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IPV as a global health priority

Intimate partner violence (IPV), defined as physical, sexual, and/or psychological violence by a current or former partner affects over 1 in 3 women worldwide (Breiding et al., 2015). IPV is associated with multiple negative physical and mental health outcomes such as chronic pain, sexually transmitted infections (including HIV), substance use and misuse, and an increased risk of developing symptoms of depression, anxiety, and posttraumatic stress (Dillon et al., 2013; El-Bassel et al., 2004; Lagdon et al., 2014; Siemieniuk et al., 2013; Stubbs & Szoeke, 2021; Walker et al., 2022).

IPV and Substance Use

Among women who use or misuse substances such as alcohol or illicit drugs, the risk of IPV is particularly acute. IPV may be a risk factor for substance use through intimate partner coercion, as well as the use of substances as a means of self-medication and coping (Ogden et al., 2022). Conversely, substance use may increase one's vulnerability to IPV, exacerbate abuse, create financial insecurity, and pose obstacles to seeking treatment services (Stone & Rothman, 2019). 

IPV and Posttraumatic Stress Symptoms

Posttraumatic distress is a consistently identified consequence of exposure to IPV (Dillon et al., 2013; Grose et al., 2019; Meinhart et al., 2021), with lifetime prevalence of traumatic distress ranging between 31% and 84% among IPV survivors (Golding, 1999). Posttraumatic stress symptoms (PTSS) encompass symptoms of intrusion, avoidance, negative alterations in cognition or mood, and alterations in arousal and/or reactivity (American Psychiatric Association, 2013). The research literature has demonstrated a clear link between IPV and PTSS, but findings have been mixed with regard to the relative impact of different forms of IPV on PTSS. 

New Study

Gaps in the Literature and Research Question

Studies of IPV and PTSS have often overlooked marginalized populations of women who are particularly vulnerable to IPV. Moreover, few studies have examined the association between different forms of IPV and PTSS among women who use drugs in Central Asia; this is a critical gap, as Central Asian countries, including Kyrgyzstan, have high rates of substance use, particularly injection drug use (United Nations [U.N.] Office on Drugs and Crime, 2022) and limited access to both IPV survivor support services (National Statistical Committee of Kyrgyz Republic, 2021) and quality mental health treatment (Pinchuk et al., 2021). The present study addresses several gaps in the literature by examining the associations between different forms of IPV and severe PTSS in a sample of 213 women in Kyrgyzstan who reported using drugs or engaging in hazardous alcohol use. The study was conducted in collaboration with multiple harm reduction community organizations in Kyrgyzstan. Findings from this study indicated high prevalence of lifetime and past 3-month IPV, as well as PTSS in the prior month. Findings also revealed significant relations between overall IPV and PTSS, as well as between specific forms of IPV and PTSS, including both physical IPV and injurious IPV. The study's findings support existing evidence that women who use substances face more extreme risks for IPV, and that exposure to IPV increases the risk for traumatic distress. Results suggest the need for more research on the mechanisms that explain the patterns observed, as well as the need for timely and targeted responses in clinical practice, especially in the context of harm reduction. 

Discussion Questions

1. What are the unique associations between different forms of IPV and PTSS among women who use or misuse substances?
2. How might trauma-informed care support women who use and/or misuse substances and are experiencing IPV?

Original Research Article

Jiwatram-Negrón, T., Meinhart, M., Ward, M., Michalopoulos, L., Zhan, Q., Nitikin, D., & Gilbert, L. (2024). Association between different forms of intimate partner violence and post-traumatic stress among women who use drugs and alcohol in Kyrgyzstan. Journal of Traumatic Stress. Advanced online publication. https://doi.org/10.1002/jts.23017

About the Authors

Tina Jiwatram-Negrón, Ph.D. is an Assistant Professor at the School of Social Work at Arizonia State University and faculty of the Office of Gender-Based Violence. Her research focuses on Gender Based Violence (GBV) among socially and economically marginalized women globally and addressing health and mental health disparities associated with GBV through intervention development in partnership with community-based organizations. Keep up with Dr. Jiwatram-Negrón on X at @tinajiwatram

Melissa Meinhart, Ph.D. is an independent research consultant. She obtained her Ph.D. from Columbia University's School of Social Work. Her research focuses on the measurement and examination of gender inequality, violence, and social discordance in low- and middle-income countries. 

Malorie Ward is a masters student studying social work at the Arizona State University School of Social Work in Phoenix, Arizona, U.S.

Lynn Michalopoulos, Ph.D. is an Associate Professor at the School of Social Work and Director of Global Intiatives at the University of Maryland, Baltimore. Her work is focused on trauma, HIV, and mental health, particularly among migrant populations. 

Qihao Zhan is a doctoral student at the School of Social Work, University of Illinois Urbana-Champaign, Urbana, Illinois, U.S.

Danil Nikitin, MSSW, is Chairperson at the Global Research Institute (GLORI) Foundation. GLORI is a Kyrgyzstan-based agency that explores solutions to a range of globally significant health and social issues including gender-based violence, drug use, HIV/AIDS, Tuberculosis, and mental health. Danil's research focuses on health systems' reform and the promotion of policies and programs to improve access to services and enhanced health outcomes. 

Louisa Gilbert, Ph.D., is a Professor of Social Work at Columbia University and Co-Director of the Global Health Research Center of Central Asia. Her research focuses on developing and advancing evidence-based interventions that address the co-occurring issues of gender-based violence, HIV, and overdose among women who use drugs. 


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