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Abstract：
Intimate partner violence (IPV) is an important public health problem with health and socioeconomic consequences and is endemic in Namibia. Studies assessing risk factors for IPV often use logistic and Poisson regression without geographical location information and spatial effects. We used a Bayesian spatial semi-parametric regression model to determine the risk factors for IPV in Namibia; assess the non-linear effects of age difference between partners and determine spatial effects in the different regions on IPV prevalence.
We used the couples\' dataset of the 2013-2014 Namibia Demographic and Health Survey (DHS) obtained on request from Measure DHS. The DHS domestic violence module included 2226 women. We generated a binary variable measuring IPV from the questions \"ever experienced physical, sexual or emotional violence?\" Covariates included respondent\'s educational level, age, couples\' age difference, place of residence and partner\'s educational level. All estimation was done with the full Bayesian approach using R version 3.5.2 implementing the R2BayesX package.
IPV country prevalence was 33.3% (95% CI = 30.1-36.5%); Kavango had the highest [50.6% (95% CI = 41.2-60.1%)] and Oshana the lowest [11.5% (95% CI = 3.2-19.9%)] regional prevalence. IPV prevalence was highest among teenagers [60.8% (95% CI = 36.9-84.7%)]). The spatial semi-parametric model used for adjusted results controlled for regional spatial effects, respondent\'s age, age difference, respondent\'s years of education, residence, wealth, and education levels. Women with higher education were 50% less likely to experience IPV [aOR: 0.46, 95% CI = 0.23-0.87]. For non-linear effects, the risk of IPV was high for women ≥ 5 years older or ≥ 25 years younger than their partners. Younger and older women had higher risks of IPV than those between 25 and 45 years. For spatial variation of IPV prevalence, northern regions had low spatial effects while western regions had very high spatial effects.
The prevalence of IPV among Namibia women was high especially among teenagers, with higher educational levels being protective. The risk of IPV was lower in rural than urban areas and higher with wide partner age differences. Interventions and policies for IPV prevention in Namibia are needed for couples with wide age differences as well as for younger women, women with lower educational attainment and in urban and western regions.
We used the couples\' dataset of the 2013-2014 Namibia Demographic and Health Survey (DHS) obtained on request from Measure DHS. The DHS domestic violence module included 2226 women. We generated a binary variable measuring IPV from the questions \"ever experienced physical, sexual or emotional violence?\" Covariates included respondent\'s educational level, age, couples\' age difference, place of residence and partner\'s educational level. All estimation was done with the full Bayesian approach using R version 3.5.2 implementing the R2BayesX package.
IPV country prevalence was 33.3% (95% CI = 30.1-36.5%); Kavango had the highest [50.6% (95% CI = 41.2-60.1%)] and Oshana the lowest [11.5% (95% CI = 3.2-19.9%)] regional prevalence. IPV prevalence was highest among teenagers [60.8% (95% CI = 36.9-84.7%)]). The spatial semi-parametric model used for adjusted results controlled for regional spatial effects, respondent\'s age, age difference, respondent\'s years of education, residence, wealth, and education levels. Women with higher education were 50% less likely to experience IPV [aOR: 0.46, 95% CI = 0.23-0.87]. For non-linear effects, the risk of IPV was high for women ≥ 5 years older or ≥ 25 years younger than their partners. Younger and older women had higher risks of IPV than those between 25 and 45 years. For spatial variation of IPV prevalence, northern regions had low spatial effects while western regions had very high spatial effects.
The prevalence of IPV among Namibia women was high especially among teenagers, with higher educational levels being protective. The risk of IPV was lower in rural than urban areas and higher with wide partner age differences. Interventions and policies for IPV prevention in Namibia are needed for couples with wide age differences as well as for younger women, women with lower educational attainment and in urban and western regions.
摘要：
亲密伴侣暴力（IPV）是一个重要的公共卫生问题，具有健康和社会经济后果，在纳米比亚很普遍。评估IPV危险因素的研究通常使用逻辑和泊松回归，没有地理位置信息和空间效应。我们使用贝叶斯空间半参数回归模型来确定纳米比亚IPV的危险因素；评估伴侣之间年龄差异的非线性影响，并确定不同地区对IPV患病率的空间影响。
我们使用了应MeasureDHS要求获得的2013-2014年纳米比亚人口与健康调查（DHS）的夫妻数据集。国土安全部的家庭暴力模块包括2226名妇女。我们从“曾经经历过的物理问题”中生成了一个测量IPV的二进制变量，性暴力或情感暴力？“协变量包括受访者的教育水平，年龄,夫妻年龄差异,居住地和伴侣的教育水平。所有估计都是使用R版本3.5.2实现R2BayesX包的完整贝叶斯方法完成的。
IPV国家患病率为33.3％（95％CI=30.1-36.5％）；Kavango地区患病率最高[50.6％（95％CI=41.2-60.1％）]，Oshana地区患病率最低[11.5％（95％CI=3.2-19.9％）]。青少年IPV患病率最高[60.8%(95%CI=36.9-84.7%)]。用于控制区域空间效应的调整结果的空间半参数模型，受访者的年龄，年龄差异,受访者的教育年限，residence,财富,和教育水平。受过高等教育的女性患IPV的可能性降低50%[aOR:0.46,95%CI=0.23-0.87]。对于非线性效应，年龄≥5岁或年龄≥25岁的女性患IPV的风险较高.年轻和老年女性患IPV的风险高于25至45岁的女性。对于IPV患病率的空间变化，北部地区的空间效应较低，而西部地区的空间效应很高。
纳米比亚妇女的IPV患病率很高，尤其是在青少年中，更高的教育水平是保护。农村地区的IPV风险低于城市地区，而伴侣年龄差异较大。纳米比亚需要为年龄差异较大的夫妇以及年轻妇女提供预防IPV的干预措施和政策，受教育程度较低的妇女，在城市和西部地区。
我们使用了应MeasureDHS要求获得的2013-2014年纳米比亚人口与健康调查（DHS）的夫妻数据集。国土安全部的家庭暴力模块包括2226名妇女。我们从“曾经经历过的物理问题”中生成了一个测量IPV的二进制变量，性暴力或情感暴力？“协变量包括受访者的教育水平，年龄,夫妻年龄差异,居住地和伴侣的教育水平。所有估计都是使用R版本3.5.2实现R2BayesX包的完整贝叶斯方法完成的。
IPV国家患病率为33.3％（95％CI=30.1-36.5％）；Kavango地区患病率最高[50.6％（95％CI=41.2-60.1％）]，Oshana地区患病率最低[11.5％（95％CI=3.2-19.9％）]。青少年IPV患病率最高[60.8%(95%CI=36.9-84.7%)]。用于控制区域空间效应的调整结果的空间半参数模型，受访者的年龄，年龄差异,受访者的教育年限，residence,财富,和教育水平。受过高等教育的女性患IPV的可能性降低50%[aOR:0.46,95%CI=0.23-0.87]。对于非线性效应，年龄≥5岁或年龄≥25岁的女性患IPV的风险较高.年轻和老年女性患IPV的风险高于25至45岁的女性。对于IPV患病率的空间变化，北部地区的空间效应较低，而西部地区的空间效应很高。
纳米比亚妇女的IPV患病率很高，尤其是在青少年中，更高的教育水平是保护。农村地区的IPV风险低于城市地区，而伴侣年龄差异较大。纳米比亚需要为年龄差异较大的夫妇以及年轻妇女提供预防IPV的干预措施和政策，受教育程度较低的妇女，在城市和西部地区。
