Search

Black men are disproportionately affected by firearm assaults in the United States, and these disparities are rooted in structural and social inequities. The objective of this scoping review of research was to identify risk and protective factors for firearm assault injuries among Black men at all levels of the social-ecological framework. The search was conducted in 2021. The initial search generated 1,122 articles. Studies were eligible if they (a) included an analysis of modifiable risk or protective factors for firearm assaults among Black men; (b) reported an estimate of correlation, association, or effect between risk or protective factors and firearm assault injuries, firearm violence, and/or firearm homicides; and (c) were published peer-reviewed articles. In all, 19 articles were identified for review. Risk factors identified at each ecological level include the following: (1) Individual: firearm possession/weapon use and criminal legal system interaction; (2) Relationships: gang membership and exposure to other people who have experienced a firearm assault; (3) Community: indicators for socioeconomic status and racial residential segregation; and (4) Societal: historical racist policy. Individual-level substance use had mixed results. Few (26%) studies examined protective factors at any ecological level, but community-level factors like neighborhood tree cover were identified. Future research needs to examine risk and protective factors at the societal level and multiple ecological levels simultaneously leading to more effective multi-level interventions that will guide policy formation. A greater diversity of study designs, research methods, and theoretical frameworks is needed to better understand factors associated with firearm assault among Black men.

As ecosystems that support human health, societies, and civilization change in the era of the Anthropocene, individuals with disproportionate balance of salivary hormones may be at greatest risk of morbidity and mortality. Vulnerable communities, in particular, are overburdened by inequities in features of built environments linked to health disparities. This study examined the cross-sectional association of greenness in the built environment with the ratio of cortisol to dehydroepiandrosterone (DHEA) in an urban-dwelling high-risk community sample of African American women (n = 84, age 18-44 years). Saliva samples, collected across 2 consecutive days, were assayed for cortisol and DHEA. Controlling for sexual violence, perceived stress, education, and income, as well as crime, traffic density, and vacant properties, we observed a significant positive cross-sectional association between greenness and the cortisol to DHEA ratio, (β = 7·5, 95% CI: 0.89, 14.19). The findings highlight environmental influence on stress response at waking when there is the greatest individual variation. Implications for advancing our understanding of the waking ratio of cortisol to DHEA as a potential marker of physiological resilience are discussed.

BackgroundBlack women disproportionately suffer from violence and its subsequent mental health outcomes. Increasing levels of perceived stress are associated with greater symptoms of depression and post-traumatic stress disorder (PTSD). Social support and resilience can potentially mediate the negative consequences of perceived stress on women's mental health. This study assesses the association between perceived stress and mental health outcomes among Black women. In addition, this study examines social support and resilience as mediators of association between perceived stress and mental health.MethodsBlack women residing in Baltimore, MD (n = 310) were recruited from STD clinics into a retrospective cohort study (2013-2018) on sexual assault and HIV risk. Social support and resilience served as coping variables and were assessed as mediators in the associations between perceived stress and mental health. Analyses were stratified by exposure to sexual violence in adulthood.ResultsAlmost half of our sample (46%) experienced severe depression and about one-third (27%) experienced severe PTSD. Resilience partially mediated the association between perceived stress and severe depressive symptoms among exposed women. Social support partially mediated the association between perceived stress and severe PTSD symptoms among exposed women.LimitationsSince this is a cross-sectional analysis, we are unable to determine the temporal relationship between outcome and exposure variables. The CES-D-10 and NSESSS are scales that measure the severity of depressive and PTSD symptoms, respectively, and are not clinical diagnoses.ConclusionThere is a critical need to develop interventions focused on reducing the burden of stress on mental health.

Purpose of reviewThis theoretical review identifies physiological mechanisms by which violence against women (VAW) may increase women's susceptibility to HIV through trauma, stress, and immune dysfunction.Recent findingsResearch documents systemic and local immune responses are related to stress and trauma from abuse across the life course (i.e., childhood, IPV, adulthood re-victimization). Findings are interpreted within a theoretical framework grounded in the Social Stress Theory and the concept of toxic stress, and highlight the current state of the science connecting: (1) VAW to the physiological stress response and immune dysfunction, and (2) the physiological stress response and inflammation to HIV susceptibility and infection in the female reproductive tract. Despite a dearth of research in human subjects, evidence suggests that VAW plays a significant role in creating a physiological environment conducive to HIV infection. We conclude with a discussion of promising future steps for this line of research.

Intimate partner violence (IPV) is an epidemic among transgender and gender diverse (TGD) people. However, intimate partner homicide (IPH) among TGD people is under researched. Thus, thematic content analysis was used to describe and examine antecedents of severe assault and IPH among TGD adults who have experienced IPV (N = 13), via community listening sessions. While some themes resembled known severe assault and IPH risks among cisgender women, several themes were unique to TGD people and should be considered when safety planning with TGD individuals or adapting IPV screening tools for this population. [ABSTRACT FROM AUTHOR]

Purpose: Research shows strong associations between intimate partner violence (IPV) among women and suicidal ideation but this topic is understudied among immigrant women in abusive relationships in the United States. Empowerment may play a significant role in protecting abused immigrant women from suicidal ideation but has not been studied with quantitative data. Method: The current study used convenience sampling. Immigrant women who experienced IPV were asked about IPV severity, empowerment, and where they were born. Bivariate associations among variables were assessed; empowerment was tested as a moderator of the relationship between IPV and suicidal ideation. Results: The sample comprised 293 immigrant women, with 62.8% reporting suicidal ideation with a significantly greater proportion of women from South America than elsewhere reporting suicidal ideation. Empowerment buffered the effect of IPV on suicidal ideation. Conclusion: Prevalence of suicidal ideation among immigrant women experiencing IPV is concerning. Severity of IPV, region of the world where women were born, and empowerment were all related to suicidal ideation, showing directions for future research. Empowerment nursing interventions are needed to address IPV and resulting mental health problems among immigrant women. [Journal of Psychosocial Nursing and Mental Health Services, 62(9), 19–28.] [ABSTRACT FROM AUTHOR]

Despite the importance of intimate partner violence (IPV) and homicide research to women's health and safety, much remains unknown about risk factors for intimate partner homicide (IPH). This article presents the Arizona Intimate Partner Homicide Study, pilot research that is being conducted in one U.S. state to update and expand on risk factors for IPH. In the context of presenting this study, we summarize the literature on data collection techniques, various marginalized and under researched populations, and the importance of gathering data about the victim-offender relationship and situational IPH risk factors. Additional research is needed to update risk factors for IPH to account for changes in technology and to examine differential risk across diverse populations. Local, community based data collection strategies are likely to provide more comprehensive and nuanced insight into IPH; though, to understand risk factors among marginalized populations, it may be necessary to increase sample size through a national strategy. Although not a panacea, we present this ongoing research as a model for other states to emulate and improve upon, in the hopes of developing more comprehensive data examining risk for IPH among victims of IPV., Author(s): Jill Theresa Messing [sup.1] , Millan A. AbiNader [sup.1] , Jesenia M. Pizarro [sup.2] , Jacquelyn C. Campbell [sup.3] , Megan Lindsay Brown [sup.1] , Karissa R. Pelletier [sup.2] [...]

This study culturally adapted and validated a Nepalese version of the Abuse Assessment Screen (AAS) tool for identifying domestic violence among pregnant women in Nepal, creating the Nepalese Abuse Assessment Screen (N-AAS). International and national topic experts reviewed the initial N-AAS version using the Delphi method, and pregnant women participated in cognitive interviews, providing feedback on the N-AAS as user experts. Subsequent pre-testing of a comprehensive questionnaire, which included the translated version of the N-AAS, occurred in two tertiary care hospitals using an electronic format known as Color-Coded Audio Computer-Assisted Self-Interview (C-ACASI). The study assessed the content validity index, compared the concurrent validity of the N-AAS with the gold standard interview, estimated the prevalence of domestic violence from two hospitals, and calculated the Kappa coefficient. The reliability of the entire questionnaire was also evaluated through a test-retest analysis, with content validity rated as "good to excellent" by topic and user experts and high test-retest reliability (91.2–98.9%), indicating consistency across questionnaires completed at two different time points, with 12% of participants reporting any form of violence. The N-AAS demonstrated ≥91.7% specificity for all forms of abuse, accurately identifying non-abuse cases. In addition, moderate to excellent sensitivity was observed for emotional abuse (52.5%) and physical abuse since marriage (50%), while sensitivity for physical abuse in the past 12 months was 100%. Thus, the N-AAS demonstrated reliable test-retest results with a good Kappa coefficient and specificity, as well as showing excellent sensitivity for detecting recent physical abuse and moderate sensitivity for detecting emotional abuse and physical abuse since marriage. Because cultural context often leads women to normalize and tolerate abuse from spouses and family members and women are thus reluctant to report abuse, the results imply that the N-AAS can serve as a valuable screening tool for domestic abuse in antenatal care settings in Nepal. [ABSTRACT FROM AUTHOR]

We examined associations between intimate partner forced sex (IPFS) and HIV sexual risk behaviors among physically abused Black women. Women aged 18-55 in intimate relationships were interviewed in health clinics in Baltimore, MD and St. Thomas and St. Croix, US Virgin Islands (USVI). Of 426 physically abused women, 38% experienced IPFS; (Baltimore = 44 and USVI = 116). USVI women experiencing IPFS were more likely to have 3+ past-year sex partners (AOR 2.06, 95% CI 1.03-4.14), casual sex partners (AOR 2.71, 95% CI 1.42-5.17), and concurrent sex partners (AOR 1.94, 95% CI 1.01-3.73) compared to their counterparts. Baltimore women reporting IPFS were more likely to have exchanged sex (AOR 3.57, 95% CI 1.19-10.75). Women experiencing IPFS were more likely to report their abuser having other sexual partners in Baltimore (AOR 3.30, 95% CI 1.22-8.88) and USVI (AOR 2.03, 95% CI 1.20-3.44). Clinicians should consider the influence of IPFS on individual and partnership HIV sexual risk behaviors.

BackgroundIntimate partner violence (IPV) is associated with HIV infection. We aimed to assess whether provision of a combination of IPV prevention and HIV services would reduce IPV and HIV incidence in individuals enrolled in the Rakai Community Cohort Study (RCCS), Rakai, Uganda.MethodsWe used pre-existing clusters of communities randomised as part of a previous family planning trial in this cohort. Four intervention group clusters from the previous trial were provided standard of care HIV services plus a community-level mobilisation intervention to change attitudes, social norms, and behaviours related to IPV, and a screening and brief intervention to promote safe HIV disclosure and risk reduction in women seeking HIV counselling and testing services (the Safe Homes and Respect for Everyone [SHARE] Project). Seven control group clusters (including two intervention groups from the original trial) received only standard of care HIV services. Investigators for the RCCS did a baseline survey between February, 2005, and June, 2006, and two follow-up surveys between August, 2006, and April, 2008, and June, 2008, and December, 2009. Our primary endpoints were self-reported experience and perpetration of past year IPV (emotional, physical, and sexual) and laboratory-based diagnosis of HIV incidence in the study population. We used Poisson multivariable regression to estimate adjusted prevalence risk ratios (aPRR) of IPV, and adjusted incidence rate ratios (aIRR) of HIV acquisition. This study was registered with ClinicalTrials.gov, number NCT02050763.FindingsBetween Feb 15, 2005, and June 30, 2006, we enrolled 11 448 individuals aged 15-49 years. 5337 individuals (in four intervention clusters) were allocated into the SHARE plus HIV services group and 6111 individuals (in seven control clusters) were allocated into the HIV services only group. Compared with control groups, individuals in the SHARE intervention groups had fewer self-reports of past-year physical IPV (346 [16%] of 2127 responders in control groups vs 217 [12%] of 1812 responders in intervention groups; aPRR 0·79, 95% CI 0·67-0·92) and sexual IPV (261 [13%] of 2038 vs 167 [10%] of 1737; 0·80, 0·67-0·97). Incidence of emotional IPV did not differ (409 [20%] of 2039 vs 311 [18%] of 1737; 0·91, 0·79-1·04). SHARE had no effect on male-reported IPV perpetration. At follow-up 2 (after about 35 months) the intervention was associated with a reduction in HIV incidence (1·15 cases per 100 person-years in control vs 0·87 cases per 100 person-years in intervention group; aIRR 0·67, 95% CI 0·46-0·97, p=0·0362).InterpretationSHARE could reduce some forms of IPV towards women and overall HIV incidence, possibly through a reduction in forced sex and increased disclosure of HIV results. Findings from this study should inform future work toward HIV prevention, treatment, and care, and SHARE's ecological approach could be adopted, at least partly, as a standard of care for other HIV programmes in sub-Saharan Africa.FundingBill & Melinda Gates Foundation, US National Institutes of Health, WHO, President's Emergency Plan for AIDS Relief, Fogarty International Center.

BackgroundWomen of African descent are disproportionately affected by intimate partner abuse; yet, limited data exist on whether the prevalence varies for women of African descent in the United States and those in the US territories.ObjectiveIn this multisite study, we estimated lifetime and 2-year prevalence of physical, sexual, and psychological intimate partner abuse (IPA) among 1,545 women of African descent in the United States and US Virgin Islands (USVI). We also examined how cultural tolerance of physical and/or sexual intimate partner violence (IPV) influences abuse.DesignBetween 2009 and 2011, we recruited African American and African Caribbean women aged 18-55 from health clinics in Baltimore, MD, and St. Thomas and St. Croix, USVI, into a comparative case-control study. Screened and enrolled women completed an audio computer-assisted self-interview. Screening-based prevalence of IPA and IPV were stratified by study site and associations between tolerance of IPV and abuse experiences were examined by multivariate logistic regression analysis.ResultsMost of the 1,545 screened women were young, of low-income, and in a current intimate relationship. Lifetime prevalence of IPA was 45% in St. Thomas, 38% in St. Croix, and 37% in Baltimore. Lifetime prevalence of IPV was 38% in St. Thomas, 28% in St. Croix, and 30% in Baltimore. Past 2-year prevalence of IPV was 32% in St. Thomas, 22% in St. Croix, and 26% in Baltimore. Risk and protective factors for IPV varied by site. Community and personal acceptance of IPV were independently associated with lifetime IPA in Baltimore and St. Thomas.ConclusionsVariance across sites for risk and protective factors emphasizes cultural considerations in sub-populations of women of African descent when addressing IPA and IPV in given settings. Individual-based interventions should be coupled with community/societal interventions to shape attitudes about use of violence in relationships and to promote healthy relationships.

Firearms are the leading cause of intimate partner violence-related murders of women in the US. This study aimed to understand differing consequences of partners' firearm possession on abused women and barriers women face in reporting threats to safety due to the partners' possession of a firearm. Additionally, the study explored participants' perceptions of effective approaches to risk assessments and safety planning with women who are at-risk for being harmed by their partners' possession of a firearm. Qualitative semi-structured interviews with 17 service providers and 45 immigrant women survivors of intimate partner violence were conducted. Data were analyzed using a content analysis procedure. Participants shared that the partners' possession of a firearm can increase risk for firearm-related injury or fatality in situations of escalation of violence. Abused women living with a partner with firearm possession live in constant fear or threat. The presence of a firearm can also be a trigger of unwanted memories of the past and can have legal and other consequences for survivors. Impediments to reporting threats to safety were barriers such as lack of knowledge of firearm-related risks and gender and social norms. The findings can be informative for safety planning with survivors of IPV whose partners own or have access to a firearm. Comprehensive assessment of risks and barriers can be used to develop individualized and tailored safety plans for survivors with a partner who possesses a firearm. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to provide insight from maternal survivors of intimate partner violence (IPV) describing their experiences with their ex-partners' firearm ownership, access, storage and behaviours in the context of co-parenting and separation. Design: We conducted a qualitative descriptive study informed by the IPV and Coparenting Model. Methods: The analytic sample consists of self-identified maternal survivors (n= 14) who completed semi-structured qualitative interviews between January and May 2023 describing experiences of post-separation abuse. Participants were recruited through social media and domestic violence advocacy and legal aid organizations. In the interview guide, participants were asked one item about firearm exposure: Have you or your children had any experiences with guns and your ex-partner that made you or your children feel scared? Interviews were audio-recorded and transcribed. Interview transcripts were managed and coded in ATLAS.ti using a codebook. Codes were applied using descriptive content analysis, discrepancies reconciled and themes related to firearm exposure in the context of post-separation abuse identified. Results: Six themes emerged related to firearm experiences and post-separation abuse: (1) gun ownership (2) gun access; (3) unsafe storage; (4) direct and symbolic threats; (5) involving the children; (6) survivors' protective actions. Conclusion: This manuscript provides context on how abusive ex-partners' firearm ownership, access and threats cause terror and pervasive fear for mothers and children following separation. Analysis of qualitative data provides important insights into opportunities to address firearm injury prevention. Impact: Findings add to the contextual understanding of how survivors of IPV experience non-fatal firearm abuse. Existing quantitative data may not capture the full extent of fear caused by perpetrators' gun ownership access and symbolic threats. Data from this study can help inform firearm injury prevention efforts. [ABSTRACT FROM AUTHOR]