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

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.