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Peer-reviewedCC BY 4.0Reproductive Health

Intimate partner violence and covert contraception use among Ugandan women: a cross-sectional inquiry

  • Craig J. Heck1
  • Kyle Wu2
  • Hadijja Nakawooya3
  • Tom Lutalo3
  • Seda Shirinian2
  • Fred Nalugoda3
  • John Santelli4
  • Jennifer Wagman2
4 affiliations
  1. 1Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY 10032 USA
  2. 2Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Dr. South Room 46-071B CHS, Los Angeles, CA 90095 USA
  3. 3Rakai Health Sciences Program, Old Bukoba Road, Kalisizo, Uganda
  4. 4Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, 722 West 168th St, New York, New York 10032 USA
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Abstract

Introduction: Intimate partner violence (IPV) is prevalent globally, adversely impacting women’s health and autonomy. Covert contraceptive use (CCU), using contraception without a partner’s knowledge, may arise in response to IPV and restrictive gender norms. This study examines associations between verbal, physical, and sexual IPV and CCU among Ugandan women, providing insight into the socio-cultural dynamics influencing reproductive health choices.

Methods: We conducted a secondary analysis using data from the 2011–2013 Rakai Community Cohort Survey, which collected demographic, reproductive, and IPV-related data from women in South-Central Uganda. We included women who reported (1) ever having sex, (2) no current pregnancies, and (3) current use of contraception, including intra-uterine devices, pills, injectables, or implants. Adjusted prevalence ratios (APR) and 95% Confidence Intervals (CI) were estimated using Poisson regression, adjusting for age, education, marital status, HIV status, alcohol use, and other confounders.

Results: Among 2,094 women, 27%, 21%, and 12% respectively survived verbal, physical, and sexual IPV, and 26% practiced CCU. Positive IPV-CCU associations arose for physical IPV (APR = 1.39, CI = 1.17–1.65) and verbal IPV (APR = 1.30, CI = 1.12–1.52), whereas sexual IPV’s association was marginally significant (APR = 1.22, CI = 0.99–1.49).

Conclusions: IPV may influence women’s choices about contraception and/or women’s use of contraception may precipitate IPV. Integrating efforts to prevent IPV and provide contraception are needed to better serve women.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12978-026-02425-7.

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Cite

BibTeXRIS
BibTeX
@article{heck2026intimate,
  title = {{Intimate partner violence and covert contraception use among Ugandan women: a cross-sectional inquiry}},
  author = {Craig J. Heck and Kyle Wu and Hadijja Nakawooya and Tom Lutalo and Seda Shirinian and Fred Nalugoda and John Santelli and Jennifer Wagman},
  journal = {Reproductive Health},
  year = {2026},
  month = aug,
  doi = {10.1186/s12978-026-02425-7},
  url = {https://doi.org/10.1186/s12978-026-02425-7},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Intimate partner violence and covert contraception use among Ugandan women: a cross-sectional inquiry
AU  - Craig J. Heck
AU  - Kyle Wu
AU  - Hadijja Nakawooya
AU  - Tom Lutalo
AU  - Seda Shirinian
AU  - Fred Nalugoda
AU  - John Santelli
AU  - Jennifer Wagman
PY  - 2026
DA  - 2026/08/12
JO  - Reproductive Health
DO  - 10.1186/s12978-026-02425-7
UR  - https://doi.org/10.1186/s12978-026-02425-7
AB  - Introduction: Intimate partner violence (IPV) is prevalent globally, adversely impacting women’s health and autonomy. Covert contraceptive use (CCU), using contraception without a partner’s knowledge, may arise in response to IPV and restrictive gender norms. This study examines associations between verbal, physical, and sexual IPV and CCU among Ugandan women, providing insight into the socio-cultural dynamics influencing reproductive health choices.  Methods: We conducted a secondary analysis using data from the 2011–2013 Rakai Community Cohort Survey, which collected demographic, reproductive, and IPV-related data from women in South-Central Uganda. We included women who reported (1) ever having sex, (2) no current pregnancies, and (3) current use of contraception, including intra-uterine devices, pills, injectables, or implants. Adjusted prevalence ratios (APR) and 95% Confidence Intervals (CI) were estimated using Poisson regression, adjusting for age, education, marital status, HIV status, alcohol use, and other confounders.  Results: Among 2,094 women, 27%, 21%, and 12% respectively survived verbal, physical, and sexual IPV, and 26% practiced CCU. Positive IPV-CCU associations arose for physical IPV (APR = 1.39, CI = 1.17–1.65) and verbal IPV (APR = 1.30, CI = 1.12–1.52), whereas sexual IPV’s association was marginally significant (APR = 1.22, CI = 0.99–1.49).  Conclusions: IPV may influence women’s choices about contraception and/or women’s use of contraception may precipitate IPV. Integrating efforts to prevent IPV and provide contraception are needed to better serve women.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12978-026-02425-7.
SN  - 1742-4755
ER  -