@article{ref1,
title="Delayed visits for contraception due to concerns regarding pelvic examination among women with history of intimate partner violence",
journal="Journal of general internal medicine",
year="2020",
author="Holt, Hunter K. and Sawaya, George F. and El Ayadi, Alison M. and Henderson, Jillian T. and Rocca, Corinne H. and Westhoff, Carolyn L. and Harper, Cynthia C.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Concern regarding pelvic examinations may be more common among women experiencing intimate partner violence.   OBJECTIVE: We examined women's attitudes towards pelvic examination with history of intimate partner violence (pressured to have sex, or verbal, or physical abuse).   DESIGN: Secondary analysis of data from a cluster randomized trial on contraceptive access.   PARTICIPANTS: Women aged 18-25 were recruited at 40 reproductive health centers across the USA (2011-2013).   MAIN MEASURES: Delays in clinic visits for contraception and preference to avoid pelvic examinations, by history of ever experiencing pressured sex, verbal, or physical abuse from a sexual partner, reported by frequency (never, rarely, sometimes, often). We used multivariable logistic regression with generalized estimating equations for clustered data.   KEY RESULTS: A total of 1490 women were included. Ever experiencing pressured sex was reported by 32.4% of participants, with 16.5% reporting it rarely, 12.1% reporting it sometimes, and 3.8% reporting it often. Ever experiencing verbal abuse was reported by 19.4% and physical abuse by 10.2% of participants. Overall, 13.2% of participants reported ever having delayed going to the clinic for contraception to avoid having a pelvic examination, and 38.2% reported a preference to avoid pelvic examinations. In multivariable analysis, women reporting that they experienced pressured sex often had significantly higher odds of delaying a clinic visit for birth control (aOR 3.10 95% CI 1.39-6.84) and for reporting a preference to avoid pelvic examinations (aOR 2.91 95% CI 1.57-5.40). We found no associations between delay of clinic visits or preferences to avoid a pelvic examination and verbal or physical abuse.   CONCLUSIONS: History of pressured sex from an intimate partner is common. Among women who have experienced pressured sex, concern regarding pelvic examinations is a potential barrier to contraception. Communicating that routine pelvic examinations are no longer recommended by professional societies could potentially reduce barriers and increase preventive healthcare visits.<p /> <p>Language: en</p>",
language="en",
issn="0884-8734",
doi="10.1007/s11606-020-06334-8",
url="http://dx.doi.org/10.1007/s11606-020-06334-8"
}