Prevalence and correlates of partner violence among adolescent girls and young women: Evidence from baseline data of a cluster randomised trial in Tanzania

Autoři: Daniel Nyato aff001;  Jacqueline Materu aff001;  Evodius Kuringe aff001;  Jeremie Zoungrana aff002;  Deusdedit Mjungu aff002;  Ruth Lemwayi aff002;  Esther Majani aff002;  Baltazar Mtenga aff001;  Soori Nnko aff001;  Grace Munisi aff002;  Amani Shao aff001;  Mwita Wambura aff001;  John Changalucha aff001;  Mary Drake aff002;  Albert Komba aff002
Působiště autorů: Department of Sexual and Reproductive Health, National Institute for Medical Research, Mwanza Centre, Tanzania aff001;  Jhpiego Tanzania - An Affiliate of Johns Hopkins University, Dar-es-Salaam, Tanzania aff002
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222950



Little has been documented about partner violence among adolescent girls and young women (AGYW) who are out of school, a factor associated with HIV acquisition. To understand areas for prioritising HIV prevention intervention efforts, we explored the prevalence and correlates of partner violence among out of school AGYW in Shinyanga, Tanzania.


A cross-sectional analysis of data from AGYW aged 15–23 years recruited in a cluster randomised trial conducted between October and December 2017 was used to examine correlates of partner violence. Data were collected through an Audio Computer-Assisted Self-interview. Multivariate logistic regression analysis was used to evaluate the association.


2276 (75.5%) AGYW were sexually active. Of these, 816 (35.9%) reported having experienced violence from partners in the last six months. After adjusting for other covariates, being formerly married (AOR = 1.55, 95% CI:1.02, 2.37), having children (AOR = 1.79, 95% CI:1.47, 2.16), anxiety and depression symptoms (AOR = 3.27, 95%CI: 2.15, 4.96), having engaged in sex work in the past six months (AOR = 1.92, 95% CI: 1.45, 2.53) and economic deprivation (AOR = 1.61, 95% CI: 1.34,1.92) were significantly associated with partner violence.


Almost one in three sexually active AGYW had experienced partner violence in the 6 months preceding the survey. The findings underscore the need for future research to focus on understanding the reasons and dynamics underlying high level of partner violence among AGYW. Furthermore, there is a need for implementing intervention programs that aim to reduce economic deprivation among AGYWs and address social norms and structures perpetuating violence against AGYW.

Trial registration—ID NCT03597243.

Klíčová slova:

Anxiety – Emotions – HIV – Children – Mental health and psychiatry – Schools – Tanzania – Sex work


1. Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C. 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. The Lancet. 2008;371(9619):1165–72.

2. Andersson N, Ho-Foster A, Mitchell S, Scheepers E, Goldstein S. Risk factors for domestic physical violence: national cross-sectional household surveys in eight southern African countries. BMC Women’s Health. 2007;7(1):11.

3. Devries KM, Mak JY, García-Moreno C, Petzold M, Child JC, Falder G, et al. The global prevalence of intimate partner violence against women. Science. 2013;340(6140):1527–8. doi: 10.1126/science.1240937 23788730

4. Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH. Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. The Lancet. 2006;368(9543):1260–9.

5. WHO. WHO/WHD Violence against women: a priority health issue. Geneva: World Health Organization. 1997.

6. García-Moreno C, Pallitto C, Devries K, Stöckl H, Watts C, Abrahams N. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence: World Health Organization; 2013.

7. WHO. WHO multi-country study on women’s health and domestic violence against women: summary report of initial results on prevalence, health outcomes and women’s responses. 2005.

8. Mulawa M, Kajula LJ, Yamanis TJ, Balvanz P, Kilonzo MN, Maman S. Perpetration and victimization of intimate partner violence among young men and women in Dar es Salaam, Tanzania. Journal of interpersonal violence. 2016:0886260515625910.

9. National Bureau of Statistics (NBS) [Tanzania] and ICF Macro. Tanzania Demographic and Health Survey and Malaria Indicator Survey 2015–2016. National Bureau of Statistics, Dar es Salaam, Tanzania Calverton, Maryland, USA: ICF Macro. 2011.

10. Nyamhanga TM, Frumence G. Gender context of sexual violence and HIV sexual risk behaviors among married women in Iringa Region, Tanzania. Global health action. 2014;7(1):25346.

11. Laisser RM, Nyström L, Lugina HI, Emmelin M. Community perceptions of intimate partner violence-a qualitative study from urban Tanzania. BMC Women’s Health. 2011;11(1):13.

12. Lary H, Maman S, Katebalila M, Mbwambo J. Exploring the association between HIV and violence: young people’s experiences with infidelity, violence and forced sex in Dar es Salaam, Tanzania. International Family Planning Perspectives. 2004:200–6. doi: 10.1363/ifpp.30.200.04 15590386

13. Baumgartner JN, Kaaya S, Karungula H, Kaale A, Headley J, Tolley E. Domestic violence among adolescents in HIV prevention research in Tanzania: participant experiences and measurement issues. Maternal and child health journal. 2015;19(1):33–9. doi: 10.1007/s10995-014-1492-1 24740725

14. Speizer IS. Individual and community-level tolerance of spouse abuse and the association with the circumstances of first sex among youth from six sub-Saharan African countries. AIDS care. 2012;24(3):291–300. doi: 10.1080/09540121.2011.608784 21902559

15. Maman S, Yamanis T, Kouyoumdjian F, Watt M, Mbwambo J. Intimate partner violence and the association with HIV risk behaviors among young men in Dar es Salaam, Tanzania. Journal of interpersonal violence. 2010;25(10):1855–72. doi: 10.1177/0886260509354498 19966247

16. Koenig MA, Lutalo T, Zhao F, Nalugoda F, Wabwire-Mangen F, Kiwanuka N, et al. Domestic violence in rural Uganda: evidence from a community-based study. Bulletin of the World Health Organization. 2003;81(1):53–60. 12640477

17. Campbell JC. Health consequences of intimate partner violence. The Lancet. 2002;359(9314):1331–6.

18. Dillon G, Hussain R, Loxton D, Rahman S. Mental and physical health and intimate partner violence against women: A review of the literature. International journal of family medicine. 2013;2013.

19. Stöckl H, Devries K, Rotstein A, Abrahams N, Campbell J, Watts C, et al. The global prevalence of intimate partner homicide: a systematic review. The Lancet. 2013;382(9895):859–65.

20. Dunkle KL, Decker MR. Gender‐based violence and HIV: Reviewing the evidence for links and causal pathways in the general population and high‐risk groups. American Journal of Reproductive Immunology. 2013;69(s1):20–6.

21. Hatcher AM, Smout EM, Turan JM, Christofides N, Stöckl H. Intimate partner violence and engagement in HIV care and treatment among women: a systematic review and meta-analysis. Aids. 2015;29(16):2183–94. doi: 10.1097/QAD.0000000000000842 26353027

22. Jenny C, Hooton TM, Bowers A, Copass MK, Krieger JN, Hillier SL, et al. Sexually transmitted diseases in victims of rape. New England Journal of Medicine. 1990;322(11):713–6. doi: 10.1056/NEJM199003153221101 2155389

23. Berhan A, Berhan Y. Is the sexual behaviour of HIV patients on antiretroviral therapy safe or risky in Sub-Saharan Africa? Meta-analysis and meta-regression. AIDS research and therapy. 2012;9(1):14. doi: 10.1186/1742-6405-9-14 22583930

24. Adedimeji AA, Hoover DR, Shi Q, Gard T, Mutimura E, Sinayobye JdA, et al. Sexual behavior and risk practices of HIV positive and HIV negative Rwandan women. AIDS and behavior. 2015;19(7):1366–78. doi: 10.1007/s10461-014-0964-z 25488169

25. Johnson SD, Cottler LB, Abdallah AB, O’Leary CC. History of sexual trauma and recent HIV-risk behaviors of community-recruited substance using women. AIDS and behavior. 2011;15(1):172–8. doi: 10.1007/s10461-010-9752-6 20625927

26. Kaysen D, Dillworth TM, Simpson T, Waldrop A, Larimer ME, Resick PA. Domestic violence and alcohol use: Trauma-related symptoms and motives for drinking. Addictive behaviors. 2007;32(6):1272–83. doi: 10.1016/j.addbeh.2006.09.007 17098370

27. Schuler SR, Lenzi R, Badal SH, Bates LM. Women’s empowerment as a protective factor against intimate partner violence in Bangladesh: a qualitative exploration of the process and limitations of its influence. Violence against women. 2017;23(9):1100–21. doi: 10.1177/1077801216654576 27486126

28. Sweetman C. Introduction: Working with men on gender equality. Gender & Development. 2013;21(1):1–13.

29. Peacock D, Barker G. Working with men and boys to prevent gender-based violence: Principles, lessons learned, and ways forward. Men and Masculinities. 2014;17(5):578–99.

30. Jewkes R, Flood M, Lang J. From work with men and boys to changes of social norms and reduction of inequities in gender relations: a conceptual shift in prevention of violence against women and girls. The Lancet. 2015;385(9977):1580–9.

31. Wagner K, Yates D, Walcott Q. Engaging men and women as allies: A workplace curriculum module to challenge gender norms about domestic violence, male bullying and workplace violence and encourage ally behavior. Work. 2012;42(1):107–13. doi: 10.3233/WOR-2012-1334 22635154

32. Ziraba A, Orindi B, Muuo S, Floyd S, Birdthistle IJ, Mumah J, et al. Understanding HIV risks among adolescent girls and young women in informal settlements of Nairobi, Kenya: Lessons for DREAMS. PLoS one. 2018;13(5):e0197479. doi: 10.1371/journal.pone.0197479 29851988

33. Chimbindi N, Mthiyane N, Birdthistle I, Floyd S, McGrath N, Pillay D, et al. Persistently high incidence of HIV and poor service uptake in adolescent girls and young women in rural KwaZulu-Natal, South Africa prior to DREAMS. PLoS one. 2018;13(10):e0203193. doi: 10.1371/journal.pone.0203193 30325932

34. Kelly CA, Hewett PC, Mensch BS, Rankin JC, Nsobya SL, Kalibala S, et al. Using biomarkers to assess the validity of sexual behavior reporting across interview modes among young women in Kampala, Uganda. Studies in family planning. 2014;45(1):43–58. doi: 10.1111/j.1728-4465.2014.00375.x 24615574

35. Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics. 2009;50(6):613–21 19996233

36. Liang K-Y, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73(1):13–22.

37. Molenberghs Ga, V Geert. Models for Discrete Longitudinal Data. 233 Spring Sreet., New York, NY 10013, USA.: Springer Science+Business Media, Inc.; 2005.

38. Vyas S, Heise L. How do area-level socioeconomic status and gender norms affect partner violence against women? Evidence from Tanzania. International journal of public health. 2016;61(8):971–80. doi: 10.1007/s00038-016-0876-y 27557746

39. Ministry of Health CD, Gender, Elderly, Children MoH, National Bureau of Statistics, Office of the Chief Government Statistician, ICF. Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015–16. MoHCDGEC, MoH, NBS, OCGS, and ICF Dar es Salaam, Tanzania, and Rockville, Maryland, USA; 2016.

40. Ezekiel MJ, Chitama D. Magnitude and factors associated with intimate partner violence in mainland Tanzania. BMC public health. 2016;16(1):494.

41. Kidanto HL, Mgaya AH, Essen B. Intimate partner violence among HIV infected and uninfected pregnant women delivering at a national hospital in Tanzania: Using a modified screening tool. Tanzania Journal of Health Research. 2017;19(3).

42. Mapayi B, Makanjuola R, Mosaku S, Adewuya O, Afolabi O, Aloba O, et al. Impact of intimate partner violence on anxiety and depression amongst women in Ile-Ife, Nigeria. Archives of women’s mental health. 2013;16(1):11–8.

43. Karaoglu L, Celbis O, Ercan C, Ilgar M, Pehlivan E, Gunes G, et al. Physical, emotional and sexual violence during pregnancy in Malatya, Turkey. The European Journal of Public Health. 2005;16(2):149–56. doi: 10.1093/eurpub/cki161 16157613

44. DeMaris A, Benson ML, Fox GL, Hill T, Van Wyk J. Distal and proximal factors in domestic violence: A test of an integrated model. Journal of Marriage and Family. 2003;65(3):652–67.

45. Jewkes R. Emotional abuse: a neglected dimension of partner violence. The Lancet. 2010;376(9744):851–2.

46. Tomison AM, Tucci J. Emotional abuse: The hidden form of maltreatment: Australian Institute of Family Studies, for National Child Protection …; 1997.

47. Moss VA, Pitula CR, Campbell JC, Halstead L. The experience of terminating an abusive relationship from an Anglo and African American perspective: A qualitative descriptive study. Issues in mental health nursing. 1997;18(5):433–54. 9362722

48. Burke JG, Gielen AC, McDonnell KA, O’campo P, Maman S. The process of ending abuse in intimate relationships: A qualitative exploration of the transtheoretical model. Violence Against Women. 2001;7(10):1144–63.

49. Wuest J, Merritt-Gray M. Beyond survival: Reclaiming self after leaving an abusive male partner. Canadian Journal of Nursing Research Archive. 2016;32(4).

50. Kidman R. Child marriage and intimate partner violence: a comparative study of 34 countries. International journal of epidemiology. 2016;46(2):662–75.

51. Jewkes R. Intimate partner violence: causes and prevention. The lancet. 2002;359(9315):1423–9.

52. Goodman LA, Smyth KF, Borges AM, Singer R. When crises collide: How intimate partner violence and poverty intersect to shape women’s mental health and coping? Trauma, Violence, & Abuse. 2009;10(4):306–29.

53. Ellsberg M, Arango DJ, Morton M, Gennari F, Kiplesund S, Contreras M, et al. Prevention of violence against women and girls: what does the evidence say? The Lancet. 2015;385(9977):1555–66.

54. Hughes C, Bolis M, Fries R, Finigan S. Women’s economic inequality and domestic violence: exploring the links and empowering women. Gender & Development. 2015;23(2):279–97.

55. Clark CJ, Ferguson G, Shrestha B, Shrestha PN, Batayeh B, Bergenfeld I, et al. Mixed methods assessment of women’s risk of intimate partner violence in Nepal. BMC Women’s Health. 2019;19(1):20. doi: 10.1186/s12905-019-0715-4 30691430

56. Jordan CE, Campbell R, Follingstad D. Violence and women’s mental health: The impact of physical, sexual, and psychological aggression. Annual review of clinical psychology. 2010;6:607–28. doi: 10.1146/annurev-clinpsy-090209-151437 20192793

57. Golding JM. Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of family violence. 1999;14(2):99–132.

58. Schwartz JP, Hage SM, Bush I, Burns LK. Unhealthy parenting and potential mediators as contributing factors to future intimate violence: A review of the literature. Trauma, Violence, & Abuse. 2006;7(3):206–21.

59. Weaver CM, Borkowski JG, Whitman TL. Violence breeds violence: Childhood exposure and adolescent conduct problems. Journal of community psychology. 2008;36(1):96–112. doi: 10.1002/jcop.20219 21720452

60. Wilson M, Daly M. Spousal homicide risk and estrangement. Violence and victims. 1993;8:3-. 8292563

61. Rezey ML. Separated Women’s Risk for Intimate Partner Violence: A Multiyear Analysis Using the National Crime Victimization Survey. Journal of interpersonal violence. 2017:0886260517692334.

62. Young K. Widows without rights: challenging marginalisation and dispossession. Gender & Development. 2006;14(2):199–209.

63. Gupta SK, Sekher T. Are Elderly Widows More Vulnerable to Abuse and Violence? Findings from Jharkhand, India. Abuse and Neglect of the Elderly in India: Springer; 2018. p. 139–56.

64. Lam WK, Fals-Stewart W, Kelley ML. Parent training with behavioral couples therapy for fathers’ alcohol abuse: Effects on substance use, parental relationship, parenting, and CPS involvement. Child maltreatment. 2009;14(3):243–54. doi: 10.1177/1077559509334091 19502478

65. Baucom KJ, Sevier M, Eldridge KA, Doss BD, Christensen A. Observed communication in couples two years after integrative and traditional behavioral couple therapy: Outcome and link with five-year follow-up. Journal of consulting and clinical psychology. 2011;79(5):565. doi: 10.1037/a0025121 21942502

66. Karakurt G, Whiting K, Van Esch C, Bolen SD, Calabrese JR. Couples therapy for intimate partner violence: A systematic review and meta-analysis. Journal of marital and family therapy. 2016;42(4):567–83. doi: 10.1111/jmft.12178 27377617

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