Using Friendship Ties to Understand the Prevalence of, and Factors Associated With, Intimate Partner Violence Among Adolescents and Young Adults in Kenya: Cross-Sectional, Respondent-Driven Survey Study

Abstract

Background: Optimization of innovative approaches is required for estimating the intimate partner violence (IPV) burden among adolescents and young adults (AYA). Further investigation is required to identify risk and protective factors associated with IPV among AYA. There remain significant gaps in understanding these factors among this vulnerable population. Objective: The goal of our study was to determine the prevalence of IPV among an urban population of AYA and to identify factors associated with IPV among AYA. Methods: A cross-sectional study design utilizing respondent-driven sampling was adopted. The study was conducted among 887 AYA, aged 15 to 24 years, residing in Nairobi, Kenya. Data were collected through a phone-based survey using the REACH (Reaching, Engaging Adolescents and Young Adults for Care Continuum in Health)-AYA app. Questions on behavioral and psychosocial factors were adopted from different standardized questionnaires. Descriptive, bivariate, and multivariable statistics were used to describe the characteristics of the study sample. Results: Of the 887 participants, a higher proportion were male (540/887, 60.9%) compared to female (347/887, 39.1%). The prevalence of IPV was 22.3% (124/556). IPV was associated with being unsure if it was okay for a boy to hit his girlfriend, living in a home with physical violence or abuse, and being bullied (P=.005). The likelihood of experiencing IPV was higher among respondents whose friends and family members used alcohol (odds ratio [OR] 1.80, 95% CI 1.09-2.98) and among those who had repeated a class at school in the past two years (OR 1.90, 95% CI 1.11-3.23). Respondents who visited a health facility or doctor for reproductive health services were 2 times more likely to experience IPV (OR 2.23, 95% CI 1.40-3.70). Respondents who had used illicit drugs were 2 times more likely to experience IPV (OR 4.31, 95% CI 2.64-7.04). The probability of experiencing IPV decreased by 63% (OR 0.37, 95% CI 0.16-0.85) among respondents who refused to have sex with someone who was not prepared to use a condom. Conclusions: IPV remains a significant public health priority because of its impact to society. Our results are in congruence with other similar studies. Efforts toward incorporating appropriate IPV core measures into the comprehensive care package for every AYA seeking health services should be explored. Programs need to address constellations of risk and protective factors linked to IPV in an effort to prevent its occurrence.