Intimate partner violence against women: the Peruvian case.

To the Editor—In their original article, Ali et al1 state that in Karachi, the biggest city of Pakistan which is a country with an illiteracy rate of 45.1%,2 and one of the three countries with highest consumption of opiates,3 the factors most commonly associated with intimate partner violence (IPV) include illiteracy of women (odds ratio [OR]=5.9; 95% confidence interval [CI], 1.8-19.6), illiteracy of husbands (OR=3.9; 95% CI, 1.4-10.7), current smoker status of husbands (OR=3.3; 95% CI, 1.9-5.8), and substance use other than tobacco by husbands (OR=3.1; 95% CI, 1.7-5.7). Peru is a South American country where more alcohol is consumed per capita (8.1 L) than the average consumption in the rest of the world (6.1 L).4 According to Blitchtein-Winicki and ReyesSolari,5 alcohol consumption is the factor most commonly associated with IPV (OR=7.2; 95% CI, 5.4-9.6), along with a history of physical aggression of the father towards the mother (OR=1.7; 95% CI, 1.4-1.9). Other factors associated with increased risk of IPV include having previous partners (OR=1.4; 95% CI, 1.1-1.7) and cohabiting (OR=1.4; 95% CI, 1.2-1.6). This apparent difference in factors associated with IPV could be explained by the ecological theory according to which, to properly approach this phenomenon, one must take into account the interaction of factors at different levels of analysis, namely, individual, family relationships, relationships with others, and social. Thus, in different cultures, we find the same phenomenon but different causes associated with IPV (Table).1,5