Exposure to domestic violence and abuse and consultations for emergency contraception: nested case-control study in a UK primary care dataset

被引:16
作者
Jackson, Joni [1 ,4 ]
Lewis, Natalia, V [5 ]
Feder, Gene S. [5 ]
Whiting, Penny [2 ]
Jones, Timothy [3 ,4 ]
MacLeod, John [5 ]
Redaniel, Maria Theresa [3 ,4 ]
机构
[1] Univ Bristol, Bristol Med Sch, Quantitat Appl Hlth Res, Bristol, Avon, England
[2] Univ Bristol, Bristol Med Sch, Epidemiol Hlth Serv, Bristol, Avon, England
[3] Univ Bristol, Bristol Med Sch, Univ Hosp Bristol NHS Fdn Trust,Hlth Serv Res & E, Natl Inst Hlth Res Collaborat Leadership Appl Hlt, Bristol, Avon, England
[4] Univ Bristol, Bristol Med Sch, Populat Hlth Sci, 9th Floor, Bristol BS1 2NT, Avon, England
[5] Univ Bristol, Bristol Med Sch, Populat Hlth Sci, Ctr Acad Primary Care, Bristol, Avon, England
关键词
contraception; domestic violence; emergency contraception; general practice; intimate partner violence; postcoital; primary health care; PARTNER VIOLENCE; GENERAL-PRACTICE; ASSOCIATIONS; PREVALENCE; SAFETY;
D O I
10.3399/bjgp18X700277
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Evidence of an association between exposure to domestic violence and abuse (DVA) and use of emergency contraception (EC) is lacking in the UK. Aim To quantify the association between exposure to DVA and consultations for EC in general practice. Design and setting Nested case-control study in UK general practice. Method Using the Clinical Practice Research Datalink, the authors identified all women all women aged 15-49 years registered with a GP between 1 January 2011 and 31 December 2016. Cases with consultations for EC (n = 43 570) were each matched on age and GP against four controls with no consultations for EC (n = 174 280). The authors calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the association between exposure to DVA in the previous year and consultations for EC. Covariates included age, ethnicity, socioeconomic status, pregnancy, children, alcohol misuse, and depression. Results Women exposed to DVA were 2.06 times more likely to have a consultation for EC than unexposed women (95% CI = 1.64 to 2.61). Women aged 25-39 years with exposure to DVA were 2.8 times more likely to have a consultation for EC, compared with unexposed women (95% CI = 2.08 to 3.75). The authors found some evidence of an independent effect of exposure to DVA on the number of consultations for EC (OR 1.48, 95% CI = 0.99 to 2.21). Conclusion A request for EC in general practice can indicate possible exposure to DVA. Primary care consultation for EC is a relevant context for identifying and responding to DVA as recommended by the World Health Organization and National Institute for Health and Care Excellence guidelines. DVA training for providers of EC should include this new evidence.
引用
收藏
页码:E199 / E207
页数:9
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