Being in abusive relationships makes women use contraception less often, a new, large meta-analysis of previous studies finds. When they do use contraception, they're likely not to choose condoms.
The finding could explain why women in abusive relationships are more likely to get abortions and to contract HIV, which previous studies have documented. HIV prevention campaigns should think about addressing domestic violence, the meta-analysis's authors write in a paper published last month in the journal PLoS One. So should campaigns to improve people's access to contraception overall, the paper's lead author, McGill University doctoral student Lauren Maxwell, said in a statement.
In violent relationships, abusers often refuse to use condoms and restrict their partners' access to contraception. For abusers, it's just another, potent form of control.
It's not necessarily surprising that women in abusive relationships are less likely to use contraception. In violent relationships, abusers often refuse to use condoms and restrict their partners' access to other types of contraception. For abusers, it's just another, potent form of control.
What's new in the meta-analysis is that it brings together so much data. The 10 studies included in the analysis cover five countries, including the United States, and more than 14,000 women. In addition, the analysis finds that, in studies, the abuse occurs first, then women start using contraception less often. A first-this-then-that relationship is important to establishing that something causes something else, and that the two things aren't just correlated by chance. The analysis also finds that the more severely abusive a woman's partner is, the less likely the woman is to use contraception. In medicine, doctors call that a dose-response relationship. Like sequential events, dose-response relationships are good evidence for causation.
In studies, it's often hard to tease out causal relationships like this. Now that researchers have found one, it's time to work to break the chain.