Screening men for partner violence in a primary care setting. A new strategy for detecting domestic violence.

BACKGROUND Health care domestic violence initiatives have given little attention to screening men for violent behavior toward their partners. We conducted this study to assess whether men would answer questions about partner violence in a health care setting, to estimate the prevalence of violent behavior in male primary care patients, and to identify characteristics associated with violent behavior. METHODS We used an anonymous written survey at three family medicine clinics. The survey instrument included the Conflict Tactics Scale to measure aggressive and violent behavior. Standard questions assessed demographic variables and health behaviors. RESULTS Three hundred seventy-five men were seen during the study. Of these, 317 (85%) participated and 237 met inclusion criteria. Thirty-two men (13.5%, 95% confidence interval (CI), 9.1-17.9) disclosed physical violence toward their partner in the previous 12 months. Ten men (4.2%, 95% CI, 3.7-4.8) reported severe violence. Men with increased alcohol consumption, depression, or history of abuse as children were more likely to report violent behavior. Presence of all three variables resulted in a probability of violence of 41%, compared with a baseline probability of 7% if no risk factors were present. CONCLUSIONS Primary care physicians should consider screening male patients for aggressive behavior toward their intimate partners. Physicians should be especially cognizant of this possibility in men who are depressed, heavy alcohol users, or were childhood victims of abuse.