Intimate partner violence as a predictor of marital disruption in rural Rakai, Uganda: a longitudinal study.
OBJECTIVE
We assessed the association between intimate partner violence (IPV) and union disruption (divorce or separation) in the rural Ugandan setting of Rakai District.


METHODS
We analyzed longitudinal data collected from April 1999 to June 2006, from 6834 women (15-49 years) living in 50 communities in Rakai. Participants were either officially married, traditionally married or in a consensual union during one or more surveys and completed at least one follow-up survey. The primary outcome was union disruption through divorce or separation from the primary sexual partner.


RESULTS
Past year IPV ranged from 6.49 % (severe physical abuse) to 31.99 % (emotional abuse). Severe physical IPV was significantly associated with divorce/separation, after adjusting for other covariates (aOR = 1.80, 95 % CI 1.01-3.22). Another predictor of union disruption was a woman having two or more sexual partners in the past year (aOR = 8.42, 95 % CI 5.97-11.89). Factors protecting against divorce/separation included an increasing number of co-resident biological children and longer duration of union.


CONCLUSIONS
IPV, particularly severe physical abuse, is an important risk factor for union disruption. Marital counseling, health education and interventions should address the role of IPV on the wellbeing of women and the stability of couples in Uganda.
Division of Global Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA. jwagman@ucsd.edu.
Jennifer A
JA
Wagman
Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Blake
B
Charvat
Department of Family Science, School of Public Health, University of Maryland, 4200 Valley Drive Bldg 255, College Park, MD, USA.
Marie E
ME
Thoma
Rakai Health Sciences Program, Uganda Virus Research Institute, Nakiwogo Road, P.O Box 49, Entebbe, Uganda.
Anthony
A
Ndyanabo
Rakai Health Sciences Program, Uganda Virus Research Institute, Nakiwogo Road, P.O Box 49, Entebbe, Uganda.
Fred
F
Nalugoda
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 627 N. Washington Street, 2nd Floor, Baltimore, MD, 21205, USA.
Joseph
J
Ssekasanvu
Rakai Health Sciences Program, Uganda Virus Research Institute, Nakiwogo Road, P.O Box 49, Entebbe, Uganda.
Grace
G
Kigozi
Makerere University School of Public Health, Old Mulago Hill Road, New Mulago Hospital Complex, P.O Box 7072, Kampala, Uganda.
David
D
Serwadda
Rakai Health Sciences Program, Uganda Virus Research Institute, Nakiwogo Road, P.O Box 49, Entebbe, Uganda.
Joseph
J
Kagaayi
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 627 N. Washington Street, 2nd Floor, Baltimore, MD, 21205, USA.
Maria J
MJ
Wawer
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 627 N. Washington Street, 2nd Floor, Baltimore, MD, 21205, USA.
Ronald H
RH
Gray
D000293:Adolescent; D000328:Adult; D004243:Divorce / Q000639:trends*; D005260:Female; D006801:Humans; D000066511:Intimate Partner Violence; D008137:Longitudinal Studies; D008297:Male; D008393:Marriage; D008875:Middle Aged; D012424:Rural Population; D011795:Surveys and Questionnaires; D014454:Uganda; D055815:Young Adult
Divorce; Global health; Intimate partner violence; Longitudinal analysis; Sub-Saharan Africa; Union dissolution