(PS12-C63) Correlates of Intimate Partner Violence Victimization and Perpetration Among Adolescents and Young Adults in Sub-saharan Africa: A Systematic Review

Background
Intimate partner violence (IPV) is a global public health crisis, with long term adverse consequences for both victims and perpetrators. Historically, the literature has focused on IPV in adult relationships, though patterns of violence begin in adolescent romantic relationships. The current review begins to fill these gaps through the following aims: 1) to describe correlates of IPV in adolescents and young adults in SSA, and 2) to organize identified correlates within an adapted multi-level conceptual framework.

Methods
A systematic review was conducted to identify correlates of IPV victimization and perpetration among adolescents and young adults (ages 10 - 24) in sub-Saharan Africa (SSA) to inform future intervention work. PsycInfo, PubMed, Embase, and African Index Medicus were searched from January 1, 2000 to February 4, 2022. Correlates were defined as any condition or characteristic associated with statistically significant increased or decreased risk of IPV victimization or perpetration. Results were analyzed using qualitative synthesis and then further organized in a conceptual framework. The search resulted in 3,384 original studies, of which 55 met inclusion criteria and were analyzed. Correlates were first synthesized by developmental period (e.g., early adolescence, older adolescence, and young adulthood) and then organized in a conceptual framework by correlate type (e.g., socio-demographic; health, behavior, or attitudes; relational; contextual). 

Results
IPV victimization was more commonly studied (n=37) than perpetration (n=10). Eight studies looked at both outcomes, and two of those identified the correlates of dual IPV—the bidirectional experience of both victimization and perpetration. Nearly all the studies included physical IPV as an outcome type (91% of studies); sexual IPV was also a frequent outcome (75%). Psychological IPV  was explored in fewer studies (40%), and only one study measured economic IPV. Across developmental periods, associations between socio-demographic correlates and IPV are mixed, but associations with individual health and behavior factors seem to be more clear. Mental health challenges (e.g., depression, substance use, post-traumatic stress disorder), sexual risk behaviors, and exposure to traumatic events (e.g., child abuse, sexual violence, witnessing IPV among parents) were all associated with increased victimization and perpetration from early adolescence through young adulthood. Interestingly, emerging evidence from the developmental period of early to mid-adolescence is beginning to disentangle the complexity of gender in victim-perpetrator dynamics.

Conclusion
Literature from the past two decades in SSA reflects the complexity of IPV. This review encapsulates the evidence, not only to provide a comprehensive overview, but also, to lay the groundwork for developmentally appropriate prevention efforts. Our findings point to opportunities for intervention at multiple levels, but heavily emphasize the urgent need for combined efforts to address mental health and violence outcomes.