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Intimate partner violence as a predictor of marital disruption in rural Rakai, Uganda: a longitudinal study

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

We assessed the association between intimate partner violence (IPV) and union disruption (divorce or separation) in the rural Ugandan setting of Rakai District.

Methods

We analyzed longitudinal data collected from April 1999 to June 2006, from 6834 women (15–49 years) living in 50 communities in Rakai. Participants were either officially married, traditionally married or in a consensual union during one or more surveys and completed at least one follow-up survey. The primary outcome was union disruption through divorce or separation from the primary sexual partner.

Results

Past year IPV ranged from 6.49 % (severe physical abuse) to 31.99 % (emotional abuse). Severe physical IPV was significantly associated with divorce/separation, after adjusting for other covariates (aOR = 1.80, 95 % CI 1.01–3.22). Another predictor of union disruption was a woman having two or more sexual partners in the past year (aOR = 8.42, 95 % CI 5.97–11.89). Factors protecting against divorce/separation included an increasing number of co-resident biological children and longer duration of union.

Conclusions

IPV, particularly severe physical abuse, is an important risk factor for union disruption. Marital counseling, health education and interventions should address the role of IPV on the wellbeing of women and the stability of couples in Uganda.

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References

  • Abramsky T, Watts CH, Garcia-Moreno C, Devries K, Kiss L, Ellsberg M, Jansen HA, Heise L (2011) What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women’s health and domestic violence. BMC Public Health 11:109. doi:10.1186/1471-2458-11-109

    Article  PubMed  PubMed Central  Google Scholar 

  • Anderson DK, Saunders DG (2003) Leaving an abusive partner: an empirical review of predictors, the process of leaving, and psychological well-being. Trauma Violence Abuse 4(2):163–191

    Article  PubMed  Google Scholar 

  • Baholo M, Christofides N, Wright A, Sikweyiya Y, Shai NJ (2015) Women’s experiences leaving abusive relationships: a shelter-based qualitative study. Cult Health Sex 17(5):638–649. doi:10.1080/13691058.2014.979881 (Epub 2014 Dec 3)

    Article  PubMed  Google Scholar 

  • Campbell J (2002) The health consequences of intimate partner violence. Lancet 359:1509–1514

    Article  Google Scholar 

  • DeMaris A (2000) Till discord do us part: the roles of physical and verbal conflict in union disruption. J Marr Fam 62:683–692

    Article  Google Scholar 

  • DeMaris A (2001) The influence of intimate violence on transitions out of co-habitations. J Marr Fam 63:235–246

    Article  Google Scholar 

  • Devries KM, Mak JY, GarcíaMoreno C, Petzold M, Child JC, Falder G, Lim S, Bacchus LJ, Engell RE, Rosenfeld L, Pallitto C, Vos T, Abrahams N, Watts CH (2013) Global health. The global prevalence of intimate partner violence against women. Science 340(6140):1527–1528. doi:10.1126/science.1240937 (Epub 2013 Jun 20)

    Article  CAS  PubMed  Google Scholar 

  • Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C, WHO Multi-country Study on Women’s Health and Domestic Violence against Women Study Team (2008) Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: an observational study. Lancet 371(9619):1165–1172

    Article  PubMed  Google Scholar 

  • Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH, WHO Multi-country Study on Women’s Health and Domestic Violence against Women Study Team (2006) Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet 368(9543):1260–1269

    Article  PubMed  Google Scholar 

  • South SJ, Glenna Spitze G (1986) Determinants of divorce over the marital life course. Am Sociol Rev 51(4):583–590

    Article  Google Scholar 

  • Hawkins AJ, Blanchard VL, Baldwin SA, Fawcett EB (2008) Does marriage and relationship education work? A meta-analytic study. J Consult Clin Psychol 76(5):723

    Article  PubMed  Google Scholar 

  • Heise L, Kotsadam A (2015) Cross-national and multilevel correlates of partner violence: an analysis of data from population-based surveys. Lancet Global Health 3:e332–e340

    Article  PubMed  Google Scholar 

  • Hirschberger G, Srivastava S, Marsh P, Cowan CP, Cowan PA (2009) Attachment, marital satisfaction, and divorce during the first fifteen years of parenthood. Pers Relatsh 16(3):401–420

    Article  PubMed  PubMed Central  Google Scholar 

  • Jacobson NS, Gottman JM, Gortner E, Berns S, Shortt JW (1996) Psychological factors in the longitudinal course of battering: when do the couples split up? When does the abuse decrease? Violence Vict 11:371–392

    CAS  PubMed  Google Scholar 

  • Karamagi CA, Tumwine JK, Tylleskar T, Heggenhougen K (2006) Intimate partner violence against women in eastern Uganda: implications for HIV prevention. BMC Public Health 6:284

    Article  PubMed  PubMed Central  Google Scholar 

  • Koenig M, Zablotska I, Lutalo T, Nalugoda F, Wagman J, Gray R (2004) Coerced first intercourse and reproductive health outcomes among adolescent women in Rakai, Uganda. Int Family Plan Perspect 30(4):156–163

    Article  Google Scholar 

  • Kouyoumdjian FG, Calzavara LM, Bondy SJ, O’Campo P, Serwadda D, Nalugoda F, Kagaayi J, Kigozi G, Wawer M, Gray R (2013a) Intimate partner violence is associated with incident HIV infection in women in Uganda. AIDS 27(8):1331–1338. doi:10.1097/QAD.0b013e32835fd851

    Article  PubMed  Google Scholar 

  • Kouyoumdjian FG, Calzavara LM, Bondy SJ, O’Campo P, Serwadda D, Nalugoda F, Kagaayi J, Kigozi G, Wawer M, Gray R (2013b) Risk factors for intimate partner violence in women in the Rakai Community Cohort Study, Uganda, from 2000 to 2009. BMC Public Health 10(13):566. doi:10.1186/1471-2458-13-566

    Article  Google Scholar 

  • Kurz D (1996) Separation, divorce and woman abuse. Viol Against Women 2:63–81

    Article  CAS  Google Scholar 

  • Makumbi FE, Nakigozi G, Sekasanvu J, Lukabwe I, Kagaayi J, Lutalo T, Wawer M, Gray R (2012) Incidence of orphanhood before and after implementation of a HIV care programme in Rakai, Uganda: alpha Network HIV Supplement. Trop Med Int Health. 17(8):e94–e102. doi:10.1111/j.1365-3156.2012.03031.x Epub 2012 Jun 21

    Article  PubMed  PubMed Central  Google Scholar 

  • McGrath JW, Rwabukwali CB, Schumann DA, Pearson-Marks J, Nakayiwa S, Namande B, Nakyobe L, Mukasa R (1993) Anthropology and AIDS: the cultural context of sexual risk behavior among urban Baganda women in Kampala, Uganda. Soc Sci Med 36(4):429–439

    Article  CAS  PubMed  Google Scholar 

  • Nalugoda F, Guwatudde D, Bwaninka JB, Makumbi FE, Lutalo T, Kagaayi J, Sewankambo NK, Kigozi G, Serwadda DM, Kong X, Wawer MJ, Wabwire-Mangen F, Gray RH (2014) Marriage and the risk of incident HIV infection in Rakai, Uganda. J Acquir Immune Defic Syndr 65(1):91–98. doi:10.1097/QAI.0b013e3182a7f08a

    Article  PubMed  PubMed Central  Google Scholar 

  • Olowo-Freers BPA, Barton TG (1992) In pursuit of fulfillment: studies of cultural diversity and sexual behaviour in Uganda. Marianum Press, Kisubi, Uganda

    Google Scholar 

  • Polis CB, Lutalo T, Wawer M, Serwadda D, Kigozi G, Nalugoda F, Kiwanuka N, Gray R (2009) Coerced sexual debut and lifetime abortion attempts among women in Rakai, Uganda. Int J Gynaecol Obstet 104(2):105–109. doi:10.1016/j.ijgo.2008.10.002 (Epub 2008 Nov 20)

    Article  PubMed  Google Scholar 

  • Porter L, Hao L, Bishai D, Serwadda D, Wawer MJ, Lutalo T, Gray R, Rakai Project Team (2004) HIV status and union dissolution in sub-Saharan Africa: the case of Rakai, Uganda. Demography 41(3):465–482

    Article  PubMed  Google Scholar 

  • StataCorp (2013) Stata Statistical Software: release 13. StataCorp LP, College Station

    Google Scholar 

  • Straus MA (1979) Measuring intrafamily conflict and violence. The conflict tactics (CT) scales. J Marriage Fam 41:75–88

    Article  Google Scholar 

  • Thompson RS, Bonomi AE, Anderson M, Reid RJ, Dimer JA, Carrell D, Rivara FP (2006) Intimate partner violence: prevalence, types, and chronicity in adult women. Am J Prev Med. 30(6):447–457

    Article  PubMed  Google Scholar 

  • Uganda Bureau of Statistics (UBOS) (2002) 2002 Uganda population and housing census report. Uganda Bureau of Statistics, Entebbe

    Google Scholar 

  • Uganda Bureau of Statistics (UBOS) and ICF International Inc. (2011) 2012 Uganda demographic and health survey. UBOS, Kampala, Uganda and ICF International Inc., Calverton, Maryland

  • United Nations (2015) Sustainable development Goals. http://www.un.org/sustainabledevelopment/sustainable-development-goals/. Accessed Jul 2016

  • Wagman JA, Namatovu F, Nalugoda F, Kiwanuka D, Nakigozi G, Gray R, Wawer MJ, Serwadda D (2012) A public health approach to intimate partner violence prevention in Uganda: the SHARE Project. Violence Against Women 18(12):1390–1412. doi:10.1177/1077801212474874

    Article  PubMed  Google Scholar 

  • Wathen CN, Tanaka M, MacGregor JC, Ferro MA, McKee C, Boyle M, Ford-Gilboe M, MacMillan HL (2016) Trajectories for women who disclose intimate partner violence in health care settings: the key role of abuse severity. Int J Public Health (Epub ahead of print)

  • Wawer MJ, Gray RH, Sewankambo NK, Serwadda D, Paxton L, Berkley S, McNairn D, Wabwire-Mangen F, Li C, Nalugoda F, Kiwanuka N, Lutalo T, Brookmeyer R, Kelly R, Quinn TC (1998) A randomized, community trial of intensive sexually transmitted disease control for AIDS prevention, Rakai, Uganda. AIDS 12(10):1211–1225

    Article  CAS  PubMed  Google Scholar 

  • World Health Organization (2001) WHO ethical and safety recommendations for research on domestic violence against women. World Health Organization, Geneva

  • Zlotnick C, Johnson DM, Kohn R (2006) Intimate partner violence and long-term psychosocial functioning in a national sample of American women. J Interpers Violence 21(2):262–275

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The data used in this publication come from the Rakai Community Cohort Study (RCCS), an ongoing population-based HIV surveillance cohort initiated in 1994. RCCS is conducted in approximately 50 communities of the Rakai District, by researchers from the Rakai Health Sciences Program. The views expressed here are those of the author(s). They are not necessarily those of the RCCS participants or its funders. The authors thank the Rakai Health Sciences Program for their efforts in study design, implementation, data collection and management; and the RCCS study participants for providing extensive information for this research. This publication is dedicated to the memory of Blake Charvat.

Author information

Authors and Affiliations

  1. Division of Global Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA

    Jennifer A. Wagman

  2. Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA

    Blake Charvat

  3. Department of Family Science, School of Public Health, University of Maryland, 4200 Valley Drive Bldg 255, College Park, MD, USA

    Marie E. Thoma

  4. Rakai Health Sciences Program, Uganda Virus Research Institute, Nakiwogo Road, P.O Box 49, Entebbe, Uganda

    Anthony Ndyanabo, Fred Nalugoda, Grace Kigozi & Joseph Kagaayi

  5. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 627 N. Washington Street, 2nd Floor, Baltimore, MD, 21205, USA

    Joseph Ssekasanvu, Maria J. Wawer & Ronald H. Gray

  6. Makerere University School of Public Health, Old Mulago Hill Road, New Mulago Hospital Complex, P.O Box 7072, Kampala, Uganda

    David Serwadda

Authors
  1. Jennifer A. Wagman
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  2. Blake Charvat
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  3. Marie E. Thoma
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  4. Anthony Ndyanabo
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  7. Grace Kigozi
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  8. David Serwadda
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  9. Joseph Kagaayi
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  10. Maria J. Wawer
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  11. Ronald H. Gray
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Corresponding author

Correspondence to Jennifer A. Wagman.

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Funding

The Rakai Community Cohort Study (RCCS) was funded by the Bill & Melinda Gates Foundation (22006) and the US National Institute of Allergy and Infectious Diseases (U01AI51171). The Fogarty International Center (5D43TW001508) contributed to training RHSP’s junior investigators. Analysis of the research reported in this publication was supported by a training grant from the National Institute on Drug Abuse (T32DA023356).

Conflict of interest

The authors declare no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

This article is part of the special issue “Violence and Health: Implications of the 2030 Agenda for South–North Collaboration”.

Blake Charvat: Deceased.

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Wagman, J.A., Charvat, B., Thoma, M.E. et al. Intimate partner violence as a predictor of marital disruption in rural Rakai, Uganda: a longitudinal study. Int J Public Health 61, 961–970 (2016). https://doi.org/10.1007/s00038-016-0891-z

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  • DOI: https://doi.org/10.1007/s00038-016-0891-z

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