(P274) Intimate partner violence reported by pregnant and recently postpartum women participating in a sexually transmitted infection screening study in Gaborone, Botswana

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Chibuzor M. Babalola, MD, MPH

Postdoctoral Research Associate & Part-time Professor
Keck School of Medicine Department of Population and Public Health Sciences, University of Southern California, United States

Co-Author(s)

RR

Rebecca Ryan, BMBCh, DTM&H, PGCert(MedEd), DFSRH, MRCP (she/her/hers)

Research Physician
Botswana Harvard Partnership, Botswana

Co-author(s)

Aamirah Mussa, n/a

Student
University of Edinburgh / Botswana Harvard Partnership, Botswana
AW

Adriane Wynn, PhD (she/her/hers)

Assistant Professor
University of California, San Diego
Fullerton, California, United States
Emily Hansman, BA (she/her/hers)

Medical Student
University of California, Los Angeles, United States
BB

Bame Bame

Botswana Harvard Partnership, Botswana
Jeffrey D. Klausner, MD (he/him/his)

Clinical Professor
Department of Population and Public Health Sciences, University of Southern California
Los Angeles, California, United States
CM

Chelsea Morroni

Botswana Harvard Partnership / Univerity of Edinburgh, Botswana

Introduction

Intimate partner violence (IPV), ‘behaviour by an intimate partner that causes physical, sexual or psychological harm’, is associated with increased risk for sexually transmitted infections (STIs) including HIV infection, and may initiate or escalate during pregnancy. We examined IPV occurrence and associations in pregnant and postpartum women participating in an STI screening study in Botswana.

Methods

Longitudinal data were analysed from the Maduo Study, a non-randomised cluster study evaluating Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) screening in pregnant women in Gaborone, Botswana. IPV was assessed at first antenatal care (ANC) and 6-8-week postnatal care (PNC) visit using a validated screening tool on verbal, physical and sexual abuse by an intimate partner. Women disclosing IPV were offered support by the research team using the WHO Listen, Inquire, Validate, Enhance Safety and Support approach, and further referred locally. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression.

Results

Of 500 enrolled pregnant women, 419 (84%) and 398 (80%) answered IPV questions at ANC and PNC visits respectively: 45 women disclosed IPV. At first ANC, 37 (9%) disclosed IPV in the previous 12-months: 29 (7%) verbal abuse; 16 (4%) physical abuse; and 3 (0.7%) sexual abuse. Of those 37, 25 (65%) disclosed IPV occurred during their current pregnancy; whilst 15 (41%) reported the most recent episode occurred under the influence of alcohol. Fifteen (41%) wanted to talk to someone about IPV. At PNC, 9 (2.3%) reported new IPV since their third trimester (36-38-week) visit: 7 (16%), 3 (0.8%) and 0 (0%) reported verbal, physical and sexual abuse respectively. There was no association between IPV and testing positive for CT/NG (OR 1.1; 95%CI 0.5-2.5), or IPV and maternal HIV status (OR 0.9; 95%CI 0.4-2.1). There was a strong association between IPV and unintended pregnancy (OR 2.2; 95%CI 1.2-4.2) and alcohol use during pregnancy (OR 5.4; 95%CI 2.3-12.4).

Conclusion

In this study from Botswana, a number of pregnant women reported IPV, predominantly in the current pregnancy. Although IPV was not associated with increased risk of STIs, screening for IPV should be a key part of ANC in Botswana to prevent maternal and infant harm.