Intimate Partner Violence (IPV) is a significant issue in the United States and abroad. According to the CDC, the term “intimate partner violence” describes violence or harm by a current or former partner or spouse. It has been cited as the most common cause of injury in women. An examination of the history and development of research conducted around the subject reveals the progress the United States has made in terms of the management of IPV. In the mid-1990’s, surveys were conducted to assess the extent and nature of training curricula among Obstetricians and Gynecologists around the subject. One such study published in the American Journal of Obstetrics and Gynecology, not only revealed extremely low levels of reporting on the prevalence of IPV, but also a lack of education around the topic. Another study included over 6,500 physicians and determined that most did not screen for current or past domestic violence. Around the same time, women who had experienced domestic violence presenting to the Emergency Room were seldom identified as well.
We have come a long way in the US in terms of managing this issue, but the process remains arduous and ongoing. In 2009, a study in the AMA Journal of Ethics noted that, although most US medical students received adequate training in the issue, only a third thought such training would be relevant. However, the article also referenced a randomized study demonstrating that community outreach experience and didactic training can double knowledge and confidence when encountering victims of IPV. Multiple screening tools now exist for IPV and it has now become a high grade recommendation of the United States Preventive Task Force to screen women of childbearing age.
There is, however, still room to improve the current screening methods we have available. A recent high level of evidence revealed significant associations between IPV and depression, anxiety, sexually transmitted infections, and somatic symptoms. Although the screening tools we have at our disposal are comprehensive, many lack reliability and do not include these symptomatic associations as part of their assessments.
Since COVID-19 began to wreak havoc, an unexpected consequence emerged, due in part to being increasingly homebound and having lack of access to community resources. A recent robust level of evidence published in August 2021 reveals a considerable increase in cases of IPV impacting women in nearly every continent including North America. As a result, it has become increasingly paramount that knowledge of how to identify and manage suspected cases of IPV be shared globally and consistently.
Abroad, the situation is more troubling. A recent study published through the World Health Organization revealed that health care providers still face barriers related to training and access to an effective referral system in Egypt. Indeed, the US has faced similar issues for decades and has made great strides to address them. Still, for other parts of the world, more help is needed, and knowledge, as well as access, are critical when it comes to facing the growing international crisis of intimate partner violence amid an ever-looming pandemic. To quote Baron C.P. Snow, “A scientist has to be neutral in his search for the truth but cannot be neutral as to the use of that truth when found.”
Sources: CDC, American Journal of Obstetrics and Gynecology, National Library of Medicine, AMA Journal of Ethics, Journal of General Internal Medicine, Agency for Healthcare Research and Quality, Family Practice, World Health Organization