Correlates of intimate partner sexual violence among pregnant women in Napak district Northern Uganda

Abstract

Although historically portrayed as a gender issue, intimate partner sexual violence is of immense reproductive health importance, particularly during pregnancy. It is associated with gynecological complications not limited to vaginal trauma, dyspareunia, Vaginismus, Pelvic Floor Dysfunction and Bacterial Vaginosis. Most of these have been found to be significant causes of infertility, and high risk pregnancies. That is in addition to Most of these have been found to be significant causes of high-risk pregnancies in addition to being significant antecedents of intrapartum complications, some of which are indications for cesarean births. Objective: The purpose of the study was to assess the correlates of intimate partner sexual violence (IPSV) among pregnant women in Napak district – northern Uganda. An analytical cross-sectional survey design was used to study 284 pregnant women in Napak district, who were sampled at both hospital and health centre III facilities. The hospital was purposively. The health center IIIs were randomly sampled. Pregnant women were randomly sampled at the hospital and center IIIs respectively. They were engaged in structured interviews, and the data captured using structured questionnaires, following which it was analyzed in SPSS version 25 using descriptive and inferential methods. A total of 284 women participated in the study. Slightly more than half 158/284(56%) of the pregnant women had experienced IPSV during their current pregnancies, with the most prevalent form being unwanted sexual advances 100 (63. 3%).The prevalence of IPSV was lower among women of gravidity of two (aPR = 0.785, CI = 0.684 - 0.901, P < 0.001), with a history of IPV in any earlier pregnancy (aPR = 0.742, CI = 0.681 - 0.808, P <0.001), with a history of emotional type violence (aPR = 0.823, CI = 0.705 - 0.961, P = 0.014). The prevalence is higher among multipara pregnant women (aPR = 1.907, CI =1.512 - 1.199, P <0.001), with a high rating of communication with spouses (aPR = 1.255, CI = 1.074 - 1.467, P = 0.004). IPSV is negatively correlated with ages of 29 and 39 years old (aPR = 0.762, CI = 0.704 - 0.825, P< 0.001), duration in marital relationship (aPR = 0.805, CI = 0.736 - 0.881, P <0.001), being catholic (aPR = 0.671, CI = 0.612 - 0.735, P<0.001). The prevalence of IPSV is lower among women with spouse‘s aged between the ages of 18 and 28 years (aPR = 0.667, CI = 0.588 - 0.756,P <0.001), higher among women with formally educated spouses (aPR = 1.117, CI = 1.024 - 1.220, P= 0.013), lower among women whose spouse were educated to primary (aPR = 0.762, CI = 0.652 - 0.891, P = 0.001), but higher among women whose spouses use non-illicit substances (aPR = 1.744, CI = 1.521 - 1.999, P <0.001). Being undecided about the belief that marital rape is not considered a grave crime traditionally, even during pregnancy (aPR = 0.671, CI = 0.598 - 0.753, P <0.001), reception of emotional support from anyone in society (aPR = 1.279, CI = 1.084 - 1.509, P = 0.004) and the perception that a pregnant woman who is sexually violated is not allowed to report to the elders (aPR = 1.225, CI = 1.010 - 1.486, P = 0.039) were the societal correlates of IPSV. Intimate partner sexual violence during pregnancy is highly prevalent among pregnant women in Napak district; about 6 in 10 of them experience it during pregnancy. Unwanted sexual advances are the commonest form of IPSV, followed by marital rape. Intimate partner sexual violence among pregnant women in Napak district is correlated with individual, relationship and societal characteristics, with individual characteristics being relatively more important.