Prevalence of Intimate Partner Violence in Urban Young Women Leslie Davidson, MD, MSc, E. Carolyn Olson MPH, Leslie Rottenberg CSW, Vicki Breitbart CSW EdD, Lynne Stevens CSW BCD, Vaughn Rickert, PsyD Columbia University, Joseph L. Mailman School of Public Health Planned Parenthood of New York City Funded by the CDC through the Center for Youth Violence Prevention at Columbia University

Intimate Partner Violence “…is a pattern of assaultive and coercive behaviors that may include inflicted physical injury, psychological abuse, sexual assault, progressive social isolation, stalking, deprivation, intimidation and threats. These behaviors are perpetrated by someone who is, was, or wishes to be involved in an intimate or dating relationship with an adult or adolescent, and are aimed at establishing control by one partner over the other.” - FVPF

Objectives Prevalence of violence in young women seeking family planning services Impact of violence on contraceptive use Views of younger women re health sector & IPV

Procedures 645 Young women aged recruited at Margaret Sanger Clinic of PPNYC Anonymous computer-assisted audio interview (CASI-A) Compensated $10 gift certificate Offered assistance, referral and handouts: Healthy relationships Information card about agencies and support

Age of Participants Adolescent (15-18): 37% Young Adult (19-21): 41% Adult (22-23): 22% N=638

Ethnicity of Participants 33% Hispanic 28% Black 23% White 12% Asian 5% Other N=638

Reproductive History: Pregnancy and Childbirth Pregnancy 44% have been pregnant % pregnant once % pregnant twice 11% pregnant three or more times Children 10% have had children 573 9% have had one baby 1% have had two or three babies 6

Prevalence: Violence in Last Year Physical Violence 1 (4 questions) 22% 136/617 Sexual Violence 1 (4 questions) 37% 229/616 Controlling Behavior (7 questions) 67% 419/617 1 CADRI 1 1

Experience of Violence (in last yr) 1 Sexual Violence Controlling Behavior Physical Violence 1% 27% 4% 8%20% 12% 1% N=618 1 CADRI and controlling Q’s None = 25% Phys/Sex = 46%

Results: Lifetime “Abuse” 1 Physical (one question) 16% Sexual (one question) 9% 56 Verbal/Emotional (one question) 39% Initial Survey Questions (abused) N=

Lifetime Dating Violence Physical (10 questions) 66% % “abuse” Sexual (2 questions) 29% 184 9% “abuse” Verbal/Emotional (11 questions) 93% % “abuse” N=

Comparing Sexual “Abuse” Question with DVI Sexual Violence Questions Raped, forced into sex by partner 29% of women Missed 2% of women who said they had been “sexually abused” “Sexually abused” by partner 9% of women Missed 59% of the women who had been forced into sex or raped by partner Unsure about 15% of women who had been forced into sex or raped by partner

What are the view of young women ? Their expectations and experiences of the health care sector

Focus Group Results 1 Women do not want to be talked down to by a provider. Providers should ask about the relationship before launching into questions about violence (i.e., “How is your relationship going?”). Providers should not use terms “violence” or “abuse,” but descriptions of behaviors. Providers should normalize screening questions. Providers must be clear about limits of confidentiality and of intervention young women

Disclosure Only 11% of the 321 who identified themselves as “abused” had previously talked to a provider about it 1 53% of the whole sample had already been asked about violence by a provider 1 Initial questions

Recommendations from women who had disclosed abuse What would make women more likely to disclose in the future? Confidentiality assured Clinic environment is friendly and understanding Comfort with provider, harder if it is a man 1 Provider wouldn’t take any action without patient’s permission 1 64% 15-19, 26% – p<07

Screening: Recommendations 1 from the women surveyed 87% would not mind being asked2 2,3 73% felt they could be honest 90% of women feel screening all women is a good or a very good idea 2 74% of women would find it easier if the provider were a woman 3 1 Whole sample of 645 women 2 Varies by violence experience 3 Varies by age or ethnicity

Participants’ views: Who Should Be Asking them? Parents 90% mom 73% dad 65% stepmom 57% stepdad Professionals 95% health care professional 89% counselor or social worker 58% coach

Survey Conclusions High prevalence rates in young women Many young women are exposed to several types of violence in their relationships, and rarely are they exposed to ONLY one. Violence affects women’s contraceptive use Young women support being asked about IPV, particularly by their health care provider Many women who consider themselves abused are not disclosing IPV to their providers.