title: Husband's Alcohol Use, Intimate Partner Violence, and Family Maltreatment of Low-Income Postpartum Women in Mumbai, India.
abstract: Husbands' alcohol use has been associated with family-level stress and intimate partner violence (IPV) against women in India. Joint family systems are common in India and IPV often co-occurs with non-violent family maltreatment of wives (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care). Alcohol use increases for some parents following the birth of a child. This study examined 1,038 postpartum women's reports of their husbands' alcohol use and their own experiences of IPV (by husband) and non-violent maltreatment from husbands and/or in-laws. We analyzed cross-sectional, quantitative data collected in 2008, from women (ages 15-35) seeking immunizations for their infants <6 months at three large urban health centers in Mumbai, India. Crude and adjusted logistic regression models estimated associations between the independent variable (husbands' past month use of alcohol) and two dependent variables (postpartum IPV and maltreatment). Overall, 15% of husbands used alcohol, ranging from daily drinkers (10%) to those who drank one to two times per week (54%). Prevalence of postpartum IPV and family maltreatment was 18% and 42%, respectively. Prevalence of IPV among women married to alcohol users was 27%. Most abused women's husbands always (27%) or sometimes (37%) drank during violent episodes. Risk for IPV increased with a man's increasing frequency of consumption. Women who lived with a husband who drank alcohol, relative to non-drinkers, were more likely to report postpartum IPV, aOR = 2.0, 95% confidence interval (CI) = [1.3, 3.1]. Husbands' drinking was marginally associated with increased risk for family maltreatment, aOR = 1.4, 95% CI = [1.0, 2.1]. Our findings suggest that men's alcohol use is an important risk factor for postpartum IPV and maltreatment. Targeted services for Indian women contending with these issues are implicated. Postpartum care offers an ideal opportunity to screen for IPV, household maltreatment, and other health risks, such as husband's use of alcohol. There is need to scale up proven successful interventions for reducing men's alcohol use and design strategies that provide at-risk women protection from alcohol-related IPV.
authors.affiliation: 1 University of California, San Diego, CA, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Wagman
authors.affiliation: 2 National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India.
authors.forename: Balaiah
authors.initials: B
authors.lastname: Donta
authors.affiliation: 1 University of California, San Diego, CA, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Ritter
authors.affiliation: 2 National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India.
authors.forename: D D
authors.initials: DD
authors.lastname: Naik
authors.affiliation: 3 National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India.
authors.forename: Saritha
authors.initials: S
authors.lastname: Nair
authors.affiliation: 4 Population Council, HIV and AIDS Program, New Delhi, India.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Saggurti
authors.affiliation: 1 University of California, San Diego, CA, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Raj
authors.affiliation: 1 University of California, San Diego, CA, USA.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Silverman
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D018585:Battered Women / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D000066511:Intimate Partner Violence / Q000523:psychology* / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008393:Marriage / Q000706:statistics & numerical data; D049590:Postpartum Period / Q000523:psychology*; D011203:Poverty; D018454:Spouses / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: India; alcohol use; family-level maltreatment; husbands; infants; intimate partner violence; low-income women; postpartum