title: Intimate partner violence among African American and African Caribbean women: prevalence, risk factors, and the influence of cultural attitudes.
abstract: BACKGROUND
  Women of African descent are disproportionately affected by intimate partner abuse; yet, limited data exist on whether the prevalence varies for women of African descent in the United States and those in the US territories.
  
  
  OBJECTIVE
  In this multisite study, we estimated lifetime and 2-year prevalence of physical, sexual, and psychological intimate partner abuse (IPA) among 1,545 women of African descent in the United States and US Virgin Islands (USVI). We also examined how cultural tolerance of physical and/or sexual intimate partner violence (IPV) influences abuse.
  
  
  METHODS
  Between 2009 and 2011, we recruited African American and African Caribbean women aged 18-55 from health clinics in Baltimore, MD, and St. Thomas and St. Croix, USVI, into a comparative case-control study. Screened and enrolled women completed an audio computer-assisted self-interview. Screening-based prevalence of IPA and IPV were stratified by study site and associations between tolerance of IPV and abuse experiences were examined by multivariate logistic regression analysis.
  
  
  RESULTS
  Most of the 1,545 screened women were young, of low-income, and in a current intimate relationship. Lifetime prevalence of IPA was 45% in St. Thomas, 38% in St. Croix, and 37% in Baltimore. Lifetime prevalence of IPV was 38% in St. Thomas, 28% in St. Croix, and 30% in Baltimore. Past 2-year prevalence of IPV was 32% in St. Thomas, 22% in St. Croix, and 26% in Baltimore. Risk and protective factors for IPV varied by site. Community and personal acceptance of IPV were independently associated with lifetime IPA in Baltimore and St. Thomas.
  
  
  CONCLUSIONS
  Variance across sites for risk and protective factors emphasizes cultural considerations in sub-populations of women of African descent when addressing IPA and IPV in given settings. Individual-based interventions should be coupled with community/societal interventions to shape attitudes about use of violence in relationships and to promote healthy relationships.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego La Jolla, CA, USA; jstockman@ucsd.edu.
authors.forename: Jamila K
authors.initials: JK
authors.lastname: Stockman
authors.affiliation: Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA.
authors.forename: Marguerite B
authors.initials: MB
authors.lastname: Lucea
authors.affiliation: Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA.
authors.forename: Richelle
authors.initials: R
authors.lastname: Bolyard
authors.affiliation: Caribbean Exploratory NIMHD Research Center, School of Nursing, University of the Virgin Islands, St. Thomas, US Virgin Islands.
authors.forename: Desiree
authors.initials: D
authors.lastname: Bertand
authors.affiliation: Caribbean Exploratory NIMHD Research Center, School of Nursing, University of the Virgin Islands, St. Thomas, US Virgin Islands.
authors.forename: Gloria B
authors.initials: GB
authors.lastname: Callwood
authors.affiliation: Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA.
authors.forename: Phyllis W
authors.initials: PW
authors.lastname: Sharps
authors.affiliation: Caribbean Exploratory NIMHD Research Center, School of Nursing, University of the Virgin Islands, St. Thomas, US Virgin Islands.
authors.forename: Doris W
authors.initials: DW
authors.lastname: Campbell
authors.affiliation: Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA.
authors.forename: Jacquelyn C
authors.initials: JC
authors.lastname: Campbell
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data*; D000367:Age Factors; D017691:Caribbean Region / Q000453:epidemiology; D016022:Case-Control Studies; D003469:Culture; D005260:Female; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000208:ethnology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: African American; African Caribbean; cultural attitudes; intimate partner abuse; intimate partner violence; women