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  • Consecutive adult patients (aged 18 years and older) who required STI services in a dermatovenereology dispensary (STI out-patient clinic) in St. Petersburg, Russia were invited to participate in a cross-sectional study which aimed to examine factors associated with female reproductive health from May 2011 to November 2011. A total of 502 patients agreed to participate in and completed a computer-assisted interviewer-administered questionnaire. Written informed consent was obtained from all participants and the study was approved by the institutional review boards of the Biomedical Center in St. Petersburg, Russia and Yale University, CT, USA. Of the 300 women recruited into the study, 299 answered the questions about intimate partner violence and therefore comprised the final analytic sample. The decision to include only women in the present analyses was made to reduce the complexity of research questions because women and men had different recruitment criteria. Eligibility for women’s participation included: (1) age between 18 and 50; (2) sexually active during the past 6 month; (3) not trying to get pregnant; and (4) biologically able to have children. A questionnaire was used to collect information including demographic and health characteristics, alcohol and illicit drug use, sexual behaviors, sensation seeking and experience of violence including history of childhood abuse and IPV. The questionnaire was constructed in English, translated to Russian, and then translated back to English to ensure the integrity of the syntax and meaning. Demographic information included age at survey, marital status, level of education, employment status and income level. Alcohol and illicit drug use: Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test (AUDIT) which includes 10 questions with a total score that ranges from 0 to 40 [32]. A score of 8 or higher is usually indicative of alcohol misuse [32]. The Cronbach’s α for the AUDIT was 0.87 in the current sample. Participants were also asked whether they had ever used illicit drugs. Sexual behaviors: Participants were asked the age of their first sexual experience and the number of sexual partners in their lifetime. Considering that some participants had a much higher number of sexual partners, this variable was dichotomized according to the median value. Sensation seeking: The Brief Sensation Seeking Scale (BSSS-8) developed by Hoyle et al. was used to measure sensation seeking [33]. The BSSS-8 contains 8 Likert-type items, including “I would like to explore strange places,” “I would like to take off on a trip with no preplanned routes or timetables,” “I get restless when I spend too much time at home,” “I prefer friends who are exciting and unpredictable,” “I like to do frightening things,” “I would like to try bungee jumping,” “I like wild parties,” and “I like new and exciting experiences even if I have to break the rules.” All items ranged from 1 =  “strongly disagree” to 5 =  “strongly agree” and the BSSS-8 was obtained by averaging responses to all items. The scale was internally consistent in the current sample (Cronbach’s α = 0.77). History of childhood abuse: We assessed experiences of childhood abuse from two aspects, emotional abuse and physical abuse, respectively, based on two questions: “How often did your parent or caretaker insult, swear or threaten you” and “How often did your parent or caretaker push, grab, pinch or beat you” during their first 18 years. Although we asked a question related to childhood sexual abuse, “How often did your parent or caretaker touch you in a sexual way or had you touch him/her in a sexual way,” only one woman had such an experience. Thus, childhood sexual abuse was not included in the present analysis. These questions were adapted from the Conflict Tactics Scale (CTS) and the response categories were never, rarely, frequently and way too frequently [34]. The presence or absence of each type of childhood abuse was dichotomized as No–never vs. Yes–any of the three positive responses. Perpetration and victimization of IPV: IPV perpetration was defined as having ever (a) insulted, sworn at, or threatened a sexual partner; (b) pushed, grabbed, slapped, punched, beaten up, or choked a sexual partner; or (c) physically forced a sexual partner to have sex or do something sexually that he or she did not want to do. IPV victimization was defined as having ever been the target of the aforementioned actions by a sexual partner. These partner violence items were adapted from the CTS and have been successfully used in Russia to measure intimate partner violence [31], [34]. Those who answered “yes” to any one of the three items were further asked, “The last time this happened, were you or your partner high on alcohol or drugs?” An answer of “yes” was classified as IPV under the influence of a substance. Chi-square tests and ANOVA (analysis of variance) F-tests were used to examine group differences by last IPV status (e.g., last perpetration under and not under the influence of a substance and no perpetration) for categorical and continuous variables, respectively. Multinomial logistic regression was used to determine significant correlates of IPV under and not under the influence of a substance. None of the demographic characteristics were significantly associated with either IPV perpetration or victimization in the multinomial logistic regression; therefore they were not included in the final models. The significance level was defined as p<.05 and the data were analyzed using SAS software version 9.1 (SAS Institute Inc., 2003).
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