Sexual behaviors and reproductive health outcomes - Associations with wifeabuse in India

Context Wife abuse has been associated with a variety of health concerns. A ssociations between abuse and reproductive health in India are not well kno wn. Objective To examine relationships between men's reports of wife abuse and reproductive health issues in northern India. Design Structured face-to-face interviews were conducted as part of the mal e reproductive health supplement of the PERFORM System of Indicators Survey , a systematic multistage survey conducted in 1995-1996. Setting The northern state of Uttar Pradesh, one of the least developed sta tes in India. Participants A total of 6632 married men aged 15 to 65 years who lived with their wives and completed all survey questions for the study variables rep orted here. Main Measures Physically and sexually abusive behaviors toward wives, sexua l activities outside marriage, sexually transmitted disease (STD) symptoms, contraception use, unplanned pregnancies, and sociodemographic characteris tics. Results Fifty-four percent of men reported not abusing their wives, while 1 7% reported physically but not sexually abusing their wives, 22% reported s exual abuse without physical force, and 7% reported sexual abuse with physi cal force. Abuse was more common among men who had extramarital sex (for se xual abuse using force: odds ratio [OR], 6.22; 95% confidence interval [CI] , 3.98-9.72), Similarly, men who had STD symptoms were more likely to abuse their wives (with current symptoms: OR, 2.43; 95% CI, 1.73-3.42). Unplanne d pregnancies were significantly more common among wives of abusive men, es pecially sexually abusive men who used force (OR, 2.62; 95% CI, 1.91-3.60). Conclusions Wife abuse appears to be fairly common in northern India. Our f indings that abusive men were more likely to engage in extramarital sex and have STD symptoms suggest that these men may be acquiring STDs from their extramarital relationships, thereby placing their wives at risk for STD acq uisition, sometimes via sexual abuse. These abusive sexual behaviors also m ay result in an elevated rate of unplanned pregnancies.