Contraceptive Use Among Women Experiencing Intimate Partner Violence and Reproductive Coercion: The Moderating Role of PTSD and Depression
Abstract
Women experiencing reproductive coercion (RC) report more unintended pregnancies and mental health symptoms that can influence contraceptive use patterns. We examined associations between RC and contraceptive use among intimate partner violence (IPV) exposed women aged 18–35 (N = 283). We tested depression, post-traumatic stress disorder (PTSD), and co-morbid depression and PTSD as effect modifiers. Though no association was found between RC and contraception, PTSD significantly modified this relationship. Among Black women (n = 112), those reporting RC and either PTSD or comorbid PTSD and depression were less likely to use partner-independent contraception compared to those reporting RC without mental health symptoms. PTSD could be a barrier to contraceptive choice among this population.
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Biographies
Jessica L. Zemlak began her work on this research while a doctoral candidate at Johns Hopkins University School of Nursing. She is currently an Assistant Professor at Marquette University College of Nursing. Dr. Zemlak's program of research focuses on the physical and mental well-being of marginalized women. She has worked clinically as a Family and Psychiatric Nurse Practitioner among underserved communities in Milwaukee, WI.
Lea A. Marineau is a Ph.D. candidate at the Johns Hopkins University School of Nursing. Her research is focused on further understanding multi-level factors associated with recurrent violent injury. She has worked as an adult nurse practitioner in various settings caring for people from underserved communities, including a large trauma center in Baltimore, MD.
Tiara C. Willie is an Assistant Professor of Mental Health at the Johns Hopkins Bloomberg School of Public Health. Her research examines the etiology and health consequences of gender-based violence among populations at-risk or currently experiencing violence with an emphasis on HIV prevention.
Helena Addison is a PhD Candidate at the University of Pennsylvania School of Nursing, a Penn Presidential PhD Fellow, 2021 − 2023 Jonas Scholar, and a fellow in the SAMHSA Minority Fellowship Program at the ANA. Her research interests include mental health outcomes and health-seeking behaviors among individuals who have experienced trauma and various manifestations of structural racism, including incarceration. Her overall career goal is to engage in innovative and interdisciplinary research that propels scientific knowledge to promote mental health in disenfranchised populations, and more broadly, promote health equity and social justice.
Gabrielle Ann Edwards is a staff nurse in the Medical Intensive Care Unit at Christiana Care in Newark, DE.
Trace Kershaw is Professor and Chair of the Social and Behavioral Sciences Department at the Yales School of Public Health.
Kamila A. Alexander is an Associate Professor at Johns Hopkins School of Nursing. Her research focuses on prevention of sexual health outcome disparities and the complex roles that structural determinants such as intimate partner violence, societal gender expectations, and social networks play in the experience of intimate human relationships.
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Article first published online: February 9, 2023
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