One of my routine questions asked yearly to women at their annual exams is: “Do you feel safe at home?” I follow that question with more questions such as: “Is anyone punching, slapping, pushing, or kicking you?”
Some patients are shocked at my line of questions, some thank me for asking, and some unfortunately answer yes. It is the recommendation of the United States Preventive Services Task Force (USPSTF) to screen all women of reproductive age for intimate partner violence (IPV), which is abuse or aggression in an intimate relationship.
About 1 in 3 women have experienced severe physical violence from an intimate partner in their lifetime as compared to 1 in 4 men. A large number of cases never even get reported. Every community regardless of socioeconomic status, age, religion, nationality, sexual orientation, or race is affected by intimate partner violence. A 2011 Centers for Disease Control and Prevention Youth Risk Behavior Study showed that 9.4% of high school students reported being purposefully hit, slapped, or physically hurt within the last 12 months by their partner.
Physical violence, however, is just one aspect of abuse. There are 4 other categories of violence: emotional, sexual, stalking, and socio-economic.
Emotional abuse may include shaming, belittling, or continued attacks on self-esteem. Some abusers may also try to control the victim’s speech, dress, or circle of friends.
Sexual violence is forcing someone to engage in sexual acts, unwanted touching, or any sexual behavior without the partner’s consent.
Stalking is also seen in intimate partner violence. The CDC defines stalking as: “a pattern of repeated, unwanted attention and contact by a partner that causes fear or concern for one’s own safety or the safety of someone close to the victim.”
The 5th category of violence is socio-economic. Financial abuse involves controlling the money. This form of abuse could result in the abused partner not having access to the funds or being forced or coerced into spending the funds.
It is important that we know how to recognize intimate partner violence. Signs of abuse include but are not limited to:
Unexplained bruises, cuts, or broken bones
Avoidance of family gatherings
Uncomfortable behavior around partner
Constant excuses for the partner’s behavior
One partner making all of the decisions
Partner frequently checks on the victim at school or work
As mentioned earlier, adolescents are also experiencing intimate partner violence. Therefore, being aware of any behavior changes in teens is extremely important. Teenager manifestations of abuse may appear as depression, anxiety, or withdrawal.
Intimate partner violence is not just an individual matter. Victims often miss work which then results in lost revenue which could result in housing instability or food insecurity. Furthermore, witnessing violence in the home has a negative impact on children such as academic decline or mental health issues such as depression or anxiety. Children exposed to intimate partner violence are at a higher risk of abuse compared to children not exposed.
If you are experiencing intimate partner violence, seeking safety is very important. If you are in immediate danger, call 911. If not in immediate danger, seek medical care if you have been sexually assaulted or physically injured. Calling a helpline is also an option. These calls are anonymous. You can reach the National Domestic Violence Hotline at: 1-800-799-SAFE.
Denise Hooks-Anderson, MD, FAAFP can be reached at yourhealthmatters@stlamerican.com
Related materials:
1. Addressing domestic violence in Black community
3. Cori Bush speaks at ‘Rally for Rosey’
4. Domestic violence involves all of us
5. Diamond Diva Empowerment Foundation
6. Domestic violence increases over the holidays
