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Reproductive Coercion and Relationship Abuse Among Adolescents and Young Women Seeking Care at School Health Centers

NCJ Number
Obstetrics and Gynecology Volume: 134 Issue: 2 Dated: 2019 Pages: 351-359
Date Published
9 pages
This study examined demographic differences in how reproductive coercion and relationship abuse influence young females' care-seeking and sexual health behaviors.

The study conducted a secondary analysis of cross-sectional baseline survey data from sexually active female students (aged 14-19 years) who sought care from school health centers. Outcomes included recent (previous 3 months) reproductive coercion, physical or sexual adolescent relationship abuse, and non-partner sexual violence victimization. Cluster-adjusted 2 tests compared demographics and generalized linear mixed models estimated associations among reproductive coercion, adolescent relationship abuse (physical and sexual abuse in romantic relationships), care-seeking, and sexual health behaviors. The study found that of 550 sexually active high school females, 12 percent reported recent reproductive coercion, and 17 percent reported physical or sexual adolescent relationship abuse, with no significant demographic differences. The prevalence of recent non-partner sexual violence was 17 percent. There were no observed significant differences in care-seeking behaviors among those with recent reproductive coercion compared with those without. Physical or sexual adolescent relationship abuse was associated with increased odds of seeking testing or treatment for sexually transmitted infections (adjusted odds ratio [aOR] 2.08, 95 percent CI 1.05-4.13). Females exposed to both adolescent relationship abuse and reproductive coercion had higher odds of having a partner who was 5 or more years older (aOR 4.66, 95 percent CI 1.51-14.4), having two or more recent sexual partners (aOR 3.86, 95 percent CI 1.57-9.48), and using hormonal contraception only (aOR 3.77, 95 percent CI 1.09-13.1 vs hormonal methods with condoms). The study's overall conclusion is that one in eight females experienced recent reproductive coercion. There were no significant demographic differences in reproductive coercion. Partner age and number of sexual partners may elevate risk for abusive relationships. Relationship abuse is prevalent among high school students seeking care, with no clear pattern for case identification. By failing to identify factors associated with harmful partner behaviors, study results support universal assessment for reproductive coercion and relationship abuse among high school-aged adolescents, involving education, resources, and harm-reduction counseling to all patients. (publisher abstract modified)

Date Published: January 1, 2019