Intimate partner violence in three former Soviet Union countries (Azerbaijan, Moldova, and Ukraine): Prevalence, risk factors, and women's reproductive health

Abstract

A scarce body of scientific knowledge is available on IPV in the transitional countries of the former Soviet Union/fSU and the magnitude, risk factors, and acute and lifetime health consequences of IPV remain unknown in the fSU region. The fact that the transitional countries of fSU have different and perhaps unique geopolitical, socioeconomic, and cultural environments may render the research findings from other parts of the world not applicable to the region. The first paper estimates the prevalence and sociodemographic correlates of intimate partner violence (IPV) by type, severity, and frequency. The second paper is aimed at identifying the individual- and community-level risk factors associated with the lifetime occurrence of various types and severity of IPV. The third paper examines women's reproductive health outcomes associated with lifetime exposure to various types of IPV. The dissertation utilized nationally representative data collected through the Demographic and Health Survey (DHS) conducted in Azerbaijan (2006), Moldova (2005), and Ukraine (2007). Respondents were selected using stratified multi-stage cluster sampling and included ever-married females of reproductive age (N=4,420 in Azerbaijan, N=4,485 in Moldova, and N=2,437 in Ukraine). Five to twelve percent of ever-married women reported a history of severe physical IPV, in addition to 7-13% of women who reported ever experiencing only non-severe forms of physical IPV. The reported occurrence of lifetime marital rape was 2-4%. Violence resulted in severe physical injuries for 17-25% of women with a history of physical or sexual IPV. The odds of severe physical and sexual IPV were significantly higher among formerly married women (aOR=4.9-13.3).

Multilevel logistic regression models were utilized to examine individual- and community-level risk factors associated with IPV. Partner's problem drinking was the most consistent factor associated with all types of IPV (aOR=1.7-12.2). Not only individuals but also communities differed in their likelihood of physical IPV. Communities with strong patriarchal gender beliefs, measured by women's tolerance of IPV (aOR=1.17-1.68), and higher prevalence of intergenerational IPV (aOR=1.37-1.42) demonstrated higher risk for physical IPV.

Using multinomial and binomial logistic regressions and adjusting for sociodemographics covariates, the reproductive health outcomes of ever-married women were compared by their lifetime exposure to IPV. The higher odds of unmet need for family planning—failure to use contraception while being exposed to pregnancy and not planning to have children—were observed among currently married women with a history of severe physical IPV or IPV resulting in serious injuries (aOR=2.09-3.17). After controlling for lifetime contraceptive use, the odds of unintended last pregnancy were significantly higher even among women who reported lifetime exposure to less severe types of IPV, such as non-severe physical IPV, psychological IPV, and controlling behaviors (aOR=1.49-7.32). Non-severe physical IPV was also associated with increased odds of having more than average number of abortions throughout life (aOR=1.53-2.38).

Governments in the respective countries should be urged to address the problem of IPV as women's violent experiences are not isolated incidents but affect significant numbers of women on a regular basis. Violence awareness and prevention programs should be targeted at the general population rather than targeting solely women living in an abusive family environment. Reproductive health programs should be modified to account for the specific needs and circumstances of women living with abusive partners.