Intimate partner violence, adverse childhood experiences and prenatal substance use in South Africa

BACKGROUND: Intimate partner violence (IPV) is one of the most pressing public health conditions among women worldwide, particularly in sub-Saharan Africa. Intimate partner violence in South Africa, along with human immunodeficiency virus (HIV), is an epidemic that is closely linked to trauma and substance use in women. AIM: This study aimed to identify factors associated with IPV among pregnant women, with a specific focus on adverse childhood experiences (ACE), prenatal substance use, and HIV status. SETTING: A large public general hospital in the KwaZulu-Natal province. METHODS: The sampled study participants included 223 adult postpartum women (18 – 45 years) based on convenience sampling who recently gave birth. Four separate logistic regression models were fitted to examine the role of ACE, perinatal substance abuse and HIV against threat (model 1), physical violence (model 2), sexual violence (model 3) and any IPV (model 4) outcomes (threat and/or physical and/or sexual violence). RESULTS: The prevalence of threat, physical violence, sexual violence and any IPV were 19.7%, 16.6%, 1.8% and 20.2%, respectively. The total ACE scores ranged from 0 to 11 (of 13 possible events) with a mean of 3.28 (standard deviation [s.d.] = 2.76), where 14.4% reported using substances during pregnancy (n = 32) as well as 47.1% (n = 105) of participants living with HIV. The authors found that the presence of family support was protective against IPV physical. CONCLUSION: It is essential that obstetric services screen and address potential risk factors along the life course pathways from early adversity to adult maternal health that drive IPV, particularly in young women who may lack family support during pregnancy. CONTRIBUTION: This research gives insight into the dynamics between IPV, HV, ACE and perinatal substance use facing young women in South Africa