Abstract.
OBJECTIVE: Intimate partner violence (IPV) is an important risk factor for perinatal depression (PND). But IPV\'s impact on the natural prognosis of PND symptoms is not well understood. We tested two hypotheses: (1) pregnant women with IPV experiences will exhibit more severe PND symptoms than women without IPV experience; (2) IPV experience will impede the recovery prognosis of PND. We also explored the contribution of IPV to PND comparing with other risk factors.
METHODS: The sample is comprised of 813 pregnant women followed through perinatal period in Hunan, China. We assessed IPV experience using items from the Short Form of the Revised Conflict Tactics Scale (CTS2S), and PND symptoms via the Edinburgh Postnatal Depression Scale (EPSD). We conducted Linear Mixed-effects Model to compare the trajectories of PND symptoms between victims and non-victims and a multistage Generalised Estimating Equations Model to explore salient factors on the trajectory of PND symptoms.
RESULTS: There were 90 participants (11.07%) who reported IPV experience in the past 12 months. With respect to physical, psychological and sexual violence, the prevalence was 4.55% (37/813), 9.23% (75/813) and 2.34% (19/813). Victims reported more severe PND symptoms (t = 5.30, p < 0.01) and slower decreasing slope of trajectories (t = 28.89, p < 0.01). The PND trajectory was associated with IPV experience (OR = 3.78; 95% CI 1.39-10.26), social support (OR = 0.93; 95% CI 0.88-0.97), positive coping strategies (OR = 0.85; 95% CI 0.80-0.91), negative coping strategies (OR = 1.25; 95% CI 1.14-1.37) and monthly income of $0.15-$298.36 (compared to no income, OR = 0.0075; 95% CI 0.00052-0.11).
CONCLUSIONS: The findings suggest the reported prevalence of IPV is lower in Hunan than most of the previous studies during perinatal period in other provinces of China, and IPV victimisation is associated with increased severity and slowed prognosis of PND symptoms. Future studies that screen for victimisation and establish its explicit mechanism to the poorer prognosis of PND symptoms would benefit the prevention and treatment of PND.

Scaling up HIV testing is the first step in the HIV treatment continuum which is important for controlling the HIV epidemic among men who have sex with men (MSM). Following an online HIV testing intervention among MSM, we aim to examine sociodemographic and spatial factors associated with HIV testing.
We conducted a secondary analysis on data from an online HIV testing intervention among MSM who had never-tested for HIV. The survey was distributed through online networks connected to all provinces and regions of China. Univariate and multivariable analyses were performed to examine factors associated with testing three weeks post-intervention.
At three weeks after the intervention, 36% of 624 followed-up MSM underwent HIV testing, 69 men reported positive HIV test results. Having money for sex, ever tested for sexually transmitted infections and intimate partner violence experience were significant factors of post-intervention HIV testing. Students were less likely to undergo HIV testing at follow-up compared to others (adjusted odds ratio=0.69, 95% C.I.=0.47-0.99), adjusted by age and type of intervention. Moderate provincial spatial variation of testing was observed.
While high risk men generally had higher HIV testing rates, some MSM like students had lower testing rates, suggesting the need for further ways to enhance HIV testing in specific MSM communities.

To identify individual and relationship risk factors associated with current intimate partner violence (IPV) against married rural migrant women in Shanghai, China.
Cross-sectional survey.
Two subdistricts of one administrative district, Shanghai, China.
A total of 958 married rural migrant women of reproductive age were selected using a community-based two-stage cluster sampling method in April and May of 2010.
Data were collected using a modified questionnaire based on an instrument from the WHO Multi-country Study on Women\'s Health and Domestic Violence against Women. Adjusted odds ratio (AOR) and 95% CI from a multivariable logistic regression model were estimated to identify individual and relationship risk factors associated with different types of violence in the past 12 months.
Women\'s low financial autonomy was associated with all types of violence (AORs ranged from 1.98 to 7.89, p<0.05). Quarrelling with husband was a very strong risk factor (AORs >6, p<0.05) for both emotional violence and any violence. Experience of job change in the past year (AOR=4.03, 95% CI 1.57 to 10.35) and history of husband being abused (AOR=4.67, 95% CI 2.17 to 7.69) were strongly associated with physical or sexual violence.
Women\'s low financial autonomy and unstable employment status at an individual level, quarrelling with husband and history of husband beaten by family members at a relationship level were identified as the most robust risk factors for IPV among married rural migrant women. Efforts to prevent IPV among this population should be made to involve both women and their husbands, with a focus on improving financial autonomy and employment status of women, promoting problem-solving and interaction skills of the couples and changing their knowledge and attitudes towards gender norms and IPV.

Despite its prominence, intimate partner violence (IPV) against women has received little attention in Ethiopia. And as many of sub-Saharan African countries, maternal health care services utilization remains poor. Full access and utilization of maternal health care services is a key to significant reduction in maternal and child mortality, and eliminate new HIV infection in infants. Identifying the factors that contribute to the poor access and utilization should aid the design of appropriate policy and intervention strategies. Thus the objective of this study was to examine the association between IPV and use of maternal health care services in Addis Ababa, Ethiopia.
A cross sectional study on couples (N = 210; male/female pairs) with an infant less than 6 months of age was conducted. The dependent variable was use of maternal health care services and the main independent variable was IPV. Data was collected using face-to-face self-reported questionnaires and analyzed using SPSS version 20.0. Bivariate and multivariate logistic regression models were used to examine the relationship between the dependent and independent variables.
The mean age of the women was 28.7 years (SD = 5.4), on average women were 7.4 years (SD = 7.4) younger than their partners. Although most of the women (95.2%) had at least one antenatal care (ANC), only 35 (2%) had ≥4 ANC visits and about half (49.0%) had their first ANC visit within the first trimester. Women who experienced emotional IPV in their relationship were less likely to have their 1st ANC within three months of pregnancy (AOR = 0.69; 95%CI = 0.49-0.96). Women who reported physical IPV in their relationship were less likely to use ≥4 ANC (AOR = 0.48; 95%CI = 0.21-0.71), be tested for HIV (AOR = 0.26; 95%CI = 0.09-0.79), have skilled delivery attendant (AOR = 0.31; 95%CI = 0.12-0.98), and deliver in a health facility (AOR = 0.35; 95%CI = 0.14-0.88). Likewise, women experienced sexual IPV or partner control in their relationship were less likely to use ANC ≥4 times (AORsexual-IPV = 0.91; 95%CI = 0.84-0.98 and AORpartner-control = 0.38; 95%CI = 0.17-0.85 respectively).
IPV is prevalent among couples in Addis Ababa, Ethiopia where three out of four women reported having experienced one or more type of IPV in their current relationship. And all types of IPV showed significant association with poor utilization of one or more maternal health care services. Thus efforts to sustain the recent success in maternal health and further improvement should give due consideration to IPV.

Smothering and manual strangulation are not uncommon in domestic violence against women; however, no report on the combination of mechanical asphyxia and intracranial vascular malformations has been previously published. We report a middle-aged woman who was smothered and manually strangled by her husband and subsequently died from subarachnoid hemorrhage due to ruptured intracranial vascular malformations, rather than direct mechanical asphyxiation. Smothering and manual strangulation are considered provocative conditions for rupture and contributory causes of death. In this case study, we underline the importance of meticulous autopsy in cases of mechanical asphyxia and intracranial hemorrhage. Exclusion of underlying diseases that may have caused or contributed to death is also required, despite serious asphyxiation signs and neck injuries. Postmortem angiography is a valuable complement to autopsy to detect vascular pathology, with good prospects for further development in China.

Intimate partner violence (IPV) is a significant public health issue among married rural-to-urban migrant workers, the largest group of internal migrants in China. This study aims to explore the prevalence, patterns and associated factors of intimate partner violence against married rural-to-urban migrant workers in eastern China.
A cross-sectional study was conducted in Zhejiang province in China between July 2015 and April 2016, and a total of 1,744 married rural-to-urban migrant workers ultimately took part in the study. Conflict Tactics Scales and several short demographic questions were applied. Data were principally analyzed with logistic regression.
The majority of married rural-to-urban migrant workers were middle-aged couples with a low education level and a relatively long-term duration of migration in fixed migrant cities. Nearly 45% of married rural-to-urban migrant workers were experienced at least one incident of intimate partner violence during the past 12 months. The joint occurrence of multiple forms of violence is the most commonly reported features of intimate partner violence, especially three overlapping patterns of intimate partner violence. Some individual (education and age), relationship (marital satisfaction, premarital sex and extramarital affairs) and social (duration of migration and number of migratory cities) factors of the respondents, were negatively or positively associated with intimate partner violence against married rural-to-urban migrant workers.
The results indicated that one out of two married rural-to-urban migrant workers experienced at least one incident of intimate partner violence during the past 12 months in China. Accordingly, there is an obvious demand of intervention and treatment activities to prevent and reduce the occurrence of intimate partner violence among the millions of migrant workers in China.

This study aimed to estimate the self-reported prevalence of violence perpetration and victimization among Hong Kong youths and the associated health risk behaviors using a representative sample of 1,126 young adults aged 18-27 years. Perpetrating physical and emotional violence was common in Hong Kong, with prevalences ranging from 20.8% to 38.3% in males and from 6.4% to 21.3% in females. Victimization of physical and emotional violence was also common for both sexes, with prevalences ranging from 16.4% to 36.3% in males and from 6.6% to 19.2% in females. Perpetration of sexual harassment and sexual violence was less prevalent, whereas victimization of sexual harassment and sexual violence ranged from 0.6% to 3.6% in males and from 2.3% to 13.2% in females. Both violence perpetration and victimization among youths were significantly associated with substance use, risky sexual behaviors, and pregnancy. The implications of this study for violence prevention programs are discussed.

OBJECTIVE: To understand prevalence of intimate partner violence(IPV)in heterosexual men(HM)attending HIV voluntary counseling and testing(VCT)clinics and related factors in Shanghai.
METHODS: All the HM attending two VCT clinics in Shanghai during March-August, 2015 were recruited to participate in a cross-sectional survey with questionnaire interview and blood test for HIV. IPV was evaluated by using the questionnaire developed by WHO Multi-Country Study on Women\' s Health and Domestic Violence against Women.
RESULTS: A total of 327 participants were recruited, their average age was 29.4 years(s∶6.1). Among them 60.2%(197/327)were aged 26-35, 57.8%(189/327)never married, 78.8%(260/327)had educational level of ≥college degree, 49.5%(162/327)were not local residents; 72.2%(236/327)had steady female partners, 72.2%(236/327)had 2 or more female partners in the past year, 6.1%(20/327)reported being diagnosed with sexually transmitted disease(STD). 1.8%(6/327)were tested to be HIV-positive. 28.4%(93/327)had IPV behaviors against heterosexual partners. Multivariate logistic regression analysis indicated that IPV behavior against heterosexual partners was significantly associated with experience of commercial sex(aOR=2.19, 95%CI: 1.16-4.15)and witness of domestic violence in early life(aOR=3.19; 95%CI: 1.58-6.45).
CONCLUSIONS: IPV prevalence was relatively high in HM attendants in VCT clinics in Shanghai and IPV intervention is needed to conduct in VCT clinics. Multivariate regression analysis showed that the factors associated with IPV behaviors included having sex with female sex workers and the witness of domestic violence between parents. Future research is needed to further explore the association between IPV and HIV infection.

OBJECTIVE: To determine the prevalence of domestic violence and its risk factors in women presenting with urinary symptoms.
METHODS: The study was carried out in the urogynecology clinic and general gynecology clinic, Department of Obstetrics and Gynecology, Queen Mary Hospital, Hong Kong from 1st May 2013 till 31st October 2014. Two hundred and twenty-five women presenting to the urogynecology clinic with urinary symptoms were categorized according to their symptoms and were asked to complete the Modified Abuse Assessment Screen. Demographic data of the subjects and their partners were collected. Mann-Whitney U test were used for analysis of continuous variables, while Chi-square test and Fisher Exact test were used for analysis of categorical variables between the abused and non-abused group. Prevalence of domestic violence were calculated and compared.
RESULTS: The prevalence of domestic violence among this group of patients (7.6%) was found to be lower when compared with other studies. Verbal abuse was the commonest form of violence in our locality. The median age of the abused group and the non-abused group were both 56 years old, with the age ranging from 40 to 64 and 29 to 70 years old respectively. The prevalence of domestic violence among patients with overactive bladder syndrome, stress urinary incontinence and mixed urinary incontinence were 19.5%, 4.2% and 5.5% respectively (Fisher Exact test for whole group, P<0.05).
CONCLUSIONS: The prevalence and nature of abuse in our locality was different from the quoted figures worldwide. Patients with overactive bladder syndrome were more likely to be victims of abuse than patients with other urinary symptoms. The difference in the prevalence of domestic violence among patients with different urinary symptoms could be related to their underlying pathophysiology. When encountering patients with overactive bladder syndrome, clinicians should consider this high incidence of domestic violence and provide prompt referral whenever necessary.

The goal of this research was to examine the unique relationships between paternal and maternal psychological aggression (PA) and physical aggression (corporal punishment [CP] and severe physical abuse [SPA]) and children\'s anxiety in China. A total of 1,971 father-mother dyads completed the Chinese version of Parent-Child Conflict Tactics Scales (CTSPC) and the Chinese version of Spence Children\'s Anxiety Scale for Parents (SCAS-P). Results indicated that when paternal and maternal PA, CP, and SPA were considered simultaneously, parental PA and maternal CP were both significantly predictive of children\'s anxiety, whereas SPA had no significant effects on children\'s anxiety. Specifically, both paternal and maternal PA were the most unique predictors of children\'s anxiety among parental psychological and physical aggression, whereas the effects of maternal CP and paternal CP were different, with maternal CP having a stronger effect on children\'s anxiety compared with paternal CP. The findings indicated that appropriate prevention and intervention efforts are needed to target parental PA and maternal CP.