Association between intimate partner violence and modern contraceptive use among women presenting for abortion care in Lusaka, the capital city of Zambia

Intimate Partner Violence (IPV) has been shown to affect women’s access to sexual and reproductive health services, including modern contraceptives. However, there is conflicting data in the literature on how the experience of IPV among women affects modern contraceptive use, with some studies showing decreased rates of modern contraceptive use, while others have shown increased rates of modern contraceptive use among these women. This study therefore, aimed at studying the association between the experience of IPV and modern contraceptive use among women presenting for abortion care in Lusaka District, Zambia.

A cross-sectional study was conducted from 1 November to 31 December 2024 at four hospitals in Lusaka District. Women seeking abortion care were enrolled via convenience sampling, and data were obtained using a pre-tested interviewer-administered questionnaire. The outcome variable was modern contraceptive use in the preceding six months; exposures included IPV within the prior six months, as well as socio-demographic and reproductive characteristics. Analyses comprised descriptive statistics, chi-square test and multiple logistic regression.

A total of 372 women participated in the study and data was analysed for 367 women, with a median age of 25 years (IQR 22-30). IPV was reported by 231 participants (62.9%), most commonly emotional violence (44.7%). Modern contraceptive use within the preceding six months was reported by 150 women (40.9%). The odds of modern contraceptive use was lower amon women with IPV exposure compared with those who were not exposed (aOR 0.3; 95% CI 0.17–0.52), but higher among women seeking abortion care services from Chawama First Level Hospital compared to those seeking services from the Women and Newborn University Teaching Hospital ((aOR 4.4; 95% CI 1.68 – 11.65) and among women aged above 24 years compared to adolescent girls and young women (AGYW) aged 14-24 years (aOR 14; 95% CI, 6.40 – 30.60).

More than half of the women accessing abortion care services in Lusaka district experienced intimate partner violence, and less than half had used modern contraceptives within six months before they participated in the study. Thus, policies and programmes aimed at increasing modern contraceptive use among women should pay particular attention at addressing IPV and the reproductive health needs of AGYW and women residing in peri-urban areas.