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Purpose Reproductive coercion (RC) is a type of intimate partner violence that involves interference in contraceptive and reproductive decisions. A multi-methods design explored correlates (quantitative) and contributors (qualitative) of partner-perpetrated RC across the socioecological framework among intimate partner violence survivors (IPV) in Nairobi, Kenya. Methods Quantitative analyses utilize baseline data from the myPlan Kenya trial (n=327). Multivariable Poisson regression examined the association between postulated correlates and overall RC (range: 0-9), and sub-types of pregnancy coercion (range: 0-5) and condom manipulation (range: 0-4). In-depth interviews (IDIs; n=30) conducted at three-month follow-up among women indicating RC experience at baseline explored women's perceived contributors to RC via inductive thematic analysis. Results Within the past three months, over 80% of IPV survivors experienced any RC, and IPV survivors experienced 3.8 RC behaviors on average. Factors associated with overall RC included not wanting their last child at all (aIRR =1.28; p=0.009), partner's concurrent partnership (aIRR=1.33; p Conclusions Results indicate individual- and couple-level characteristics are crucial for understanding RC for Nairobi's IPV survivors. Knowledge of RC risk factors can assist practitioners in mitigating against reproductive interference, and ensuring women are using contraceptive methods most suited to their circumstances and aligned with their reproductive preferences., Author(s): Shannon N. Wood [sup.1] , S. Rachel Kennedy [sup.2] , Irene Akumu [sup.3] , Catherine Tallam [sup.3] , Ben Asira [sup.3] , Zaynab Hameeduddin [sup.1] , Linnea A. Zimmerman [...]

This mixed-methods study examined the relationship between reproductive coercion (RC) and covert contraceptive use among intimate partner violence survivors in Nairobi, Kenya. Quantitative analyses utilize baseline data from the myPlan Kenya trial (n = 321). Purposive in-depth interviews (IDIs) (n = 30) explored women's reproductive safety strategies. Multinomial analyses indicated increased covert use and decreased overt use compared to nonuse, for women experiencing RC; logistic models similarly report increased odds of covert use with RC experience. Qualitative data contextualize women's reasons for use and challenges faced. Integration of reproductive safety strategies into family planning and violence services can improve the safe use of contraception. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) harms women physically, sexually, and psychologically. Safety strategies, or harm reduction techniques implemented by women undergoing recurrent violence, may help mitigate the negative health, economic, and social consequences of IPV. This study aimed to understand recommended and utilized safety strategies among three urban informal settlements in Nairobi, Kenya. Semi-structured key informant discussions (KIDs; n = 18) with community-based service providers and focus group discussions (FGDs; n = 49) with IPV survivors were conducted. All interviews were audio-recorded, transcribed, and translated verbatim from Swahili to English. Inductive thematic analysis was used to structure codes. Convergence matrices were used to analyze emergent strategies by data source (service providers vs. IPV survivors). Women preferred safety strategies that they could implement unassisted as first line of harm reduction. Strategies included removing stressors, proactive communication, avoidance behaviors, sexual and reproductive health (SRH), economic, leaving partner for safety, child safety, and securing personal property. Strategies recommended by service providers and utilized by IPV survivors differed, with clear divergence indicated for leaving the abusive relationship, SRH, and personal property strategies. Innovative strategies emerged from IPV survivors for safeguarding property. Similar to upper-income and other low and middle-income contexts, women experiencing IPV in urban informal settlements of Nairobi actively engage in behaviors to maximize safety and reduce harm to themselves and their families. Integration of strategies known to be helpful to women in these communities into community-based prevention and response is strongly encouraged. Increased synergy between recommended and implemented safety strategies can enhance programming and response efforts. [ABSTRACT FROM AUTHOR]