Intimate partner violence norms cluster within households: an observational social network study in rural Honduras.

BACKGROUND Intimate partner violence (IPV) is a complex global problem, not only because it is a human rights issue, but also because it is associated with chronic mental and physical illnesses as well as acute health outcomes related to injuries for women and their children. Attitudes, beliefs, and norms regarding IPV are significantly associated with the likelihood of both IPV experience and perpetration. METHODS We investigated whether IPV acceptance is correlated across socially connected individuals, whether these correlations differ across types of relationships, and whether social position is associated with the likelihood of accepting IPV. We used sociocentric network data from 831 individuals in rural Honduras to assess the association of IPV acceptance between socially connected individuals across 15 different types of relationships, both within and between households. We also investigated the association between network position and IPV acceptance. RESULTS We found that having a social contact that accepts IPV is strongly associated with IPV acceptance among individuals. For women the clustering of IPV acceptance was not significant in between-household relationships, but was concentrated within households. For men, however, while IPV acceptance was strongly clustered within households, men's acceptance of IPV was also correlated with people with whom they regularly converse, their mothers and their siblings, regardless of household. We also found that IPV was more likely to be accepted by less socially-central individuals, and that the correlation between a social contact's IPV acceptance was stronger on the periphery, suggesting that, as a norm, it is held on the periphery of the community. CONCLUSION Our results show that differential targeting of individuals and relationships in order to reduce the acceptability and, subsequently, the prevalence of IPV may be most effective. Because IPV norms seem to be strongly held within households, the household is probably the most logical unit to target in order to implement change. This approach would include the possible benefit of a generational effect. Finally, in social contexts in which perpetration of IPV is not socially acceptable, the most effective strategy may be to implement change not at the center but at the periphery of the community.