|  Adult patient providers have an opportunity to address IPV with their patients, safely and confidentially. Focus group studies consistently demonstrate that over 75% of women patients want to be asked about IPV as long as the inquiry occurs in private by a compassionate and non-judgmental provider. Important studies show that the roots of unhealthy adult behaviors and adult disease can be found in childhood. The "Adverse Childhood Experiences (ACE)" Study demonstrates that childhood exposure to traumatic events including witnessing adult IPV results in more risky health practices and poor health as an adult. Adults exposed to multiple “ACE’s” as children have a higher prevalence of large number of lifetime sexual partners, smoking, substance use, depression, diabetes, hypertension, COPD, and MIs as well as other sequelae in adulthood.
Intimate partner violence is often passed on from one generation to the next—affecting multiple family members and their health in long-lasting ways. Although adult patient providers are not caring directly for the children of their patients they have an ethical obligation to educate their adult patients about the adverse effects of childhood exposure to IPV. Adult patient providers also have an obligation to inquire about and report suspected child abuse. Studies estimate that in 30-60% of families in which there is adult IPV, children are also directly abused. Even when children are not directly abused, the exposure to adult IPV can be highly damaging to a child’s emotional, behavioral, and physical health. Childhood exposure to adult IPV can create developmental problems and inappropriate risk-taking behaviors that persist into adolescence and beyond.
Learn How to Address IPV
Read the guidelines on how to address IPV in adult practices:
- Read the one-page "how to address IPV" sheets for adult medicine providers
- Follow the process on the Get Started page
- Explore the following important links for Adult Medicine Providers
- Place educational materials and posters in your practice
The Role of the Adult Patient Provider in Addressing IPV
The adult patient provider has a multi-faceted role in addressing IPV by:
- Screening women (and men who are suspected of being victimized) for IPV victimization.
- Considering piloting a program of screening male patients for IPV victimization and perpetration.
- Providing educational messages to all parents about the harmful effects of witnessing IPV on children.
- Linking adults who have been exposed to IPV with appropriate treatment services.
Caring for Pregnant Women
Adult patient providers also care for pregnant women who may begin experiencing IPV before, during, or after pregnancy. IPV has multiple adverse affects on pregnant women and newborns including an increased risk of hypertension and hospitalization of the pregnant woman, pre-term labor, low birth weight babies, and neonatal intensive care hospitalization. IPV is also associated with approximately a doubling of the STD rate. ACOG and CDC have prepared a slide show that addresses IPV in pregnancy that can be viewed on the CDC website. Download our “IPV and pregnancy” brochures for your patients.
Maintaining Safety and Confidentiality
Adult patient providers face challenges to maintaining safety and confidentiality when addressing IPV. Some research suggests that it is safe to inquire about IPV victimization with women patients when both members of a couple are cared for in the same setting (provided that the female patient is screened in private and the results of the screening are kept completely confidential). Adult patient providers must be aware that victims often feel guilty about their victimization while perpetrators of IPV often minimize, deny, and blame others for their violence. Guidelines and books can provide education regarding these dynamics.
Inquiring about IPV with Men
If adult patient providers embark upon inquiring about IPV with men, they should design the IPV program in such a way that it is clear that the program is “routine” and that a particular patient is not being screened for perpetration due to something revealed by their victimized partner. New pilot guidelines on addressing IPV with men and the accompanying review article may be helpful.
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