title: Shadow of domestic violence and extramarital sex cohesive with spousal communication among males in Nepal.
abstract: BACKGROUND
  Public health and human right issues are challenging in low and middle income countries. The main objectives of this paper were to determine the prevalence and factors associated with domestic violence, extramarital sex, and spousal communication among male.
  
  
  METHODS
  A cross-sectional study among 2466 married males in Kathmandu, Nepal was conducted using random sampling method. Adjusted odds ratios (AORs) and 95% confidence intervals (CI) of associated factors were estimated by stepwise backward likelihood ratio method.
  
  
  RESULTS
  Prevalence of domestic violence was 63.14% (95% CI 61.20-65.05), extramarital sex was 32.12% (95% CI 30.27-34.00), and spousal communication was 48.87% (95% CI 46.85-50.90). Nearly one in five male (18.20%) had not used condom during extramarital sex.Interestingly, male who had more than three or equal children were less likely to have perpetrated domestic violence compared with those who had less children. Older male aged 25 and above were more likely (AORs = 1.55, 95% CI 1.19-2.03) to have extramarital sex compared with male aged 24 or below. Those male who had studied secondary or higher level of education were less likely to have extramarital sex compared to those who had primary level or no education. Male who had higher income were more likely to have spousal communication compared to those who had less income. Surprisingly, those male who had extramarital sex were less likely to have spousal communication compared with those was not involved in extramarital sex.
  
  
  CONCLUSIONS
  Practice of domestic violence and extramarital sex is quite common among married male in Nepal, where spousal communication is sparse. These findings can be used to advocate for immediate attention and activities needs to be endorsed by policymakers and programmers.
authors.affiliation: Department of Public Health, Pokhara University, Nobel College, Sinamangal, Kathmandu, Nepal. dnbhatta@yahoo.com.
authors.forename: Dharma Nand
authors.initials: DN
authors.lastname: Bhatta
mesh_terms: D000328:Adult; D003142:Communication; D003268:Contraception Behavior; D003430:Cross-Sectional Studies; D017579:Domestic Violence; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008393:Marriage; D009390:Nepal; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D013179:Spouse Abuse