Women’s experience of intimate partner sexual violence in southwest, Nigeria

INTRODUCTION

Intimate partner sexual violence (IPSV) is a common but often overlooked form of intimate partner violence (IPV) that has far-reaching consequences for the victims and society at large.^1,2 It is a violation of trust, safety and the rights of the victim and could precipitate a cycle of trauma that may affect the mental health, social functioning and overall well-being of the victim.³ IPSV can be defined as sexual coercion, sexual assault, sexual abuse, or forced sexual activity perpetrated by an intimate partner.⁴ Although common, IPSV have often been studied by researchers subsumed within a broad definition of IPV without much consideration for its unique correlates and consequences.¹

The World Health Organization’s violence against women prevalence estimates, 2018, shows that globally, 13% of ever-married/ partnered women aged 15-49 years have experienced physical and/or sexual intimate partner violence at some point within the past 12 months of the survey.⁵ Across Africa, researchers have found that between 7.4% and 11.6% of women have experienced IPSV in the past year.^6,7 In Nigeria, the National Demographic Health Survey, which is a nationally-representative household survey that provides data for a wide range of monitoring and impact evaluation indicators in the areas of population, health, and nutrition, reported that 7% of ever-married women have experienced sexual violence by their current or most recent husband, although local studies suggest it could be as high as 20% in certain regions of the country.^8-10 It has been suggested that these estimates are largely under-reported because IPSV is associated with stigma, and silence and has been historically invalidated as a serious crime.⁴ Furthermore, victims of IPSV may be reluctant to report their experiences because their society tends to condone male sexual entitlement, minimize women's bodily autonomy, while at other times abusive partners may use emotional manipulation, financial control, and threats of physical harm to isolate the victim and discourage them from seeking help.¹¹

IPSV is particularly challenging to address because on the one hand it is difficult for victims to articulate, while on the other hand, there is a reluctance among sections of society to recognize that sexual violence can occur between intimate partners.² More often than not, the traditional African society will attribute greater responsibility for the report of IPSV to the female victim, the consequence of which is likely to be sentencing women to a lifetime of abuse.¹² Rape within a marriage was not recognized as illegal in many parts of the world until the early 1990s.¹³ In Nigeria, the prohibition of the act of marital rape was not until the Violence Against Persons Prohibition Act which came into existence in 2015. The Act seeks to eliminate violence in private and public life, prohibit all forms of violence against persons and to provide protection for victims and deterrents for perpetrators of violence.¹⁴

Several factors have been documented to be associated with higher rates of IPSV among women, which include cohabiting with a partner, poverty, financial insecurity, lower level of education, smoking, sociocultural norms surrounding masculinity and femininity, and economic stressors.^15-17 The ecological model provides a useful framework for examining how individual, relational, community, and societal factors intersect to perpetuate IPSV, offering insights into the development of multifaceted prevention strategies.¹⁸

Changing IPSV behavior is a challenge in IPV prevention research, as it is often underreported, shrouded in secrecy and there is paucity of mixed-method studies around it in Nigeria. This research aimed to fill this gap by assessing the prevalence of IPSV in rural communities and exploring the factors associated with its occurrence.

METHODS

Study design and setting

This descriptive analysis was conducted on the quantitative and qualitative data collected as part of the baseline survey of a randomized community trial, designed to assess the effect of a community mobilization intervention on the attitudes toward IPV in selected rural communities in southwest, Nigeria. As detailed elsewhere, the baseline study was conducted between July and August 2019, in two of the 12 rural local government areas of Oyo State, southwest Nigeria.^19,20

Study population and sample size

The population for this study were married females aged 18-49 years, currently living with their partners. To obtain a fairly accurate sampling frame, all women who met the above criteria were listed and assigned a number, during a household listing exercise. The desired number of married women for the study was drawn from this listing using a random generator application. A sample size of 680 women from both LGAs was calculated, assuming a 10.7% prevalence of sexual violence to allow for maximum sample size, a 5% significance level, 80% power, a design effect of 2, and significance level of 0.05.^21,22 Factoring 10% non-response, the estimated sample size was 680 individuals however, a total of 677 women completed the interviews using smartphones with the Open Data Kit (ODK) application.

Study procedures

The selection of respondents was done using a multi-stage sampling technique, involving three stages of selection, namely, the selection of the local government areas (LGA), communities and respondents. These has been described in detail in a previous publication.¹⁹

Quantitative data was collected from consenting women who responded to a modified version of the questionnaire used for the WHO multi-country study on women’s health and domestic violence.²³ The English questionnaire was translated to Yoruba and back-translated to assess the quality of the translation. Interviews were conducted in private spaces where auditory and visual privacy were ensured by trained interviewers. The interviewers were also trained to manage respondents’ emotional outbursts and refer such to the health workers in the community. The questionnaire included information about demographics, family and household structure, attitudes towards social norms and experience of IPV.

Qualitative data was collected using in-depth interviews (IDIs) and focus group discussions (FGDs). Qualitative data explored respondents’ awareness and perception of IPSV in the community. A total of twelve IDIs and nine FGDs were conducted and all interviews were audio recorded after receiving permission from the respondents and lasted for 45 to 60 minutes. The IDI/FGD guide employed for this study was adapted from published literature to include open-ended interview questions, prepared to address the objectives of the study.²⁴

Measures

The primary outcome variable in this study was women’s experience of IPSV in the year preceding the survey. This variable was measured when respondents were asked if, in the last 12 months, they were physically forced to have sexual intercourse, when they did not want to? If they had ever had sexual intercourse but did not want o because they were afraid of what their partner might do? if they had ever been forces to do something sexual that they found degrading or humiliating? Respondents were to answer ‘yes’ or ‘no’ to each of the 3 statements. Scores were allotted as follows: “no”-0 or “yes”-1. The maximum obtainable score was 3 and a score of ‘1’ or higher meant the respondent had experienced IPSV in the past year.

The secondary outcomes include attitude of women towards sexual violence which was assessed by asking respondents to respond ‘yes’ or ‘no’ to 4 scenarios in which violence was justified, as detailed in the WHO multi-country study on women’s health questionnaire.²³ Scores for each scenario were allotted as “0” for “no” or “1” for “yes”. The maximum obtainable score was 4 and a score of ‘1’ or higher meant the respondent justified sexual violence in at least one of the scenarios and was considered as having attitudes supportive of sexual violence. On the other hand, those with a score of ‘0’ did not agree that a man was justified perpetuating sexual violence in any of the scenarios and were considered as non-supportive of sexual violence.

Data analysis

Quantitative

Data were managed using the ODK Aggregate application, which was employed in capturing the dataset that was uploaded onto a cloud server, created for this study and accessible only to the researcher. After the survey, the dataset was converted into a CSV file which was imported into STATA version 15.0 for analysis.²⁵ Descriptive statistics were used to report means and standard deviations for continuous variables; frequencies and percentages for categorical variables; and cross-tabulations helped to show associations between sociodemographic, economic variables, and the outcome variable. Variables in the bivariate analysis that showed a significant association with the dependent variable, as well as other variables known to be associated with the dependent variable, were included in the multivariate analysis. Odds ratios (ORs) and adjusted odds ratios (AOR) with 95% confidence intervals (95% CI) were computed and reported where appropriate. The level of significance was set at 5%

Qualitative

All interviews were transcribed and translated into English, and the transcript was read and quality-checked by a researcher on the team. A codebook was developed and refined iteratively. The codes were grouped around themes and sub-themes using Atlas.ti.

Ethics

The study received ethical approval from the University of Ibadan’s research ethics committee as well as administrative approval from the medical officers of health of each of the two local government areas where data were collected before the recruitment of participants commenced. The study protocol was registered at ClinicalTrials.gov (ID: NCT06119984).

RESULTS

Description of study participants

Table 1 shows the sociodemographic characteristics of women selected for our analysis. Among the respondents, 38.3 percent were between the ages of 25 and 34 years of age, while about the same proportion of women (38.6 percent) were 10 or more years younger than their current partners. About half of the women had completed secondary education or higher.

More than half of the respondents (60.1 percent) were legally married to their current partner. However, about 15.5 percent of women in this study had experienced physical violence from their current partner, while more than half (54.8 percent) had attitudes supportive of physical IPV.

Women’s attitude towards and past year experience of sexual violence

Table 2 shows that more than half of the respondents (65.6 percent) had attitudes that supported sexual violence. The commonest attitude towards sexual violence that women supported was that a woman can’t decline to have sex with her partner if he is drunk (61.6 percent).

Table 3 shows that 9 percent of respondents in this study experienced sexual violence from their partners in the 12 months preceding the survey. The commonest form of sexual violence (7.5 percent) was women being forced to have sexual intercourse with their partner when they did not want to.

The results of the qualitative findings also suggested that IPSV exists within the community even though it may be kept hidden. The following quotes support this assertion:

“The issue of sexual violence is rare. This particular point is an indoor thing, like a Yoruba proverb that says, “If a masquerade fart... it will stay inside the masquerade”. It is only when they come out in the open to talk about it that one can know” (Male IDI, 38-year-old, community youth leader).

“Sexual violence within marital relationships is not common in our area here, we only have situations where the husband complains that his wife is denying him sex and vice versa. But forcing sex on one’s partner has not been recorded” (Female IDI, 49-year-old- trader).

“What happens in this our community is that some boys during this period will go out and get drunk, and when they return, they will expect the wife to have sex with him, but the wife will refuse because the husband is drunk and the husband will then rape the wife” (Male IDI, 50-year-old, community leader).

“At other times, what I see among the youths is that when they leave the house, they will not provide food for the wife to take care of the household, and when they go out to drink and return drunk, the wife will have nothing to cook and be idle, waiting for the husband being angry but as soon as the husband returns and she asked for food for the household, and since husband is drunk and will not be able to provide what is expected and will lead to fight between the couples” (Male IDI, 50-year-old, community leader).

Other respondents highlighted that women may refuse sexual advances from their partner and that may be the trigger for physical violence, they said:

“If a husband tells his wife he wants to have sex with her and she refuses, it would start a fight between them” (Female FGD, 45-year-old, trader).

“When the man did not provide basic amenities like food and shelter for the wife but comes home and say you want to have sexual intercourse with the wife. It will cause fights” (Female FGD, 30-year-old, trader).

Results from bivariate and multivariate analysis

From Table 4, it is evident that the women who have been married for between 6 to 10 years were significantly less likely to experience IPSV compared to women who have been married for 5 years or less (AOR=0.44; 95% CI 0.19-0.99). Similarly, respondents who were from households in the richer wealth tertile were significantly less likely to experience IPSV compared to their contemporaries from households in the middle and poorer wealth tertile (AOR=0.31; 95% CI 0.15-0.65).

On the other hand, respondents whose attitudes were supportive of IPSV were four times more likely to experience IPSV compared to their counterparts whose attitudes did not support IPSV (AOR=4.04; 95% CI 1.17-13.94). The findings also showed that respondents whose attitudes were supportive of physical IPV were significantly more likely to experience IPSV compared to their counterparts whose attitudes did not support physical IPV (AOR=2.99; 95% CI 1.49-6.00).

*:significant

DISCUSSION

The findings reveal a past year prevalence of IPSV among women in southwestern Nigeria that is very similar to what has been reported by other researchers in Nigeria and other African countries.^6-10 The qualitative data also suggested that IPSV exists in the study communities but also highlighted that the rarity could be due to the culture of silence around IPSV.²

The proportion of respondents who expressed attitudes that condoned IPSV was rather high underscoring the importance of the cultural environment that is likely to shape women's attitudes toward sexual violence. This high level of social acceptance of IPSV, as is the case with other forms of IPV, indicates that the norms, particularly those that prioritize male dominance and control, remain deeply entrenched in this context.^17,18 In societies such as where the current study was conducted, women’s autonomy over their bodies is minimized, and violence is usually normalized within intimate relationships.²⁶ As observed in previous studies, patriarchal societies tend to justify male authority, leading to a culture of silence and the internalization of victim-blaming attitudes among women.^19,25,26 On the other hand, much, lower rate of justifying IPSV have been reported in countries with much stronger institutional support systems and higher levels of public awareness than what exists in the setting where the current study was conducted.²⁷

Interestingly, women married for 6 to 10 years were less likely to experience IPSV compared to those married for shorter durations, which contrasts with studies in Bangladesh and other regions where longer marriage duration is associated with increased violence.²⁵ This variation may reflect differences in cultural expectations surrounding marriage. In Nigeria, particularly in rural areas, the early years of marriage often coincide with heightened economic and emotional instability, which may exacerbate the risk of violence. Over time, as couples gain more financial stability or women become more socially integrated into their communities, the risk of IPSV may decrease. However, this finding should be interpreted with caution, as it could also suggest that women in longer marriages are more likely to normalize the violence they experience, or even less likely to report it. Further research is needed to understand how duration of a union interacts with cultural norms, economic factors, and reporting behaviours in Nigeria.

These findings highlight the urgent need for multifaceted interventions to address IPSV in Nigeria. Cultural norms that condone male dominance, and economic dependency are critical factors that must be addressed to reduce the prevalence of IPSV.¹⁹ Economic empowerment initiatives, such as microfinance programs for women, could help mitigate the economic dependency that traps many women in abusive relationships, although with additionally interventions that seeks to raise awareness about IPSV and promoting gender equality through educational programs.²⁸ Importantly, like interventions to address other forms of IPV, interventions must be culturally sensitive and community-driven to ensure their effectiveness in reducing IPSV.²⁹ The legal framework in Nigeria, while improving with the introduction of the Violence Against Persons Prohibition (VAPP) Act in 2015, requires strengthening in its implementation, particularly in rural areas where IPSV is often seen as a private issue, rather than a public or criminal concern.³⁰

CONCLUSION

The study highlights a troubling prevalence IPSV in southwestern Nigeria, with 9% of women reporting incidents in the past year and 65.6% holding attitudes supportive of violence. The findings also showed that respondents with attitude that justifies sexual and physical violence were significantly more likely to experience IPSV, while being married for 6 to 10 years and being a member of a wealthier household was found to be protective of IPSV.

To reduce IPSV, culturally sensitive interventions should focus on raising awareness through community-based education programs that promote gender equality and challenge attitudes that justify all forms of violence. Economic empowerment initiatives that can support households to be more economically stable should be implemented to reduce the financial strains on households. Finally, stronger enforcement of legal protections, coupled with public education campaigns, is essential to shift societal attitudes and hold perpetrators accountable.

ACKNOWLEDGEMENTS

We thank all study participants and the community leaders for their permission to conduct the study, and extend our gratitude for the contribution the research team members towards the study.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the University of Ibadan/ University College Hospital Health Research Ethics Committee granted ethical approval [UI/UCH IRB UI/EC/17/0242]

REFERENCES

1. 1. Barker LC, Stewart DE, Vigod SN. Intimate partner sexual violence: an often overlooked problem. J Women’s Health. 2019;28(3):363-74.
2. 2. Peeren S, McLindon E, Tarzia L. “Counteract the gaslighting”- a thematic analysis of open-ended responses about what women survivors of intimate partner sexual violence need from service providers. BMC Women's Health 2024;24:110.
3. 3. Tarzia L. “It Went to the Very Heart of Who I Was as a Woman”: The invisible impacts of intimate partner sexual violence. Qual Health Res. 2021;31(2):287-97.
4. 4. Bagwell-Gray ME, Messing JT, Baldwin-White A. Intimate partner sexual violence: a review of terms, definitions, and prevalence. Trauma Violence Abuse. 2015;16(3):316-35.
5. 5. WHO. Violence against women prevalence estimates, 2018. Global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. World Report on Violence and Health. 2021. Available from: https://iris.who.int/bitstream/handle/10665/341338/9789240026681-eng.pdf. Accessed on 11 June 2024.
6. 6. Alangea DO, Addo-Lartey AA, Sikweyiya Y, Chirwa ED, Coker-Appiah D, Jewkes R, et al. Prevalence and risk factors of intimate partner violence among women in four districts of the central region of Ghana: Baseline findings from a cluster randomised controlled trial. PLoS One. 2018;13(7):1-19.
7. 7. Yaya S, Kunnuji MON, Bishwajit G. Intimate partner violence: a potential challenge for women’s health in Angola. Challenges. 2019;10(1):21.
8. 8. National Population Commission (NPC) (Nigeria) and ICF. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF. 2018. Available from: https://dhsprogram.com/pubs/pdf/FR359/FR359.pdf. Accessed on 11 June 2024.
9. 9. Balogun MO, Owoaje ET, Fawole OI. Intimate partner violence in southwestern Nigeria: are there rural-urban differences? Womens Health Issues. 2012;52(7):627-45.
10. 10. Akinyugha AO, Akinyugha A, Kareem AO, Kareem AJ, Ajewole MO, Orji EJ, et al. Perceptions of women towards screening for intimate partner violence. Afr J Prim Health Care Fam Med. 2022;14(1):1-8.
11. 11. Mbadugha EI. Intimate partner violence and sexual violence against women: any end in sight? 2016;5(1).
12. 12. Lilley C, Willmott D, Mojtahedi D, Labhardt D. Intimate partner rape: a review of six core myths surrounding women’s conduct and the consequences of intimate partner rape. Soc Sci. 2023;12(1).
13. 13. Wright EN, Anderson J, Phillips K, Miyamoto S. Help-seeking and barriers to care in intimate partner sexual violence: a systematic review. Trauma Violence Abuse. 2022;23(5):1510-28.
14. 14. Ogunwale AO, Afolabi RF. Prevalence, determinants and coercive strategies relating to marital rape among women in Oyo State, Nigeria. Ghana Med J. 2022;56(2):117-26.
15. 15. Asare BYA, Agyemang-Duah W, Adomako EB, Puri P, Ogundare DO, Vishwakarma D, et al. Association between experiences of intimate partner sexual violence and cigarette smoking among women in union in Papua New Guinea: evidence from a nationally representative survey. BMC Public Health. 2022;22(1):1-11.
16. 16. Torres Munguía JA. An analysis of the risk factors for intimate partner sexual violence against women and girls in Mexico. J Gender-Based Violence. 2024;XX(Xx):1-17.
17. 17. Tarzia L. Toward an ecological understanding of intimate partner sexual violence. J Interpers Violence. 2021;36(23-24):11704-27.
18. 18. Rieger A, Blackburn AM, Nag A, Holland H, Allen NE. Contradictions in change: Ecological factors in the implementation of outer layer sexual violence prevention. Am J Community Psychol. 2023;72(1-2):15-31.
19. 19. Awolaran O, Olaolorun FM, Asuzu MC. Experience of intimate partner violence among rural women in Southwest, Nigeria. Afr J Reprod Health. 2021;25(October):113-24.
20. 20. Awolaran O. Findings from a community mobilization intervention on intimate partner violence in rural South-west Nigeria. Abstracts of the 13^th European Congress on Tropical Medicine and International Health (ECTMIH 2023), Shaping the future of equitable and sustainable planetary health, 20-23 November 2023, Utrecht. Trop Med Int Health. 2023;28 Suppl 1:3-389.
21. 21. Balogun MO, Owoaje ET, Fawole OI. Intimate partner violence in southwestern Nigeria: are there rural-urban differences? Womens Health Issues. 2012;52(7):627-45
22. 22. Alimohamadi Y, Sepandi M. Considering the design effect in cluster sampling. J Cardiovasc Thorac Res. 2019;11(1):78.
23. 23. García-moreno C, Jansen HAFM, Ellsberg M, Heise L, Watts C. WHO Multi-country Study on Women’s Health and Domestic Violence against Women. Geneva; 2005.
24. 24. Balogun MO, John-Akinola YO. A qualitative study of intimate partner violence among women in Nigeria. J Interpers Violence. 2015;30(14):2410-7.
25. 25. STATA Corporation, College Station, TX, USA. Available from: https://www.stata.com/company/. Accessed on 11 June 2024.
26. 26. Penttinen E. The harm of normalized violence: re-identifying intimate partner violence as torture in acknowledging the stakes of abusive relationships. International Feminist Journal of Politics, 2024;26(1):150-70.
27. 27. Bott S, Guedes A, Goodwin M, Mendoza J. Violence Against Women in Latin America and the Caribbean: A comparative analysis of population-based data from 12 countries. Washington, DC: Pan American Health Organization; 2012.
28. 28. Leite TH, De Moraes CL, Marques ES, Caetano R, Braga JU, Reichenheim ME. Women economic empowerment via cash transfer and microcredit programs is enough to decrease intimate partner violence? Evidence from a systematic review. Cad Saude Pub. 2019;35(9):1-28.
29. 29. Henriksen L, Kisa S, Lukasse M, Flaathen EM, Mortensen B, Karlsen E, et al. Cultural sensitivity in interventions aiming to reduce or prevent intimate partner violence during pregnancy: a scoping review. Trauma Violence Abuse. 2023;24(1):97-109.
30. 30. Ikuteyijo OO, Hilber AM, Fatusi AO, Akinyemi AI, Merten S. Stakeholders’ engagement with law to address gender-based violence in Southwest Nigeria: a qualitative study using normalisation process theory to explore implementation challenges. BMJ Public Health. 2024;2(2).