Reproductive Coercion and Relationship Abuse Among Adolescents and Young Women Seeking Care at School Health Centers

Amber L. Hill, Kelley A. Jones, Heather L. McCauley, Daniel J. Tancredi, Jay G. Silverman, Elizabeth Miller

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To investigate demographic differences and evaluate how reproductive coercion and relationship abuse influences young females' care-seeking and sexual health behaviors. METHODS: We conducted a secondary analysis of cross-sectional baseline survey data from sexually active female students (aged 14-19 years) who sought care from school health centers. Outcomes included recent (previous 3 months) reproductive coercion, physical or sexual adolescent relationship abuse, and nonpartner sexual violence victimization. Cluster-adjusted χ tests compared demographics and generalized linear mixed models estimated associations among reproductive coercion, adolescent relationship abuse (physical and sexual abuse in romantic relationships), and care-seeking and sexual health behaviors. RESULTS: Of 550 sexually active high school females, 12% reported recent reproductive coercion and 17% reported physical or sexual adolescent relationship abuse, with no significant demographic differences. Prevalence of recent nonpartner sexual violence was 17%. There were no observed significant differences in care-seeking behaviors among those with recent reproductive coercion compared with those without. Physical or sexual adolescent relationship abuse was associated with increased odds of seeking testing or treatment for sexually transmitted infections (adjusted odds ratio [aOR] 2.08, 95% CI 1.05-4.13). Females exposed to both adolescent relationship abuse and reproductive coercion had higher odds of having a partner who was 5 or more years older (aOR 4.66, 95% CI 1.51-14.4), having two or more recent sexual partners (aOR 3.86, 95% CI 1.57-9.48), and using hormonal contraception only (aOR 3.77, 95% CI 1.09-13.1 vs hormonal methods with condoms). CONCLUSION: Almost one in eight females experienced recent reproductive coercion. We did not observe significant demographic differences in reproductive coercion. Partner age and number of sexual partners may elevate risk for abusive relationships. Relationship abuse is prevalent among high school students seeking care, with no clear pattern for case identification. By failing to identify factors associated with harmful partner behaviors, our results support universal assessment for reproductive coercion and relationship abuse among high school-aged adolescents, involving education, resources, and harm-reduction counseling to all patients. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01678378.

Original languageEnglish (US)
Pages (from-to)351-359
Number of pages9
JournalObstetrics and gynecology
Volume134
Issue number2
DOIs
StatePublished - Aug 1 2019

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Coercion
School Health Services
Sex Offenses
Odds Ratio
Demography
Sexual Partners
Reproductive Health
Health Behavior
Sexual Behavior
Students
Harm Reduction
Crime Victims
Condoms
Sexually Transmitted Diseases
Contraception
Counseling
Linear Models
Cross-Sectional Studies
Clinical Trials
Education

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Reproductive Coercion and Relationship Abuse Among Adolescents and Young Women Seeking Care at School Health Centers. / Hill, Amber L.; Jones, Kelley A.; McCauley, Heather L.; Tancredi, Daniel J.; Silverman, Jay G.; Miller, Elizabeth.

In: Obstetrics and gynecology, Vol. 134, No. 2, 01.08.2019, p. 351-359.

Research output: Contribution to journalArticle

Hill, Amber L. ; Jones, Kelley A. ; McCauley, Heather L. ; Tancredi, Daniel J. ; Silverman, Jay G. ; Miller, Elizabeth. / Reproductive Coercion and Relationship Abuse Among Adolescents and Young Women Seeking Care at School Health Centers. In: Obstetrics and gynecology. 2019 ; Vol. 134, No. 2. pp. 351-359.
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abstract = "OBJECTIVE: To investigate demographic differences and evaluate how reproductive coercion and relationship abuse influences young females' care-seeking and sexual health behaviors. METHODS: We conducted a secondary analysis of cross-sectional baseline survey data from sexually active female students (aged 14-19 years) who sought care from school health centers. Outcomes included recent (previous 3 months) reproductive coercion, physical or sexual adolescent relationship abuse, and nonpartner sexual violence victimization. Cluster-adjusted χ tests compared demographics and generalized linear mixed models estimated associations among reproductive coercion, adolescent relationship abuse (physical and sexual abuse in romantic relationships), and care-seeking and sexual health behaviors. RESULTS: Of 550 sexually active high school females, 12{\%} reported recent reproductive coercion and 17{\%} reported physical or sexual adolescent relationship abuse, with no significant demographic differences. Prevalence of recent nonpartner sexual violence was 17{\%}. There were no observed significant differences in care-seeking behaviors among those with recent reproductive coercion compared with those without. Physical or sexual adolescent relationship abuse was associated with increased odds of seeking testing or treatment for sexually transmitted infections (adjusted odds ratio [aOR] 2.08, 95{\%} CI 1.05-4.13). Females exposed to both adolescent relationship abuse and reproductive coercion had higher odds of having a partner who was 5 or more years older (aOR 4.66, 95{\%} CI 1.51-14.4), having two or more recent sexual partners (aOR 3.86, 95{\%} CI 1.57-9.48), and using hormonal contraception only (aOR 3.77, 95{\%} CI 1.09-13.1 vs hormonal methods with condoms). CONCLUSION: Almost one in eight females experienced recent reproductive coercion. We did not observe significant demographic differences in reproductive coercion. Partner age and number of sexual partners may elevate risk for abusive relationships. Relationship abuse is prevalent among high school students seeking care, with no clear pattern for case identification. By failing to identify factors associated with harmful partner behaviors, our results support universal assessment for reproductive coercion and relationship abuse among high school-aged adolescents, involving education, resources, and harm-reduction counseling to all patients. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01678378.",
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AB - OBJECTIVE: To investigate demographic differences and evaluate how reproductive coercion and relationship abuse influences young females' care-seeking and sexual health behaviors. METHODS: We conducted a secondary analysis of cross-sectional baseline survey data from sexually active female students (aged 14-19 years) who sought care from school health centers. Outcomes included recent (previous 3 months) reproductive coercion, physical or sexual adolescent relationship abuse, and nonpartner sexual violence victimization. Cluster-adjusted χ tests compared demographics and generalized linear mixed models estimated associations among reproductive coercion, adolescent relationship abuse (physical and sexual abuse in romantic relationships), and care-seeking and sexual health behaviors. RESULTS: Of 550 sexually active high school females, 12% reported recent reproductive coercion and 17% reported physical or sexual adolescent relationship abuse, with no significant demographic differences. Prevalence of recent nonpartner sexual violence was 17%. There were no observed significant differences in care-seeking behaviors among those with recent reproductive coercion compared with those without. Physical or sexual adolescent relationship abuse was associated with increased odds of seeking testing or treatment for sexually transmitted infections (adjusted odds ratio [aOR] 2.08, 95% CI 1.05-4.13). Females exposed to both adolescent relationship abuse and reproductive coercion had higher odds of having a partner who was 5 or more years older (aOR 4.66, 95% CI 1.51-14.4), having two or more recent sexual partners (aOR 3.86, 95% CI 1.57-9.48), and using hormonal contraception only (aOR 3.77, 95% CI 1.09-13.1 vs hormonal methods with condoms). CONCLUSION: Almost one in eight females experienced recent reproductive coercion. We did not observe significant demographic differences in reproductive coercion. Partner age and number of sexual partners may elevate risk for abusive relationships. Relationship abuse is prevalent among high school students seeking care, with no clear pattern for case identification. By failing to identify factors associated with harmful partner behaviors, our results support universal assessment for reproductive coercion and relationship abuse among high school-aged adolescents, involving education, resources, and harm-reduction counseling to all patients. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01678378.

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