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Intimate Partner Violence Prevention

Intimate partner violence (IPV) is a substantial public health problem for Americans that has serious consequences and costs for individuals, families, communities, and society.1,2 Recent efforts have been made to increase resources to address gaps in knowledge and to improve services for victims, perpetrators, and child witnesses.3,4,5

IPV is actual or threatened physical or sexual violence, or psychological/emotional abuse. Some of the common terms that are used to describe intimate partner violence are domestic abuse, spouse abuse, domestic violence, courtship violence, battering, marital rape, and date rape. Intimate partners include current or former spouses, boyfriends, or girlfriends (including heterosexual or same-sex partners). Readers should consult the references cited here for their exact definitions of IPV, which may vary from that described above.

Many experts consider the following figures to be underestimates of IPV, because victims may underreport IPV on surveys and because data sources may lack information identifying victim-perpetrator relationships.1,4 Further, definitions and research methods vary across studies, leading to different estimates of IPV.3

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Non-lethal intimate violence: Data from a household survey on criminal victimization, the National Crime Victimization Survey, between 1992 and 1996 indicate:

  • Nearly 1 million incidents of non-lethal IPV occurred each year from 1992 to 1996; 85% of victims were women.2

  • On average each year from 1992 to 1996, approximately 8 in 1,000 women and 1 in 1,000 men age 12 or older experienced a violent victimization perpetrated by a current or former spouse, boyfriend, or girlfriend. 2

  • On average each year between 1992 and 1996, approximately 12 per 1,000 black women experienced violence by an intimate partner, compared with about 8 per 1,000 white women. These rates are not adjusted for socioeconomic status, which may account for the higher rates in black women. 2

  • The number of violent victimization's by an intimate partner has been declining for women. In 1996, women reported 840,000 violent victimization's by an intimate partner, down from 1.1 million in 1993. 2

  • For years 1992-1993, 92% of rapes of women were committed by known assailants. About half of all rapes and sexual assaults against women are committed by friends or acquaintances; 26% are by intimate partners. 2

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Lethal intimate violence: Data from FBI Uniform Crime Reports between 1992 and 1996 indicate:

For men and for blacks, murders by intimate partners have decreased 2

In 1996 about 2,000 murders were attributed to intimate partners, down from 3,000 two decades earlier.2

In 1996, 30% of all female murders were perpetrated by husbands, ex-husbands, or boyfriends. Three percent of all male murder victims were killed by wives, ex-wives, or girlfriends.

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Pregnancy: A 1996 review of the literature indicated that estimated proportions of women experiencing IPV during pregnancy ranged between 0.9% and 20.1%. The proportion of pregnant women who had experienced IPV at any time in the past ranged between 9.7% and 29.7%.7

Stalking: A term that generally refers to repeated harassing or threatening behavior, stalking is more prevalent in the U.S. than previously thought. In a national study in which the definition of stalking required the victim to report a high level of fear, an estimated 1 million women and 370,000 men were stalked annually. Most victims were women (78%) and most perpetrators were men (87%).8

Health Effects

Studies of emergency department (ED) visits by women have found:

  • Women account for nearly 40% of all ED visits for violent victimization in 1994.9

  • In 36% of all ED visits by women for violent victimization's, intimate partners were identified as the perpetrators.9

  • Women account for 84% of those treated for injuries by intimate partner, which includes spouses, ex-spouses, boyfriends, girlfriends.9

  • In one study of ED visits by women, over half of all women in the study had experienced IPV at some time in their lives, while 11% of those with current husbands or boyfriends gave IPV as the reason for the visit.10

As a consequence of severe intimate partner violence, female victims are more likely than male victims to need medical attention, take time off from work, spend more days in bed, and suffer more from stress and depression.11

Psychological consequences for victims of intimate partner violence can include depression, suicidal thoughts and attempts, lowered self-esteem, alcohol and other drug abuse, and post- traumatic stress disorder.3

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Risk Factors

Income: Women in families with incomes below $10,000 are more likely than other women to be victims of violence by an intimate partner.1

Age: Women age 19 to 29 are more likely than other women to be victims of violence by an intimate partner.1

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  • Women whose children have been abused by a parent or other caretaker are at increased risk for IPV.12

  • Increased frequency of violence toward a spouse is associated with increased risk of the violent spouse (particularly a husband) also being abusive to the child.13

  • Each year more than ten million American children witness IPV within their families.14

  • Witnessing violence is stressful and it is a risk factor for long-term physical and mental health problems such as alcohol and substance abuse, child abuse and IPV.14

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Alcohol and other drugs: Data from the National Crime Victimization Survey indicate an association between IPV and alcohol or other drug use. Among IPV victims who were able to describe alcohol or drug use by the perpetrator, 75% reported offender alcohol or other drug use at the time of the crime.15

The nature of the relationship between IPV and substance abuse is not yet clear. Many assaults against intimate partners do not occur in the context of substance abuse, and many substance abusers are not violent with their intimate partners.3

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Stalking and other forms of violence: Data from the National Violence Against Women Survey of 1995-96 indicate a strong association between stalking and other forms of violence in intimate relationships: 81% of women who were stalked by a current or former husband or cohabiting partner were also physically assaulted by that partner; 31% were also sexually assaulted by that partner.7

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Data from the National Crime Victimization Survey between 1992 and 1996 indicate:2

  • Non-lethal intimate violence results in financial losses to women victims that are conservatively estimated to be $150 million per year.

  • Medical expenses accounted for at least 40% of these costs, property losses for another 44%, and lost pay for the remainder.

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Prevention and Intervention
Increasing access to services for victims and perpetrators of IPV and their children is a priority.16

One promising strategy, the use of coordinated community initiatives, may strengthen safety networks for high-risk individuals and families.17

School-based prevention programs for IPV have focused both on teen dating violence and on IPV among adult partners. Topics addressed have included exploration of gender roles and expectations, personal safety, legal statutes, and social norms that tolerate violence.18

Home visitation services and interventions with child witnesses to violence have shown some promise in prevention of IPV among high-risk families.18

Practice guidelines for health care providers include recommendations to ask all women patients if they have experienced IPV.19,20 Health care providers may also provide information to women at risk for IPV about community resources, such as shelters for battered women and legal resources.

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  1. Bachman R, Saltzman LE. Violence against women: estimates from the redesigned survey, Bureau of Justice Statistics, Special Report. Washington, DC: US Department of Justice; August 1995.

  2. Greenfeld L, et al., editors. Violence by intimates: analysis of data on crimes by current or former spouses, boyfriends, and girlfriends. Bureau of Justice Statistics Factbook Washington, DC: US Department of Justice; March 1998. NCJ-167237.

  3. National Research Council. Understanding violence against women. Washington, DC: National Academy Press 1996:79-80.

  4. Straus M, Gelles RJ. Physical violence in American families: risk factors and adaptations to violence in 8,145 families. New Brunswick, NJ: Transaction Publishers; 1990.

  5. Schecter S. Women and male violence: the visions and struggles of the battered women’s movement. Boston: South End Press, 1982.

  6. FBI. Crime in the United States–1996. Uniform Crime Reports: 1996. p. 17.

  7. Gazmararian JA, Lazorick S, Spitz AM, et al. Prevalence of violence against pregnant women. JAMA 1996;275:1915-1920.

  8. NIJ/CDC Research in Brief. Stalking in America: findings from the National Violence Against Women Survey. April 1998.

  9. Rand MR. Violence-related injuries treated in hospital emergency departments. Bureau of Justice Statistics, Special Report. Washington, DC: US Department of Justice, August 1997.

  10. Abbott J, Johnson R, Koziol-McLain J, et al. Domestic violence against women: incidence and prevalence in an emergency department population. JAMA 1995;273:1763-1767.

  11. Stets JE, Straus MA. Gender differences in reporting marital violence and its consequences. In: Straus MA, Gelles RJ, editors. Physical violence in American families: risk factors and adaptations to violence in 8,145 families. New Brunswick, NJ: Transaction Publishers, 1990: pp. 151-165.

  12. McKibben L, DeVos E, Newberger E. Victimization of mothers of abused children: a controlled study. Pediatrics 1989;84:531-535.

  13. Ross S. Risk of physical abuse to children of spouse abusing parents. Child Abuse and Neglect 1996;20:589-598.

  14. Straus M. Children as witnesses to marital violence: a risk factor for lifelong problems among a nationally representative sample of American men and women. In Schwartz DF (ed):Children and violence: report of the Twenty-third Ross Roundtable on critical approaches to common pediatric problems. Columbus, Ohio: Ross Laboratories, 1992, pp. 98-104.

  15. Greenfeld L, editor. Alcohol and crime: an analysis of national data on the prevalence of alcohol involvement in crime. Prepared for the Assistant Attorney General’s National Symposium on Alcohol and Crime. Washington, DC: April 1998. NCJ-168632.

  16. Rosenberg ML, Fenley MA. Violence in America: a public health approach. New York: Oxford University Press; 1991.

  17. American Medical Association. Family violence: building a coordinated community response, a guide for communities. Chicago: American Medical Association; 1996.

  18. National Research Council/Institute of Medicine. Violence in families: assessing prevention and treatment programs. Washington, DC: National Academy Press; 1998.

  19. American Medical Association. Diagnostic and treatment guidelines on domestic violence. Chicago: American Medical Association; March 1992.

  20. Osattin A, Short L. Intimate partner violence and sexual assault: a guide to training materials and programs for health care providers. Atlanta: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 1998.

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