Author Affiliations: Department of Maternal and Child Health (Drs Martin, Tsui, and Maitra), Department of Biostatistics (Dr Kupper and Mr Kilgallen), and Carolina Population Center (Dr Tsui), University of North Carolina, Chapel Hill; and Department of Statistics, Faculty of Science, Banaras Hindu University, Varanasi, India (Dr Singh).
Letter From Section Editor: Annette Flanagin,
RN, MA, Managing Senior Editor.
Context Wife abuse has been associated with a variety of health concerns. Associations
between abuse and reproductive health in India are not well known.
Objective To examine relationships between men's reports of wife abuse and reproductive
health issues in northern India.
Design Structured face-to-face interviews were conducted as part of the male
reproductive health supplement of the PERFORM System of Indicators Survey,
a systematic multistage survey conducted in 1995-1996.
Setting The northern state of Uttar Pradesh, one of the least developed
states in India.
Participants A total of 6632 married men aged 15 to 65 years who lived with their
wives and completed all survey questions for the study variables reported
Main Measures Physically and sexually abusive behaviors toward wives, sexual activities
outside marriage, sexually transmitted disease (STD) symptoms, contraception
use, unplanned pregnancies, and sociodemographic characteristics.
Results Fifty-four percent of men reported not abusing their wives, while 17%
reported physically but not sexually abusing their wives, 22% reported sexual
abuse without physical force, and 7% reported sexual abuse with physical force.
Abuse was more common among men who had extramarital sex (for sexual abuse
using force: odds ratio [OR], 6.22; 95% confidence interval [CI], 3.98-9.72).
Similarly, men who had STD symptoms were more likely to abuse their wives
(with current symptoms: OR, 2.43; 95% CI, 1.73-3.42). Unplanned pregnancies
were significantly more common among wives of abusive men, especially sexually
abusive men who used force (OR, 2.62; 95% CI, 1.91-3.60).
Conclusions Wife abuse appears to be fairly common in northern India. Our findings
that abusive men were more likely to engage in extramarital sex and have STD
symptoms suggest that these men may be acquiring STDs from their extramarital
relationships, thereby placing their wives at risk for STD acquisition, sometimes
via sexual abuse. These abusive sexual behaviors also may result in an elevated
rate of unplanned pregnancies.
Martin SL, Kilgallen B, Tsui AO, Maitra K, Singh KK, Kupper LL. Sexual Behaviors and Reproductive Health Outcomes: Associations With Wife Abuse in India. JAMA. 1999;282(20):1967–1972. doi:10.1001/jama.282.20.1967
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