title: Racial/Ethnic Differences in Women's Experiences of Reproductive Coercion, Intimate Partner Violence, and Unintended Pregnancy.
abstract: To explore racial/ethnic differences in reproductive coercion (RC), intimate partner violence (IPV), and unintended pregnancy (UIP).
  
  
  
  We analyzed cross-sectional, baseline data from an intervention that was conducted between August 2008 and March 2009 in five family planning clinics in the San Francisco, California area, to examine the association of race/ethnicity with RC, IPV, and UIP among female patients aged 16-29 (n = 1234).
  
  
  
  RC was significantly associated with race/ethnicity, p < 0.001, [prevalence estimates: Black (37.1%), multiracial (29.2%), White (18.0%), Hispanic/Latina (24.0%), and Asian/Pacific Islander/other (API/other) (18.4%)]. Race/ethnicity was not associated with IPV. UIP was more prevalent among Black (50.3%) and multiracial (47.2%) women, with an overall range of 37.1%-50.3% among all racial/ethnic groups (p < 0.001). In adjusted analyses, factors associated with UIP were RC [adjusted odds ratio (AOR) = 1.59, 95% confidence interval (95% CI) = 1.26-2.01] and Black (AOR = 1.63, 95% CI = 1.02-2.60) and API/other (AOR = 1.41, 95% CI = 1.15-1.73) race/ethnicity, which remained significant in the presence of RC. Race-stratified models revealed that RC increased odds of UIP for White (AOR = 2.06, 95% CI = 1.45-2.93) and Black women (AOR = 1.72, 95% CI = 1.14-2.60).
  
  
  
  Black and multiracial women seeking care in family planning clinics have a disproportionately high prevalence of RC and UIP. RC may partially explain differences in UIP prevalence, with the effect of race/ethnicity slightly attenuated in RC-adjusted models. However, the impact of RC on risk for UIP was similar for White and Black women. Findings from this study support the need to understand and prevent RC, particularly among women of color. Results are foundational in understanding disparities in RC and UIP that may have implications for refinement of clinical care.
authors.affiliation: 1 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Charvonne N
authors.initials: CN
authors.lastname: Holliday
authors.affiliation: 2 Department of Human Development and Family Studies, Michigan State University , East Lansing, Michigan.
authors.forename: Heather L
authors.initials: HL
authors.lastname: McCauley
authors.affiliation: 3 Division of Global Public Health, Department of Medicine, Center on Gender Equity and Health, University of California , San Diego School of Medicine, La Jolla, California.
authors.forename: Jay G
authors.initials: JG
authors.lastname: Silverman
authors.affiliation: 4 Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health , Pittsburgh, Pennsylvania.
authors.forename: Edmund
authors.initials: E
authors.lastname: Ricci
authors.affiliation: 1 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Michele R
authors.initials: MR
authors.lastname: Decker
authors.affiliation: 5 Department of Pediatrics, University of California , Davis School of Medicine, Sacramento, California.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Tancredi
authors.affiliation: 4 Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health , Pittsburgh, Pennsylvania.
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Burke
authors.affiliation: 4 Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health , Pittsburgh, Pennsylvania.
authors.forename: Patricia
authors.initials: P
authors.lastname: Documét
authors.affiliation: 6 Center for Health Equity , Research, and Promotion, VA Pittsburgh Health Care System, Pittsburgh, Pennsylvania.|7 Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Sonya
authors.initials: S
authors.lastname: Borrero
authors.affiliation: 8 Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D003068:Coercion; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005193:Family Planning Services; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D000066511:Intimate Partner Violence / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000208:ethnology* / Q000523:psychology; D011275:Pregnancy, Unwanted / Q000208:ethnology*; D015995:Prevalence; D012495:San Francisco / Q000453:epidemiology; D012747:Sexual Partners / Q000523:psychology*; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: health disparities; intimate partner violence; race/ethnicity; reproductive coercion; unintended pregnancy