How is Intimate Partner Violence associated with Sexually Transmitted Infections and Reproductive Tract Infections? A Cross-Sectional Study with Afghan Refugee Women in Iran

Abstract

Background Experiencing Intimate Partner Violence (IPV) by refugee women is debatable. Sexually Transmitted Infections (STIs) and Reproductive Tract Infections (RTIs) are IPV’s squeals. This study aimed to examine associations between IPV and RTI/STI. Methods This cross-sectional population-based household survey was conducted with 188 reproductive-age Afghan refugee women residing in a refugee settlement in a selected city in Iran, 2016-17. Data were collected using three self-report instruments: a Socio-demographic characteristics form, the Assessment of Intimate Partner Violence, Women’s self-reported RTI/STI-associated symptoms, and the Multi-country Study on Women’s Health and Domestic Violence against Women. The SPSS software (v. 22) was used to analyze the data at a significance level of less than 0.05. The chi-square test and Odds ratio (OR) with 95% confidence intervals (CI) were used. The logistic regression model evaluated associations between variables. Results The majority of women (79.8%) had ever experienced IPV during the last year and reported at least one symptom related to RTI/STI (70.2%). ‘Age 15–24 years’ (p = 0.037) (OR 0.49; 95% CI, 0.11–2.12), ‘no condom use’ (p = 0.014) (OR 5.31; 95% CI, 1.11–25.41) and ‘having forced anal sex’ (p = 0.036) (OR 0.49; 95% CI, 0.11–2.12) were found to be significantly associated with the reported symptoms. Most of the women (66.9%) neither sought help for their RTI/STI symptoms by healthcare nor received treatment. IPV was positively associated with RTI/STI -associated symptoms (p < 0.0001), having a history of RTI/STI diagnosis (p < 0.0001), and experiencing at least one of the most specific RTI/STI-associated symptoms (vaginal discharge and genital ulcers) (p < 0.0001). Women who had experienced any RTI/STI-associated symptoms experienced more sexual abuse from their spouses compared to women without any history of STI/RTI-reported symptoms (p < 0.0001) (OR 4.12; 95% CI, 1.87–9.08). Conclusions The prevalence of STI/RTI-associated symptoms among the Afghan refugee population is considerable. Also, the high prevalence of IPV and its strong links with the prevalence of reported RTI/STI-associated symptoms underline the urgent need for developing, testing, and implementing appropriate and timely interventions for managing RTI/STI and IPV simultaneously in refugee camps/settlements to tackle both violence and RTI/STI among refugee couples.