Abstract: Cycles of Violence: Examining the Association of Childhood Violence and Adult Intimate Partner Violence in a Representative Sample of Rural South Africans (Society for Social Work and Research 24th Annual Conference - Reducing Racial and Economic Inequality)

Cycles of Violence: Examining the Association of Childhood Violence and Adult Intimate Partner Violence in a Representative Sample of Rural South Africans

Friday, January 17, 2020
Marquis BR Salon 14, ML 2 (Marriott Marquis Washington DC)
* noted as presenting author
Sarah Treves-Kagan, PhD, Investigator, University of North Carolina at Chapel Hill, Chapel Hill, NC
Alison M. El Ayadi, ScD, Assistant Professor, University of California, San Francisco, CA
Jessica L. Morris, MPH, Project Manager, International Federation of Gynecology and Obstetrics, United Kingdom
Laurie M. Graham, PhD, Assistant Professor, University of Maryland at Baltimore, MD
Jessica S. Grignon, MPH, Director of Programs, I-TECH South Africa, South Africa
Lebogang Ntswane, Project Director, I-TECH South Africa, South Africa
Jennifer M. Gilvydis, MPH, Senior Program Manager, University of Washington, Seattle, WA
Scott Barnhart, MD, Professor, University of Washington, Seattle, WA
Sheri A. Lippman, PhD, Associate Professor, University of California, San Francisco, CA
Background and Purpose: Intimate partner violence (IPV) is a significant public health issue in South Africa. The country also experiences high rates of physical and sexual violence against children. Theories on cycles of violence suggest that experiencing violence in childhood plays a role in propensity to perpetrate violence and vulnerability to be subjected to violence again. Most research to date on this topic has been conducted in high-resource countries or within delimited populations. Given the need for research on relationships between childhood experiences of violence and IPV in representative samples in low-income countries, we explored the relationship between violence in childhood and IPV in adulthood in a sample of 18-49 year old adults in rural South Africa.

Methods: We conducted a population-based survey (n=1044) using a multi-stage cluster sample in two sub-districts in Northwest Province, South Africa in 2014.  We measured childhood violence before age 15 (forced sexual touching, forced sex, and serious physical violence) and IPV victimization and perpetration ever and in the last 12 months. To gather this data, we used a modified version of the World Health Organization violence against women instrument. The associations between violence exposure and outcome variables were evaluated with multivariate logistic regression, controlling for age, sub-district of residence, education and relationship status. All estimates are weighted to account for sampling design, including non-response, and represent estimates in the sub-district population. Gender was tested as an effect modifier. 

Results:  More women (2.7%) than men (0.8%) reported experiencing childhood forced sex, whereas men reported higher rates of experiencing childhood physical violence (men: 7.9%; women: 2%). Men and women reported similar rates of IPV (men: 5.4%; women: 6.8%) and IPV perpetration (men: 4.8%; women: 3.3%). Childhood sexual violence was significantly associated with IPV perpetration. Men and women who had experienced childhood sexual violence were 4 times more likely to perpetrate recent IPV (aOR = 4.0, 95% CI = [1.4, 11.5], p < .01) than those who did not experience sexual violence in childhood. Gender did not act as an effect modifier of this relationship. 

Conclusions and Implications: Our findings, at least in part, support the theory that childhood experiences of violence can make individuals more vulnerable to IPV and more likely to perpetrate IPV as an adult. Our results from a low-income, rural community in South Africa contributes to a growing evidence-base on relationships between childhood and adult experiences of violence in low- and middle-income countries. Findings support substantial investment in preventing childhood sexual abuse. Family and community programming that addresses preventing multiple forms of violence is critical; for example, healthy relationship programs, especially for those exposed to violence in childhood. Additional research on psychological or emotional violence in childhood is needed, as is longitudinal research on mediators, such as alcohol use and mental health, in order to help identify mechanisms to interrupt these cycles of violence.