Extent, Timing, and Predisposing Factors of Intimate Partner Violence in Sub-Saharan Africa: A Cross-Sectional Analysis Using Demography Health Surveys From 2015 to 2021

Background and Aims: Reliable evidence on the extent, characteristics, and timing of intimate partner violence (IPV) is crucial for guiding targeted interventions in sub-Saharan Africa (SSA). This study draws on the most recent demographic and health surveys (DHSs) conducted in SSA to identify approaches for preventing and responding effectively to women experiencing IPV. Methods: We assessed sociodemographic data, maternal characteristics, and violence from the recent DHS (2015–2021) of 18 SSA countries. We performed a latent class analysis (LCA) to identify women experiencing similar levels of physical, sexual, and emotional violence and to examine their common characteristics. We fit a Cox proportional hazard model to determine predictors of short duration to the first episode of IPV after marriage. Results: Our analysis included 84,717 women. We identified two distinct classes of IPV experience in SSA: a class with very high (class probability: physical (82.2%), sexual (77.6%), and emotional violence (33.8%) and a class with low violence. Six countries (Sierra Leone, Liberia, Uganda, Mali, Tanzania, and Zambia) constituted more than two-thirds of women who experienced all forms of violence in SSA. Approximately 25% of women had their first episode of all forms of IPV in their first year of marriage. Two important variables, the husband drinking alcohol and the woman's lack of autonomy, were associated with all forms of IPV and predicted the shortest time to the first episode of IPV after marriage. A husband drinking alcohol alone predicted 61% of IPV cases (area under the receiver operating characteristic curve (ROC) = 0.613; 95% CI: 0.609, 0.616). Conclusions: This study highlights the importance of comprehensive treatment and prevention efforts that include both criminal justice and public health strategies focusing on women who drink their partner and who have low authority in the first two to 3 years of marriage.