Use of reproductive and sexual health services among female family planning clinic clients exposed to partner violence and reproductive coercion

Abstract

To examine the associations of recent intimate partner violence (IPV) and reproductive coercion (RC) with frequency of use of reproductive and sexual health services, a cross-sectional survey was administered to 16-29 year old women seeking care in five family planning clinics (n = 1,262). We evaluated associations of recent experiences of IPV, RC, or both IPV and RC with recent care seeking for pregnancy testing, emergency contraception, and sexually transmitted infection testing using multinomial logistic regression. Sixteen percent of respondents reported IPV and 13.5 % reported RC in the past 3 months. Four percent of all respondents reported both IPV and RC. Recent RC without IPV was associated with increased odds of seeking one (AOR = 2.0, 95 % CI 1.3-2.9) or multiple pregnancy tests (AOR = 2.3, 95 % CI 1.2-4.5), multiple STI tests (AOR = 2.5, 95 % CI 1.5-4.1), or using emergency contraception once (AOR = 2.6, 95 % CI 1.2-5.8) or multiple times (AOR = 2.2, 95 % CI 1.7-2.7). Recent IPV without RC was associated with increased odds of seeking one (AOR = 1.4, 95 % CI 1.1-1.7) or multiple pregnancy tests (AOR = 2.2, 95 % CI 1.4-3.2) and using emergency contraception once (AOR = 1.6, 95 % CI 1.3-2.0). The combined effect of recent IPV and RC increased the odds of seeking multiple pregnancy tests (AOR = 3.6, 95 % CI 3.3-3.8), using emergency contraception multiple times (AOR = 2.4, 95 % CI 1.5-4.1) and seeking STI testing once (AOR = 2.5, 95 % CI 1.6-3.9) or multiple times (AOR = 2.9, 95 % CI 1.02-8.5). Frequent requests for pregnancy and STI testing and emergency contraception among young females seeking care may be an indicator of greater risk for recent RC, alone and in combination with IPV.