Adolescent intimate partner violence and pregnancy risk among adolescent females utilizing adolescent health clinics

Background/Objectives: Adolescent intimate partner violence (IPV) has been associated with pregnancy and unprotected sex in multiple epidemiologic studies. Qualitative work has identified potential mechanisms for this association including coercive and forced sex, condom non-use, and birth control manipulation in IPV relationships. While adolescent females seeking reproductive health care may be more likely to have experienced IPV, associations of IPV with these abusive partner behaviors specific to reproductive health and pregnancy outcomes have not been studied within a clinic population. Methods: Females ages 14-20 (N=520)attending five urban adolescent-specific health clinics anonymously completed an automated computer-assisted survey instrument (ACASI). Participants self-reported their experiences of physical and sexual violence victimization, reproductive health experiences (e.g., contraceptive use, condom negotiation and birth control sabotage) and pregnancy history. Results: Over one third (35%) female adolescent clinic patients reported a history of physical or sexual violence from a partner. Sexually active girls (N=389) reporting IPV were significantly more likely to report a lifetime history of pregnancy (OR 2.09, 95% CI 1.24, 3.52), adjusting for age and race. Patterns of contraceptive nonuse, birth control sabotage, and abortion based on IPV will also be discussed. Discussion: Adolescent IPV is associated with experiences of pregnancy, in the context of power and control in an abusive relationship. These results underscore the need to incorporate discussions of abusive relationships into teen pregnancy prevention programs. In addition, these patterns highlight the importance of consistent and repeated IPV screening when providing care for pregnant, parenting teens and their children.