Domestic violence and symptoms of gynecologic morbidity among women in North India.

CONTEXT: Although there is increasing recognition of the global scope of domestic violence and the potential reproductive health consequences of violence, little is known about the relationship between physical and sexual domestic violence and gynecologic morbidity in developing country settings. METHODS: A sample of 3,642 couples from northern India was created by matching husbands and wives who responded to the men's and women's surveys of the 1995-1996 PERFORM System of Indicators Survey. The association between men's reports of physical and sexual violence they had perpetrated against their wives and wives' reports of gynecologic symptoms was analyzed in bivariate and multivariate analyses. RESULTS: Overall, 37% of men said they had committed one or more acts of physical or sexual violence against their wives in the past 12 months, with 12% reporting physical violence only, 17% sexual violence only and 9% both physical and sexual violence. Thirty-four percent of women reported at least one symptom of gynecologic morbidity. Compared with women whose husbands reported no violence, those who had experienced both physical and sexual violence and those who had experienced sexual violence only had elevated odds of reporting gynecologic symptoms (odds ratios, 1.7 and 1.4, respectively). CONCLUSIONS: Plausible mechanisms through which domestic violence may influence gynecologic morbidity include physical trauma, psychological stress or transmission of STIs. Reproductive health care that incorporates domestic violence support services is needed to meet the special needs of abused women.