistically significant association between intimate partner violence and HIV testing in rural areas but not in urban areas. However, the association lost its significance when adjusted for confounding factors. No statistically significant association was found between intimate partner violence and HIV-positive status. It is encouraging that women who experienced intimate partner were testing for HIV. Prevention efforts should continue addressing the needs of this population.