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Long-term change in the prevalence of intimate partner violence: a 20-year follow-up study in León, Nicaragua, 1995-2016
  1. Mary Ellsberg1,2,
  2. William Ugarte3,4,
  3. Junior Ovince1,
  4. Alexandra Blackwell1,
  5. Margarita Quintanilla5
  1. 1Global Women's Institute, The George Washington University, Washington, DC, USA
  2. 2Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
  3. 3Faculty of Health Sciences, National Autonomous University of Nicaragua-León, León, León, Nicaragua
  4. 4Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
  5. 5Managua, Nicaragua
  1. Correspondence to Dr Mary Ellsberg; mellsberg{at}


Introduction Although intimate partner violence (IPV) affects an estimated one out of three women globally, evidence on violence prevention is still scarce. No studies have measured long-term change in larger populations over a prolonged period.

Methods The aim of this study was to measure changes in the prevalence of IPV in León, Nicaragua, between 1995 and 2016. The 2016 study interviewed 846 ever-partnered women aged 15 to 49 regarding experiences of physical, sexual and emotional IPV. These findings were analysed together with comparable data collected from 354 women in 1995. Multivariate logistic regression modelling was carried out on a pooled data set to identify differences between the two studies while controlling for potential confounding factors.

Results Lifetime physical IPV decreased from 54.8 to 27.6 per cent (adjusted OR (AOR) 0.37; 95% CI 0.28 to 0.49) and 12-month prevalence of physical IPV decreased from 28.2 to 8.3 per cent (AOR 0.29; 95% CI 0.20 to 0.42), respectively. Similar decreases were found in lifetime and 12-month emotional IPV. No significant difference was found in the prevalence of lifetime sexual violence between the two time periods.

Conclusions The results suggest that the reduction in IPV was not due to demographic shifts, such as increased education or age, but reflects a true decrease in the prevalence of IPV. The decrease is not likely to have occurred on its own, and may be attributable to multisectoral efforts by the Nicaraguan government, international donors and the Nicaraguan women’s movement to increase women’s knowledge of their rights, as well as access to justice and services for survivors during this time period.

  • epidemiology
  • health education and promotion
  • health policy
  • prevention strategies
  • cross-sectional survey

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  • Handling editor Seye Abimbola

  • Contributors ME, WU and MQ contributed to the study design, data collection, analysis and interpretation and drafting the manuscript. AB and JO contributed to analysis, interpretation and drafting report. All authors have reviewed the final manuscript prior to submission.

  • Funding Funding was received from the Sexual Violence Research Initiative through the South African Medical Research Council.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Ethics approval The 1995 study received ethical approval from the Ethical Review Board of the Medical Faculty at UNAN-León and the 2016 study received approval from the Institutional Review Boards of the George Washington University and UNAN-León.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on request from the corresponding author.