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Understanding Intimate Partner Violence

Intimate partner violence (IPV) occurs between two people in a close relationship. The term “intimate partner” includes current and former spouses and dating partners. IPV exists along a continuum from a single episode of violence to ongoing battering.

IPV includes four types of behavior:

  • Physical violence is when a person hurts or tries to hurt a partner by hitting, kicking, or other type of physical force.
  • Sexual violence is forcing a partner to take part in a sex act when the partner does not consent.
  • Threats of physical or sexual violence include the use of words, gestures, weapons, or other means to communicate the intent to cause harm.
  • Emotional abuse is threatening a partner or his or her possessions or loved ones, or harming a partner’s sense of self-worth. Examples are stalking, name-calling, intimidation, or not letting a partner see friends and family.

Often, IPV starts with emotional abuse. This behavior can progress to physical or sexual assault. Several types of IPV may occur together.

Why is IPV a public health problem?

IPV is a serious problem in the United States:

  • Nearly 3 in 10 women and 1 in 10 men in the US have experienced rape, physical violence, and/or stalking by a partner with IPV-related impact.1
  • IPV resulted in 2,340 deaths in 2007. Of these deaths, 70% were females and 30% were males.2
  • The medical care, mental health services, and lost productivity (e.g., time away from work) cost of IPV was an estimated $5.8 billion in 1995. Updated to 2003 dollars, that’s more than $8.3 billion.3,4

These numbers underestimate the problem. Many victims do not report IPV to police, friends, or family.1 Victims may think others will not believe them or that the police cannot help.1

How does IPV affect health?

IPV can affect health in many ways. The longer the violence goes on, the more serious the effects.Many victims suffer physical injuries. Some are minor like cuts, scratches, bruises, and welts. Others are more serious and can cause death or disabilities. These include broken bones, internal bleeding, and head trauma.Not all injuries are physical. IPV can also cause emotional harm. Victims may have trauma symptoms. This includes flashbacks, panic attacks, and trouble sleeping. Victims often have low self-esteem. They may have a hard time trusting others and being in relationships. The anger and stress that victims feel may lead to eating disorders and depression. Some victims even think about or commit suicide.IPV is linked to harmful health behaviors as well. Victims may try to cope with their trauma in unhealthy ways. This includes smoking, drinking, taking drugs, or having risky sex.

Who is at risk for IPV?

Several factors can increase the risk that someone will hurt his or her partner. However, having these risk factors does not always mean that IPV will occur.

Risk factors for perpetration (hurting a partner):

  • Being violent or aggressive in the past
  • Seeing or being a victim of violence as a child
  • Using drugs or alcohol, especially drinking heavily
  • Not having a job or other life events that cause stress

Note: These are just some risk factors. To learn more, go to www.cdc.gov/violenceprevention.

How can we prevent IPV?

The goal is to stop IPV before it begins. There is a lot to learn about how to prevent IPV. We do know that strategies that promote healthy behaviors in relationships are important. Programs that teach young people skills for dating can prevent violence. These programs can stop violence in dating relationships before it occurs. We know less about how to prevent IPV in adults. However, some programs that teach healthy relationship skills seem to help stop violence before it ever starts.

Where can I learn more?

National Domestic Violence Hotline  1-800-799-SAFE (7233), 1-800-787-3224 TTY, or  www.ndvh.org

National Coalition Against Domestic Violence  www.ncadv.org

National Sexual Violence Resource Center  www.nsvrc.org 

Understanding Sexual Violence

Definitions

Sexual violence (SV) is any sexual act that is perpetrated against someone’s will. SV encompasses a range of offenses, including a completed nonconsensual sex act (i.e., rape), an attempted nonconsensual sex act, abusive sexual contact (i.e., unwanted touching), and non-contact sexual abuse (e.g., threatened sexual violence, exhibitionism, verbal sexual harassment). These four types are defined in more detail below. All types involve victims who do not consent, or who are unable to consent or refuse to allow the act.

  • A completed sex act is defined as contact between the penis and the vulva or the penis and the anus involving penetration, however slight; contact between the mouth and penis, vulva, or anus; or penetration of the anal or genital opening of another person by a hand, finger, or other object.
  • An attempted (but not completed) sex act
  • Abusive sexual contact is defined as intentional touching, either directly or through the clothing, of the genitalia, anus, groin, breast, inner thigh, or buttocks of any person without his or her consent, or of a person who is unable to consent or refuse.
  • Non-contact sexual abuse does not include physical contact of a sexual nature between the perpetrator and the victim. It includes acts such as voyeurism; intentional exposure of an individual to exhibitionism; unwanted exposure to pornography; verbal or behavioral sexual harassment; threats of sexual violence to accomplish some other end; or taking nude photographs of a sexual nature of another person without his or her consent or knowledge, or of a person who is unable to consent or refuse.

Why is Sexual Violence a public health problem?

SV is a significant problem in the United States:

  • Among high school students surveyed nationwide, about 8% reported having been forced to have sex. The percentage of those having been forced to ever have sex was higher among female (11%) than male (5%) students.1
  • An estimated 20% to 25% of college women in the United States have experienced an attempted or complete rape during their college career.2
  • Nearly 1 in 5 women and 1 in 71 men in the United States have been raped at some time in their lives.3

These numbers underestimate the problem. Many cases are not reported because victims are afraid to tell the police, friends, or family about the abuse.3 Victims also think that their stories of abuse will not be believed and that police cannot help them.3 They may be ashamed or embarrassed. Victims may also keep quiet because they have been threatened with further harm if they tell anyone.

How does Sexual Violence affect health?

SV can impact health in many ways. Some ways are serious and can lead to long-term health problems. These include chronic pain, headaches, stomach problems, and sexually transmitted diseases.SV can have an emotional impact as well. Victims often are fearful and anxious. They may replay the attack over and over in their minds. They may have problems with trust and be wary of becoming involved with others. The anger and stress that victims feel may lead to eating disorders and depression. Some even think about or attempt suicide.SV is also linked to negative health behaviors. For example, victims are more likely to smoke, abuse alcohol, use drugs, and engage in risky sexual activity.

Who is at risk for Sexual Violence?

Certain factors can increase the risk for SV. However, the presence of these factors does not mean that SV will occur.

Risk factors for perpetration (harm to someone else):

  • Being male
  • Having friends that are sexually aggressive
  • Witnessing or experiencing violence as a child
  • Alcohol or drug use
  • Being exposed to social norms, or shared beliefs, that support sexual violence

How can we prevent Sexual Violence?

The ultimate goal is to stop SV before it begins. Efforts at many levels are needed to accomplish this. Some examples include:

  • Engaging high school students in mentoring programs or other skill-based activities that address healthy sexuality and dating relationships.
  • Helping parents identify and address violent attitudes and behaviors in their kids.
  • Creating policies at work, at school, and in other places that address sexual harassment.
  • Developing mass media (e.g., radio, TV, magazines, newspapers) messages that promote norms, or shared beliefs, about healthy sexual relationships.

Where can I learn more?

Rape, Abuse and Incest National Network Hotline  www.rainn.org or (800) 656-HOPE

National Sexual Violence Resource Center  www.nsvrc.org

Violence Against Women Network (VAWnet)  www.vawnet.org

Prevention Connection  www.preventconnect.org

STOP IT NOW!  www.stopitnow.org

References:

For more information contact:

Jessica Yanow, MPH

Director of Women’s Health Programs and Grant Administration

Arizona Alliance for Community Health Centers

Phone: 602.288.7545

Email: jessicay@aachc.org