This research work examines currently married women acceptance of intimate partner violence (IPV) in three selected states in India and their sexual health problems by using NFHS-3 data. Women acceptanting husband beating for not doing house work, refuse to have sex , goes with out telling , argues with husband and physical, sexual violence has been considred. The Sexual health problems such as : itching, bleeding and other gynocological problems has been considered. Influence of socioeconomic variables influencing IPV has been determined by logit regression and risk ratio has been calculated for sexual health problems for the Indian states data Andhra Pradesh, Gujarat and Bihar.

1. IPV-NFHS-3 1
Women Acceptance of Intimate
Partner Violence (IPV) and sexual
health problems in selected states in
India: NFHS-3 data analysis
By
Dr.C.P.Prakasam
c_prakasam@yahoo.com
Paper presented in International Conference on Gender-based Violence and sexual
and Reproductive Health—15-18 February, 2009,Mumbai, India

2. IPV-NFHS-3 2
Abstract:
„ Violence against women by male partner occurs in developing countries and
mostly in male dominating societies. In India intimate partner violence refers
to husband’s violence against their wives where marriage is virtually universal.
Research revealed that high proportion of women believes that husband’s use
of violence against their wives is acceptable. This physical trauma caused by
intimate partner violence may result in sexual health problems.
„ This paper examines women acceptance of intimate partner violence (IPV) in
three selected states in India (Andhra Pradesh, Gujarat and Bihar) and their
sexual health problems. Data were derived from NFHS-3 .Acceptance of IPV
has been measured by asking respondent (married women) whether, in their
opinion, a husband was justified in hitting or beating his wife in the following
situations: if she goes out without telling him, does no cook food properly, if
she argues with him, refuses to have sex etc.
„ Women acceptance of IPV with the background characteristic has been
examined. To understand the interrelationship between background variables
and women acceptance, logistic regression analysis has been done. Further IPV
and sexual health problems of women among the selected states has been
examined. Results show that women belong to poor socio economic strata
(Wealth Index-Poor), illiterate husband (Partner education-No education) and
non Hindu (Religion) accepts IPV than their counter part. Further acceptance
of IPV and sexual health problems has been examined.

3. IPV-NFHS-3 3
IPV
„ Violence against women by male partner
occurs in developing countries and
mostly in male dominating societies
„ In India intimate partner violence refers to
husband’s violence against their wives
where marriage is virtually universal.
Research revealed that high proportion of
women believes that husband’s use of
violence against their wives is acceptable.

4. IPV-NFHS-3 4
„ Physical trauma caused by intimate partner
violence may result in sexual health problems.
„ Sexual and physical violence appears to
increase women’s risk for many common
gynecological disorders.
„ Research studies conducted in India (Jejeebhoy, S and
Cook RJ, 1997; Jejeebhoy, 1998; Ramasubban and Singh 1998,Sidney Ruth
Schuler and Farzana Islam (IPV) 2008) showed association
between domestic violence and reproductive
and Sexual health problems.

5. IPV-NFHS-3 5
Objectives
„ This paper examines currently married women
acceptance of intimate partner violence (IPV) in three
selected states in India (Andhra Pradesh, Gujarat and
Bihar) and their sexual health problems by analyzing
NFHS-3** data.
„ Women acceptance of IPV with the background
characteristic has been examined.
„ Also examines the inter relationship between currently
married women experiencing IPV and Sexual health
problems
„ To achieve the objectives data were collected from NFHS-3
„ **NFHS-3: National Family Health Survey-3

6. IPV-NFHS-3 6
States
„ BIHAR, Gujarat and Andhra Pradesh states have been selected
for analysis.
„ Bihar having low age at marriage, low socio economic
development consider as one category.
„ Gujarat having age at marriage more than India, high socio
economic development as one category.
„ Andhra Pradesh having high acceptance of permanent family
planning method and better socio economic development .
„ These states have been considered to represent three different
socio economic conditions and examine different attitude of
currently married women towards IPV.

7. IPV-NFHS-3 7
Reason for justifying husband beating
„ Acceptance of IPV has been measured in
NFHS-3 by asking respondent (married women)
whether, in their opinion, a husband was
justified in hitting or beating his wife in the
following situations:
„ Wife goes with out telling husband
„ Wife neglects house or children
„ Wife argues with husband
„ Wife does not cook food properly
„ Refuse to have sex with husband

8. IPV-NFHS-3 8
Table 1: Attitude towards wife beating by selected states:
Percentage of currently married women who agrees that a husband
ustified in hitting or beating wife for specific reasons: NFHS-3 data
Percentage who agree with specific reasons
States Percentage
who agree
with at
least one
reason
Wife
goes
with out
telling
husband
Wife
neglects
house or
children
Wife
argues
with
husband
Wife does not
cook food
properly
Number of currently
married women
1. BIHAR 46.5 22.4 20.0 30.8 30.8 2992
2. GUJARAT 52.6 32.3 39.6 38.5 38.5 2829
3. ANDHRA
PRADESH
57.9 43.4 50.5 37.6 37.6 5149
„Around 50 percent women agrees husband is justified in hitting/beating wife
for at least one reason.

9. IPV-NFHS-3 9
Percentage of currently married women who agrees that a
husband is justified in hitting or beating wife for specific
reasons: NFHS-3 data
„ Percent Women who
agrees husband is justified
in hitting/beating wife found
to be high in Andhra
Pradesh for the reason
Neglects House followed by
Goes with out telling
husband.
„ In Bihar percentage of
women who agrees
husband is justified in
hitting/beating wife found to
be lower than Gujarat and
Andhra Pradesh.
22.4
32.3
43.4
20
39.6
50.5
30.8
38.5
16.3
27.5 25.9
0
10
20
30
40
50
60
Goes with
out tell
Neglects
House
Argues
with
Husband
Does not
cook food
BIHAR
GUJARAT
ANDHRA

10. IPV-NFHS-3 10
How does prevalence of acceptance of IPV vary
by women’s characteristics?
„ Background Characteristics:
1. Age of the respondent women
2. Marital Duration
3. Religion
4. Place of Residence
5. Husband living with the spouse
6. Wealth Index
7. Working for money
8. Partners Education

11. IPV-NFHS-3 11
Selected Differentials in acceptance of IPV
with at least one reason
„ Decreases by age
of the currently
married women in
all these states:
„ Ψ2
„ Bihar:14.48**
„ Gujarat:14.2**
„ Andhra :16.3**
Acceptance of IPV with at least one reason by Age
Group
54.9
59.5
66.7
49.2
55.7
43.4
0
10
20
30
40
50
60
70
80
Bihar Gujarat Andhra Pradesh
Percent
Currently
Married
Women
15-19
20-29
30-39
40-49

12. IPV-NFHS-3 12
By Wealth
and Partner
Education
Acceptance of IPV with at least one reason by
Wealth Index
0
10
20
30
40
50
60
70
80
90
Bihar Gujarat Andhra Pradesh
Percent
Currently
Married
women
Poor
Middle
Rich
Decreases
with: Wealth
and Partner
Education in all
these states.
„Ψ2 value Significant at P<.01
Acceptance of IPV with at least one reason by Partner
Education
0
10
20
30
40
50
60
70
80
Bihar Gujarat Andhra Pradesh
Percent
currently
Married
Women
Illiterate
Literate

13. IPV-NFHS-3 13
Acceptance with at least one reason
Acceptance of IPVwith at least one reason byMarital
Duration
44.2
46.9
55.9
47.2
55.5
59.3
0
10
20
30
40
50
60
70
Bihar Gujarat Andhra Pradesh
P
e
r
c
e
n
t
C
u
r
r
e
n
tly
M
a
r
r
ie
d
W
o
m
e
n
<5 years
5-10 years
>10 years
Increases
with
Marital
duration
in all these
states

14. IPV-NFHS-3 14
Table 2: Percentage of currently married women who agrees with at least one reason
of husband beating by background Variables in Selected States: NFHS-3
Percentage who agree with at least one reason
Variables
BIHAR GUJARAT ANDHRA
PRADESH
1. AGE 15-19 54.9 59.5 66.7
20-29 45.4 49.2 59.6
30-39 43.4 56.6 55.7
40-49 48.3 51.2 56.1
Ψ2=
14.48** 14.2** 16.3**
2. Marital Duration <5 years 46.5 46.9 55.9
5-10 years 44.2 48.7 55.3
>10 years 47.2 55.5 59.3
Ψ2=
NS 15.7** NS
3. Religion Hindu 45.4 52.8 63.3
Non-Hindu 52.0 51.5 39.7
Ψ2=
7.19* NS 64.4**
4. Place of Residence Urban 39.0 47.1 46.2
Rural 50.8 56.7 76.2
Ψ2=
38.41** 25.6** 45.3**
5. Husband Living With 46.6 52.8 58.3
Stays out side 46.3 49.5 51.2
Ψ2=
NS NS NS
6. Wealth Index Poor 56.6 64.6 77.3
Middle 50.6 61.4 71.3
Rich 30.1 46.3 48.1
Ψ2=
73.3** ** **
7. Working Not Paid 45.8 63.5 81.9
Paid 53.1 56.8 65.7
Ψ2=
NS ** **
8. Partners Education No EDU 56.4 65.1 67.9
Educated 41.4 49.8 53.8
Ψ2=
** ** **

15. IPV-NFHS-3 15
Table 2b: Percentage of currently married women who agrees with at least one
reason of husband beating by Reproductive Health Variables in Selected States:
NFHS-3
Percentage who agree with at least one reason
Variables
BIHAR GUJARAT ANDHRA
PRADESH
S1 Births during No birth
last 5 years One
2+
42.5
50.3
51.9
53.3
51.1
57.1
59.1
56.0
41.3
Ψ2=
** NS *
S2
Birth during No
past years 1-2
45.3
53.2
52.1
50.5
57.8
59.1
Ψ2
= ** NS NS
S3 Ever terminated No
Pregnancy Yes
46.4
46.9
53.8
47.9
57.1
64.9
Ψ2=
NS ** **
S4
Parity at sterilization
<2
3-4
5+
25.0
40.7
50.7
46.8
59.9
65.1
63.3
61.3
55.9
Ψ2
= ** ** NS
S5. Contraceptive method used
Not using any method
Permanent method
Temporary methods
49.9
42.4
38.2
54.1
57.4
41.5
55.7
61.6
24.8
**P<.001 *P<.01 Ψ2
= ** ** **

16. IPV-NFHS-3 16
Agrees that a wife is
justified in refusing to
have sex with her husband
when she:
STATES
Knows
husband has
a sexually
transmitted
disease
Knows
husband
has a sex
with other
women
BIHAR 90.3 86.6 93.3 83.6 6.0 2992
GUJARAT 77.8 80.2 86.0 71.9 10.3 2829
ANDHRA
PRADESH
77.0 75.0 81.4 70.6 13.8 5148
Percent
Women
who
agree
with
one
reason
Percent
Women
who agree
with two
reasons
Percent
Women
who agree
with NON
of the
reasons
Number of
women
Table 4: Attitude towards refusing sexual intercourse with husband by
selected states: Percentage of currently married women who believes
that a wife is justified in refusing to have sexual intercourse with her
husband in specific circumstances: NFHS-3 Data

17. IPV-NFHS-3 17
Table: 3: Odds ratio from Stepwise logistic regression analysis examining associations
between Attitudes of currently married women towards intimate partner ( husband beating)
and socioeconomic variables in selected states: NFHS-3 Data
VARIABLES
FOR STEPWISE
REGRESSION
BIHAR GUJARAT ANDHRA
PRADESH
EXP (β) EXP (β) EXP (β)
1. Age Group 15-19 yearsref
1.000
20-29 years 1.904
30-39 years 1.175
40-49 years 1.226
2. Marital Duration <5 YEARS ref
1.000
5-10 YEARS 0.637
10+ YEARS 0.714
3. Wealth Index POOR ref
1.000 1.000 1.000
MIDDLE 2.698 1.709 1.696
RICH 2.184 1.588 1.559
4. Partners
occupation
un employed ref
1.000 1.000 1.000
White collar job 0.729 0.844 0.808
Blue collar job 0.784 0.766 0.629
5. Partner education No education ref
1.000
Educated 1.325
6. Religion Hindu ref
1.000
Non Hindu 2.000
7. Place of residence Urban ref
1.000
Rural 0.442
Constant 0.503 0.926 1.337
-2log likelihood 3934.06 3776.594 6300.2
100*R2
8.00 5.75 16.7

18. IPV-NFHS-3 18
Stepwise logistic regression analysis examining associations between Attitudes of
currently married women towards IPV (Physical) and socioeconomic variables in
selected states: NFHS-3 Data
Logit Regression analysis revealed that among the
seven selected socio economic variables,
„ Wealth index and Partner occupation in Bihar
„ Age of the respondent women, marital duration,
Wealth index, Partner occupation and education in
Gujarat and
„ Wealth index, Partner occupation, religion and place
of residence in Andhra Pradesh
Showed a significant contribution in explaining
variation in attitude towards IPV.
Wealth index and Partner occupation are the common
variables among these states.

19. IPV-NFHS-3 19
IPV-Physical Violence and Sexual Health
Problems
Physical violence: Any of the following acts of violence perpetrated by
her husband:
1. Pushed her, shook her, or threw something at her
2. Slapped her
3. Twisted her arm or pulled her hair
4. Punched her
5. Kicked her, dragged her, or beat her up
6. Tried to choke her or burn her on purpose
7. Threatened her or attacked her with a weapon
Sexual Health Problems:
Had Genital sore or ulcer during last 12 months?
Experience a bad smelling abnormal genital discharge during last 12
months?
Had disease which you got through sexual contact (STD)?

20. IPV-NFHS-3 20
IPV and Sexual Health Problems
(Genital Ulcer)
Table: 5: IPV and Sexual Health Problem (Genital Ulcer) among Currently Married
women-NFHS-3
Had Genital ulcer Last
12 Months
State Physical
Violence
No Yes
Total
No 823 (42.6) 15(18.3) 838 (41.6)
Bihar
Yes 1109 (57.4) 67 (81.7) 117(58.4)
Ψ2=19.12 P<.001
No 1545 (74.8) 36 (53.7) 1581 (74.2)
Gujarat
Yes 520 (25.2) 31 (46.3) 551 (25.8)
Ψ2=15.10 P<.001
No 2732 (69.0) 40 (23.5) 2772 (68.8)
Andhra Pradesh
Yes 1230 (31.0) 15 (76.5) 1243 (31.2
Ψ2=16.26 P<.001

21. IPV-NFHS-3 21
IPV-Sexual Health Problem: Genital Ulcer
1
2
IPV-No
IPV-Yes
0
10
20
30
40
50
60
70
80
90
Percent
Women
Genital problem 1=No, 2=Yes
IPV
IPV-Sexual Health :Genital Problem-
BIHAR
1
2
IPV-No
IPV-Yes
0
20
40
60
80
Pe
rc
e
n
t
W
o
m
e
n
Genital Problem
1=No, 2=Yes
IPV-Sexual Health: Genital Problem:A.P.
IPV-Yes

22. IPV-NFHS-3 22
Table: 6: IPV and Sexual Health Problem (abnormal genital
discharge) among currently Married women-NFHS-3
Had abnormal genital
Discharge Last 12
Months
State Physical
Violence
No Yes
Total
No 756 (44.6) 82 (25.6) 838 (41.6)
Bihar
Yes 938 (55.4) 238 (74.4) 1176 (58.4)
Ψ2=2.33 P<.001
No 1425 (75.2) 156 (65.5) 1581(74.2)
Gujarat
Yes 469(24.8) 82(34.5) 551(25.8)
Ψ2=1.50 P<.001
No 2691(69.6) 45(40.9) 2736(68.8)
Andhra Pradesh
Yes 1178(30.4) 65(59.1) 1243(31.2)
Ψ2=3.26 P<.001

23. IPV-NFHS-3 23
IPV-Sexual Health Problem: (Abnormal
Genital Discharge)-Bihar, Andhra Pradesh
1
2
IPV-No
IPV-Yes
0
10
20
30
40
50
60
70
P
ercent
Wom
en
Genital
Problem:1=No
,2=Yes
IPV-Sexual Health:White Discharge-A.P.
1
2
IPV-No
IPV-Yes
0
10
20
30
40
50
60
70
80
Percent
Women
Genital Problem
1=No, 2=Yes
IPV-Sexual Health :(White Discharge)-
Bihar

24. IPV-NFHS-3 24
Table: 6: IPV and Sexual Health Problem
(Had STD during last 12 months) among
currently Married women-NFHS-3
Had STD during Last
12 Months
State Physical
Violence
No Yes
Total
No 826(42.2) 13(22.8) 839 (41.7)
Bihar
Yes 1131(57.8) 44(77.2) 1175(58.3)
Ψ2=8.57 P<.001
No 1560 (74.4) 16(53.3) 1576(74.1)
Gujarat
Yes 538(25.6) 14 (46.7) 552(25.9)
Ψ2=15.10 P<.001
No 2730 (68.9) 40(33.3) 2770(68.8)
Andhra Pradesh
Yes 1231(31.1) 80(66.7) 1310(31.2)
Ψ2=16.26 P<.001

25. IPV-NFHS-3 25
IPV-Sexual Health: STD during Last 12 Months
Bihar and Andhra Pradesh-NFHS-3 Data
1
2
IPV-No
IPV-Yes
0
10
20
30
40
50
60
70
80
Percent
women
STD-1=No 2=Yes
IPV-Sexual Health: sTD during last 12
Months: Bihar Data
1
2
IPV-No
IPV-Yes
0
10
20
30
40
50
60
70
Percent
Women
STD-1=No 2=Yes
IPV-Sexual Health:STD during Last 12 Months:
Andhra Pradesh

26. IPV-NFHS-3 26
Risk Ratio:
„ Relative risk:
Incidence of Sexual Health Problem among currently married women experiencing IPV
incidence of Sexual Health Problem among currently married women Not Experiencing IPV
Relative Risk of Sexual Health Problem due to IPV
Sexual Health Problem during last 12 Months
States
Genital Ulcer Abnormal Genital
Discharge
STD
BIHAR 3.18 2.06 2.42
Gujarat 2.47 1.51 2.49
Andhra 3.15 3.18 2.94

27. IPV-NFHS-3 27
Summary & Conclusions
„ Nearly half of the respondent women accepts husband
beating and beating for specific reason varies between
the selected states.
„ Wife argues with husband and neglect the house are the
accepted reasons for IPV.
„ Nearly 90 percent of women in Bihar, and 77 percent in
Gujarat, Andhra Pradesh Agrees that a wife is justified in
refusing to have sex with her husband when she knows
that husband has STD ,has sex with other women.
„ Only 6 to 10 percent of women disagree that a wife is
justified in refusing to have sex with her husband when she
knows that husband has STD ,has sex with other women.

28. IPV-NFHS-3 28
Contd….
„ Acceptance towards Partner Violence found to be more among
currently married women belongs to Poor family, and with
illiterate husband.
„ Logit regression analysis revealed that Wealth index and partner
literacy level are contributory variables in determining agreeing
for IPV
„ Risk of women having genital ulcer found to be 3.18 times higher
among women exposed for IPV than non exposed in Bihar, 2.47
in Gujarat and 3.15 in Andhra Pradesh.
„ Risk of women having abnormal genital discharge found to be
2.06 times higher among women exposed for IPV than non
exposed in Bihar, 1.51 in Gujarat and 3.18 in Andhra Pradesh
„ Risk of women having disease got through sexual contact found
to be 2.42 times higher among women exposed for IPV than non
exposed ,in Bihar and 2.49,2.94 times in Gujarat and Andhra
Pradesh respectively.

29. IPV-NFHS-3 29
End Note
„ Almost half of currently married women in these states
representative of India accepts IPV for different reasons.
„ Though majority of Women had strong opinion of
refusing sex with husband who had STD or affairs with
other women, rarely initiate violence against their
husband for sex.
„ Women with IPV are at risk of getting Sexual health
problems than women with out IPV.
„ Most women suffer violence in silence

30. IPV-NFHS-3 30
THE END
THE END

31. IPV-NFHS-3 31
Percentage of currently married women who agrees that a
husband is justified in hitting or beating wife for specific
reasons: NFHS-3 data
22.4
32.3
43.4
20
39.6
50.5
30.8
38.5
16.3
27.5 25.9
0
10
20
30
40
50
60
Goes with
out tell
Neglects
House
Argues
with
Husband
Does not
cook food
BIHAR
GUJARAT
ANDHRA

32. IPV-NFHS-3 32
Attitude of IPV by background characteristics
of currently married women
Acceptance of IPV with at least one reason by Age
Group
54.9
59.5
66.7
49.2
55.7
43.4
0
10
20
30
40
50
60
70
80
Bihar Gujarat Andhra Pradesh
Percent
Currently
Married
Women
15-19
20-29
30-39
40-49
Acceptance of IPV with at least one reason by Marital
Duration
44.2
46.9
55.9
47.2
55.5
59.3
0
10
20
30
40
50
60
70
Bihar Gujarat Andhra Pradesh
Percent
Currently
Married
Women
<5 years
5-10 years
>10 years
Acceptance of IPV with at least one reason by Wealth
Index
56.6
64.6
77.3
30.1
46.3 48.1
0
20
40
60
80
100
Bihar Gujarat Andhra Pradesh
Percent
Currently
Married
wom
en
Poor
Middle
Rich
Acceptance of IPV with at least one reason by Partner
Education
56.4
65.1 67.9
41.4
49.8
53.8
0
10
20
30
40
50
60
70
80
Bihar Gujarat Andhra Pradesh
Percent
currently
Married
Women
Illiterate
Literate