Disability status, partner behavior, and the risk of sexual intimate partner violence in Uganda: An analysis of the demographic and health survey data.

backgroundWomen with disabilities in developing countries experience significant marginalization, which negatively affects their reproductive health. This study examined the association between disability status and sexual intimate partner violence; the determinants of sexual intimate partner violence by disability status; and the variations in the determinants by disability status.

methodsThe study, which was based on a merged dataset of 2006, 2011 and 2016 Uganda Demographic Surveys, used a weighted sample of 9689 cases of married women selected for the domestic violence modules. Data were analyzed using frequency distributions and chi-squared tests and multivariable logistic regressions. Other key explanatory variables included partner's alcohol consumption and witnessing parental violence. A model with disability status as an interaction term helped to establish variations in the determinants of sexual intimate partner violence by disability status.

resultsSexual IPV was higher among women with disabilities (25% compared to 18%). Disability status predicted sexual intimate partner violence with higher odds among women with disabilities (aOR = 1.51; 95% CI 1.10-2.07). The determinants of sexual intimate partner violence for women with disabilities were: partner's frequency of getting drunk, having witnessed parental violence, occupation, and wealth index. The odds of sexual intimate partner violence were higher among women whose partners often or sometimes got drunk, that had witnessed parental violence, were involved in agriculture and manual work; and those that belonged to the poorer and middle wealth quintiles. Results for these variables revealed similar patterns irrespective of disability status. However, women with disabilities in the agriculture and manual occupations and in the poorer and rich wealth quintiles had increased odds of sexual intimate partner violence compared to nondisabled women in the same categories.

conclusionDeterminants of sexual intimate partner violence mainly relate to partners' behaviors and the socialization process. Addressing sexual intimate partner violence requires prioritizing partners' behaviors, and gender norms and proper childhood modelling, targeting men, women, families and communities. Interventions targeting women with disabilities should prioritize women in agriculture and manual occupations, and those above the poverty line.