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The pandemic has led to a substantial jump in the incidence of , but intimate partner violence against women was already highly prevalent globally before COVID-19, researchers reported.

Examining studies from 2000 to 2018 that captured the responses of 2 million girls and women, 27% (uncertainty interval [UI] 23-31) of those ages 15-49 years were estimated to have experienced physical and/or sexual intimate partner violence in their lifetime, with 13% (UI 10-16) experiencing it in the year before they were surveyed, according to Claudia García-Moreno, MD, MsC, of the World Health Organization (WHO) in Geneva, and colleagues.

In addition, 24% (UI 21-28) of females ages 15-19 and 26% (UI 23-30) of those ages 19-24 reported having at least one experience of intimate partner violence since age 15, they stated in .

The authors also found that "Regional variations exist, with low-income countries reporting higher lifetime and, even more pronouncedly, higher past year prevalence compared with high-income countries."

García-Moreno stressed to MedPage Today that when it comes to intimate partner violence, "the prevalence is still incredibly high everywhere, more so in low- and middle- income countries, but still ... high everywhere, and that really urgent action needs to be taken to address and to prevent and reduce the impact of violence on the lives of women and girls everywhere."

She also noted the importance of paying more attention to the high rates of intimate partner violence experienced by adolescent girls and young women, who can sometimes get lost because they are considered children in some studies and women in others.

The includes ending violence against women as a goal, but "We're not even close to reaching the target of eliminating all forms of violence against women," said García-Moreno.

"I wouldn't say that it's all gloom and doom," she added, as public awareness about intimate partner violence is growing and "even the fact that countries are collecting this data is an important thing."

Study Details

The authors "developed global, regional, and country estimates," based on data from the WHO . They created "a Bayesian multilevel model to jointly estimate lifetime and past year intimate partner violence by age, year, and country." Ultimately, 366 eligible studies were included with data from 161 countries and areas that covered 90% of the global population of women and girls, ages 15 and up.

The authors found lifetime prevalence of intimate partner violence among girls and women ages 15-49 was highest in Oceania (49%) and central Sub-Saharan Africa (44%), while the lowest estimates were found in central Asia (18%) and central Europe (16%). Also, the highest prevalence of past-year intimate partner violence was in central sub-Saharan Africa (32%), Oceania (29%), eastern sub-Saharan Africa (24%), and south Asia (19%).

García-Moreno suggested the "concentration" of high prevalence estimates in the Pacific Islands may reflect their small populations, which makes conducting national surveys easier. Regional conflicts in South Asia and sub-Saharan Africa may have contributed to high prevalence rates, she noted, but she cautioned that these factors were not studied closely so were "more of an observation."

In general, mostly high-income countries, including those in western Europe (4%), southern Latin America (5%), and North America (6%) had the lowest estimated rates of past year physical and/or sexual intimate partner violence among females ages 15-49.

The first estimates of regional and global physical and/or sexual intimate partner violence, as well as non-partner sexual violence, came from WHO in 2013, with 30% of women experiencing physical and/or sexual violence from partners only. Given the "much richer database" in 2022, and the overlap in the uncertainty intervals between the 2013 and 2022 estimates, "it doesn't appear that there's been a dramatic decrease" in prevalence rates, García-Moreno said, "and that's disappointing."

Her group wrote that "Robust evidence shows that intimate partner violence is preventable, and targeted investments are required to implement multilevel, multisectoral prevention interventions and to strengthen the health and other sectors' response to intimate partner violence."

The framework is an example of a prevention intervention, García-Moreno noted. Other interventions can be school-based programs, targeted social media campaigns, economic interventions, and parenting interventions. Studies have shown "those who are exposed to violence as children, also go on to perpetrate it," she said.

"There is growing evidence around interventions ... focused on changing social norms, around the acceptability of violence, around consent, around more equal relationships and decision-making. But I think it's very important to target not just young girls but to also work with young men on these issues," García-Moreno stated.

Study limitations included the fact that the quality of the data varied across the analyzed research. Also, studies relied on self-report so there was the potential for under-reporting of violence due to stigma, García-Moreno noted.

In an , Jessica Leight, PhD, MPhil, of the International Food Policy Research Institute in Washington, stated that the "findings highlight the importance of more carefully analyzing the evolution of intimate partner violence and other related forms of violence targeting girls and women over the life course."

She also pointed out another study limitation: A lack of "estimates of violence for subpopulations that other literature has identified as particularly vulnerable to violence, including disabled girls and women and girls and women living with HIV."

García-Moreno and colleagues are working to measure violence against women with disabilities and "to better capture the experiences of violence of older women," she told MedPage Today.

COVID Connection

As for the pandemic, the authors pointed out that "its associated control measures (i.e., lockdowns, mobility restrictions, and curfews) are further exacerbating the already heavy burden of intimate partner violence...The full effect of the COVID-19 pandemic will only be known when population-based surveys are able to fully resume."

Leight noted that "the burden of intimate partner violence has actually increased during the COVID-19 pandemic," citing a 2020 study from and a 2021 study done in .

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