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Intimate Partner Violence Reproductive and Sexual Coercion

Intimate Partner Violence

1. Intimate partner violence is a pattern of assaultive and coercive behaviors that may include inflicted physical injury, psychological abuse, sexual assault, _____________, stalking, deprivation, intimidation, and threats.

A. Manipulation

B. Progressive Isolation

C. Repeated Control

D. None of the above


Reproductive and Sexual Coercion

2. Reproductive and sexual coercion involves behaviors aimed to maintain power and control over reproductive health by someone who is, was, or wishes to be involved in an intimate or dating relationship with an adult or adolescent.

A. True

B. False


Sexual Coercion

3. Sexual coercion includes a range of behaviors that a partner may used related to sexual decision-making to pressure or coerce a person to have sex without using physical force.

A. True

B. False


What Message Do We Want to Share with Adolescent and Adult Males?

4. Recent research provides some insight into gay and bisexual males' experiences with sexual coercion, with a survey of this population indicating that 14.8% reported unwanted sexual activity.  

A. True

B. False


Magnitude of the Problem

5. Intimate partner violence (IPV) and reproductive and sexual coercion are health issues that disproportionately affect women, as demonstrated by which of the following?

A. 20% of females college students and 4% of male college students reported one or more experiences of unwanted sexual intercourse.

B. A survey of 10th and 11th graders revealed that one-third of girls and 8.4% of boys had been victims of sexual coercion, defined as sexual behaviors involving verbal coercion, threats of force, or use of drugs or alcohol

C. Approximately 1 in 5 women have been physically and/or sexually assaulted by a current or former partner

D. Nearly half (45.9%) of women experiencing physical abuse in a relationship also disclose forced sex by their intimate partner


6. Health care providers have an essential role in prevention of IPV and reproductive and sexual coercion by discussing healthy, consensual, and safe relationships with all patients.

A. True

B. False


General Reproductive Health Effects of Abuse

7. In one study, adolescent girls who experienced IPV were nearly ___ times more likely to have forgone health care in the past 12 months compared to non-abused girls.

A. 2

B. 2 ½

C. 3

D. 3 ½


Condom Use

8. Studies indicate that adolescent boys who perpetrate dating violence are less likely to use condoms, and for girls, current involvement in verbally abusive relationships was associated with not using a condom during the most recent sexual intercourse.

A. True

B. False


Teen Pregnancy

9. Each of the following is an accurate statement about teen pregnancy, IPV, and dating violence EXCEPT:

A. Adolescent girls who are currently involved in physically abusive relationships are 3.5 times more likely to become pregnant than non-abused girls

B. Adolescent mothers who experience physical partner abuse within three months after delivery were nearly twice as likely to have a repeat pregnancy within 24 months

C. In a qualitative study of adolescent girls who experienced dating violence, approximately one-quarter (26.4%) reported that their partners were trying to get them pregnant

D. Among female teens seen at family planning clinics, 1 in 3 had experienced physical or sexual IPV and pregnancy pressure


The Role of Pregnancy Coercion in Women Terminating or Continuing Their Pregnancies

10. Women and teens who seek abortions are nearly 5 times more likely to have been victimized by an intimate partner in the past year compared to women who continue their pregnancies.  

A. True

B. False


11. For women, being in an abusive relationship increases the likelihood of:

A. Having an eating or mood disorder

B. Poor school or job performance

C. Having a partner with known HIV risk factors

D. None of the above


Preparing Your Practice-Creating a Safe Environment for Assessment and Disclosure

12. Having a written policy and providing training on IPV and reproductive and sexual coercion, including the appropriate steps to inform patients about confidentiality and reporting requirements, is an important step in creating a safe health care setting.

A. True

B. False


Training Resources

13. Promising Futures: Family Violence Prevention is a free resource developed by Futures that can be used for self-directed training and to provide training to staff and students about IPV and women's health.

A. True

B. False


Verbal Assessment

14. While assessment questions for IPV should be embedded in self-administered medical history forms, asking questions above IPV and reproductive and sexual coercion as part of a face-to-face assessment is not recommended, as this may make the patient uncomfortable and less likely to seek treatment.

A. True

B. False


Brief, Evidence-Based Assessment and Intervention With Safety Card

15. The safety card for reproductive health includes self-administered questions for IPV and safety planning strategies including:

A. If your partner checks your cell phone, talk to your health care provider about using their phone to call domestic violence services-so your partner can't see it on your call log

B. If you have an STD and are afraid your partner will hurt you if you tell him, talk with your health care provider about how to be safer and how they might tell your partner about the infection without using your name

C. Studies show educating friends and family about abuse can help them take steps to be safe-giving them this card can make a difference in their lives

D. All of the above


How Can Using the Safety Card Help With Screening Given Many Women Choose Not To Disclose What Is Happening To Them?

16. Research shows that ___________________ about rape and sexual assault influence(s) a woman's perceptions of sexually coercive experiences.

A. Cultural stereotypes

B. Familial messages

C. Community education

D. Environmental customs


17. Regardless of whether a patient discloses abuse, assessment is an opportunity to provide education about how abusive and controlling behaviors in a relationship can affect her reproductive health.

A. True

B. False


18. The use of the safety card providers an integrated approach to inform patients about the increased risk of contracting STIs/HIV in abusive relationships, teaches condom negotiation skills, and offers female-controlled protective strategies that can lead to improved reproductive health outcomes and enhanced quality of care.

A. True

B. False


Birth Control Options Counseling

19. The best contraceptive method for those experiencing reproductive coercion who want to prevent or defer pregnancy is probably the birth control shot (Depo-Provera) because it is safe and effective and only needs to be given every few months.  

A. True

B. False


Emergency Contraceptive Visit

20. When someone comes to a health care setting for Emergency Contraception (EC), often called the morning after pill, key questions should be asked and patient education provided to help determine whether the sex was consensual or if any contraceptive tampering may be occurring.

A. True

B. False


Supported Referral

21. Two key strategies for supported referral to address reproductive/sexual coercion and IPV are acknowledging a patient's safety concerns and:  

A. Providing harm reduction strategies

B. Offering options

C. Demonstrating the link between violence and reproductive health

D. Contacting an on-call advocate or counselor


What is Trauma Informed Reporting?

22. When professionals are completing a mandated trauma report, they should inform patients about the process of reporting and help them to understand what to expect but should not involve them in making the report, as this may increase their fear and anxiety.

A. True

B. False


Documentation and Follow-Up

23. Which of the following information should NOT be routinely documented in patients' charts?  

A. Confirmation that the patient was screened for IPV and reproductive and sexual coercion or the reason why screening could not be done

B. Patient's family history of domestic or sexual violence

C. Patient response to screening

D. Documentation of resources provided such as Safety Cards and any referrals made


What About Boys and Men?

24. The opportunities for screening, education, and prevention with male patients are very different to those described for female patients so practitioners need to be aware of these differences.

A. True

B. False


Part 4: Policy Implications and System Response

25. Health care setting protocols for identifying and responding to IPV should incorporate assessment strategies that include setting, frequency, cultural consideration, and:

A. Education level of the patient

B. Age and gender

C. Language issues

D. Psychological history


Creating Change and Helping Staff Exposed to Violence

26. In any work environment, life experiences of the staff may influence their comfort level and effectiveness with addressing IPV and reproductive and sexual coercion with patients.

A. True

B. False


27. When documenting relevant history which of the following is NOT generally included in the relevant history?

A. Social history, including relationship to abuser and abuser's name if possible

B. Patient's appearance and demeanor

C. Patients' accounts of any threats made or other psychological abuse

D. Patient's specific statement about what events lead up to the abuse


Follow-Up and Continuity of Care for Victims

28. For current and previous victims of IPV, providers should ensure that the patient has a connection to a primary care or OB/GYN provider, and coordinate and monitor an integrated care plan with community based experts and other health care specialists or professionals as needed.

A. True

B. False


Appendix C: The American College of Obstetricians & Gynecologist-Committee Opinion-Consequences of IPV

29. Approximately ________  pregnant women are abused each year in the United States, and IPV has been associated with poor pregnancy weight gain, infection, anemia, tobacco use, fetal injury, stillbirth, preterm delivery, and low birth weight. 

A. 324,000

B. 369,000

C. 286,000

D. 245,000


Role of Health Care Providers

30. Obstetrician gynecologists are in the unique position to provide assistance to women, so screening for IPV during obstetric care should occur at the first prenatal visit and at least one other time during the pregnancy or at the postpartum checkup.

A. True

B. False


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