title: Spousal concordance in attitudes toward violence and reported physical abuse in African couples.
abstract: OBJECTIVE
  We examined the potential association between African couples' concordance on attitudes toward violence (ATV) and risk for intimate partner violence (IPV).
  
  
  METHODS
  Analyses included 13,837 couples from Demographic and Health Surveys conducted between 2003 and 2007, from six African countries. Concordance on ATV was defined as both spouses justifying physical abuse, and IPV was defined as incidence of a physically violent act against the wife. We constructed a concordance measure from the surveys to assess overall and country-level differences in couple's ATV concordance rates and assessed the association between concordance in ATV and IPV using hierarchical regression modeling that adjusted for multilevel influences on risk estimates. Negative concordance (perfect agreement in negative ATV) was used as referent category in all analyses.
  
  
  RESULTS
  Overall, spousal ATV concordance was associated with higher likelihood for IPV (adjusted odds ratio [AOR] = 2.27, 95% confidence interval [CI] = [2.01, 2.56]). The level of wealth, educational attainment, rural/urban residence, presence of a cowife, religion, maternal age, and parity were characteristics that predicted the occurrence of IPV within couples. Spousal ATV concordance was significantly associated with violence in every African nation included in the analysis except Rwanda.
  
  
  CONCLUSIONS
  African couples with high rates of ATV concor- dance experience higher risks for IPV, with some variation in magnitude of risk across countries. In African settings, ATV positive concordance could serve as a supplemental screening tool to detect spousal violence. Understanding ATV could potentially enhance our ability to formulate public health intervention to detect and prevent spousal abuse.
authors.affiliation: University of South Florida, Tampa, FL 33612, USA. aalio@health.usf.edu
authors.forename: Amina P
authors.initials: AP
authors.lastname: Alio
authors.forename: Heather B
authors.initials: HB
authors.lastname: Clayton
authors.forename: Madeleine
authors.initials: M
authors.lastname: Garba
authors.forename: Alfred K
authors.initials: AK
authors.lastname: Mbah
authors.forename: Ellen
authors.initials: E
authors.lastname: Daley
authors.forename: Hamisu M
authors.initials: HM
authors.lastname: Salihu
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D000374:Aggression / Q000523:psychology; D001294:Attitude to Health; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008019:Life Style; D008297:Male; D008393:Marriage / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D018454:Spouses / Q000706:statistics & numerical data*; D055815:Young Adult