Purpose

Reproductive coercion (RC) is a type of intimate partner violence that involves interference in contraceptive and reproductive decisions. A multi-methods design explored correlates (quantitative) and contributors (qualitative) of partner-perpetrated RC across the socioecological framework among intimate partner violence survivors (IPV) in Nairobi, Kenya.

Methods

Quantitative analyses utilize baseline data from the myPlan Kenya trial (n=327). Multivariable Poisson regression examined the association between postulated correlates and overall RC (range: 0-9), and sub-types of pregnancy coercion (range: 0-5) and condom manipulation (range: 0-4). In-depth interviews (IDIs; n=30) conducted at three-month follow-up among women indicating RC experience at baseline explored women’s perceived contributors to RC via inductive thematic analysis.

Results

Within the past three months, over 80% of IPV survivors experienced any RC, and IPV survivors experienced 3.8 RC behaviors on average. Factors associated with overall RC included not wanting their last child at all (aIRR =1.28; p=0.009), partner’s concurrent partnership (aIRR=1.33; p<0.001), and inconvenient contraceptive method use (aIRR=1.36; p=0.01), whereas increased couple communication was protective against RC (aIRR=0.96; p<0.001). IDIs revealed potential contributors to RC, including partner’s desire for children; partner fear of contraceptive side effects; cultural norms surrounding family planning use within marriage; decision-making power disparities reinforced by economics; partner’s fear of abandonment; and presence of children from previous relationships.

Conclusions

Results indicate individual- and couple-level characteristics are crucial for understanding RC for Nairobi’s IPV survivors. Knowledge of RC risk factors can assist practitioners in mitigating against reproductive interference, and ensuring women are using contraceptive methods most suited to their circumstances and aligned with their reproductive preferences.

中文翻译：

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肯尼亚内罗毕亲密伴侣暴力幸存者在整个社会生态框架中生殖胁迫的相关性和贡献者

目的

生殖胁迫 (RC) 是一种亲密伴侣暴力行为，涉及干预避孕和生殖决策。一项多方法设计探索了肯尼亚内罗毕亲密伴侣暴力幸存者 (IPV) 社会生态框架中伴侣实施的 RC 的相关性（定量）和贡献者（定性）。

方法

定量分析利用来自 myPlan Kenya 试验的基线数据 ( n =327)。多变量泊松回归检查了假定的相关性与总体 RC（范围：0-9）以及妊娠胁迫（范围：0-5）和安全套操作（范围：0-4）的亚型之间的关联。深入访谈（IDIs；n = 30）对女性进行了三个月的随访，表明基线 RC 经验通过归纳主题分析探索了女性对 RC 的感知贡献者。

结果

在过去三个月中，超过 80% 的 IPV 幸存者经历过任何 RC，IPV 幸存者平均经历了 3.8 次 RC 行为。与整体 RC 相关的因素包括根本不想要他们的最后一个孩子 (aIRR = 1.28; p = 0.009)、伴侣的同时伴侣关系 (aIRR = 1.33; p <0.001) 和不方便的避孕方法使用 (aIRR = 1.36; p = 0.01) ，而增加的夫妻交流对 RC 有保护作用（aIRR=0.96；p<0.001)。IDI 揭示了 RC 的潜在贡献者，包括伴侣对孩子的渴望；伴侣害怕避孕的副作用；围绕婚姻中使用计划生育的文化规范；经济学强化了决策权的差距；伴侣害怕被抛弃；和以前的关系中的孩子的存在。

结论

结果表明，个人和夫妻层面的特征对于了解内罗毕 IPV 幸存者的 RC 至关重要。了解 RC 风险因素可以帮助从业者减轻生殖干扰，并确保女性使用最适合其情况并符合其生殖偏好的避孕方法。