Wife Beating and the Link with Poor Sexual Health and Risk Behavior among Men in Urban Slums in India *

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INTRODUCTION

There is growing awareness that domestic and sexual violence is a problem of public health significance worldwide (Heise et al., 1994). Most studies on violence in developing countries have interviewed women only and population based estimates are still rare. The link of intimate partner violence with women"s reproductive health as well as the impact on child survival and health have been documented (Heise, 1994; Jejeebhoy, 1998; Maman et al., 2000; Moore, 1999). There is great need for a better understanding of the determinants and context of partner violence. In a recent review, an ecological model of factors associated with partner abuse has been proposed (Heise et aL, 1999). This framework includes factors at the individual level (of the perpetrator), the level of family and relationship, the community and societal level, and emphasizes that no single factor alone causes violence. Studies in South Asia reveal that men beat their wives for variety of cultural reasons situated in the gender norms about male superiority. The vast majority of these reasons involve discrepancies between role expectations and actual behavior. Economic issues are also important factors, such as a woman incurring an expense or asking for something for herself, or the man attempting to extort something from his wife or her family (Schuler etal., 1996). In India the risk of wife beating has indeed been shown to increase with smaller dowry payments (Rao, 1997). Men who have little education, and those who are extremely poor are also more likely than others to physically abuse their wives (Martin et al., 1999b). These socio-cultural factors combine with individual-level factors of the perpetrator, including witnessing marital violence as a child and alcohol use, to raise the likelihood of abuse (Heise et al., 1999). In India, wife beating is closely linked with other less-acceptable behavior on the part of men like gambling, alcohol consumption and extra-marital and premarital sex (Martinet al, 1999a; Rao, 1997).

Despite the general consensus in the literature that violence against women needs to be understood within a gender framework, very little attention is given, either in research or interventions, to the perpetrators of violence in developing countries. In a study in Uttar Pradesh, men who reported symptoms of sexually transmitted infections (STIs) were more likely than those who did not to have abused their wives (Martin et al., 1999a). This link suggests that there is a need to closely examine the relationship between sexual behavior, sexual health problems and wife beating.

Sexuality is at the core of gender relations and influences self-image and perceived health. Studying sexual health is therefore more complex than focussing on specific diseases. Recent research informing HIV/AIDS interventions have shown that sexual health concerns among Indian men are much broader than problems indicative of STIs. Sexual performance disorders and semen-related anxieties (involuntary semen loss, nocturnal emissions, quality and quantity of semen) are more prominent health concerns than sexually transmitted infections as shown in both qualitative and survey research (Collumbien and Hawkes, 2000; Verma et al., 2000). Semen is considered to be the ultimate vital force, the source of physical as well as spiritual strength. The sexual anxieties about loss of strength are encoded in the ethnophysiology of sex in South Asia and the cultural hot/cold belief system underlies the physiology of leaking semen (Edwards, 1983; Pool, 1987). The significance of these anxieties about semen loss and associate d weakness have been well-documented in the psychiatric and ethnographic literature as culturally bound syndromes and expressions of psychosocial distress (Edwards, 1983; Nichter, 1981; Weiss et al., 1986). Since these non-infectious sexual health concerns are inherently linked with male sexuality and sexual behaviour, they are likely to have reproductive health implications for both men and women including the quality of marital relationship (Pelto et al, 2000). …