title: Gender-based violence against adolescent and young adult women in low- and middle-income countries.
abstract: OBJECTIVE
  Gender-based violence (GBV) is a global health and human rights issue with individual and social determinants. Youth are considered high risk; national influences include norms, policies and practices. By age, nation, and region, we contrast key GBV indicators, specifically intimate partner violence (IPV) and forced sexual debut among adolescent and young adult women using Demographic and Health Surveys across low- and middle-income countries.
  
  
  METHODS
  National prevalence estimates were generated among adolescents (15-19 years) and young adults (20-24 years) for lifetime and the past-year physical and sexual IPV among ever-married/cohabitating women (30 nations) and forced sexual debut among sexually experienced women (17 nations). Meta-analyses provided regional estimates and cross-national comparisons, and compared the past-year IPV prevalence among adolescent and young adult women to adult women.
  
  
  RESULTS
  An estimated 28% of adolescent and 29% of young adult women reported lifetime physical or sexual IPV, most prevalent in the East and Southern Africa region. Regional and cross-national variation emerged in patterns of violence by age; overall, young adult women demonstrated higher risk for the past-year IPV relative to adult women (meta-analysis odds ratio, 1.20; 95% confidence interval, 1.10-1.37) and adolescents had a comparable risk (meta-analysis odds ratio, 1.07; 95% confidence interval, .91-1.23). Forced sexual debut was estimated at 12% overall, highest in the East and Southern Africa region.
  
  
  CONCLUSIONS
  GBV is pervasive among adolescent and young adult women in low- and middle-income countries. The unique risk to youth varies across nations, suggesting an age-place interaction. Future research is needed to clarify contextual determinants of GBV. Findings provide direction for integrating youth within GBV prevention efforts.
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: mdecker@jhsph.edu.
authors.forename: Michele R
authors.initials: MR
authors.lastname: Decker
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Amanda D
authors.initials: AD
authors.lastname: Latimore
authors.affiliation: Department of Sociology, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, Maryland.
authors.forename: Suzumi
authors.initials: S
authors.lastname: Yasutake
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Miriam
authors.initials: M
authors.lastname: Haviland
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Saifuddin
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Blum
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Freya
authors.initials: F
authors.lastname: Sonenstein
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Urban Institute, Washington DC.
authors.forename: Nan Marie
authors.initials: NM
authors.lastname: Astone
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012742:Sex Offenses / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013179:Spouse Abuse / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Adolescent; Forced sexual debut; Intimate partner violence; Sexual assault