Top

Published in:

01-08-2010 | Original Paper

The Effects of Husband’s Alcohol Consumption on Married Women in Three Low-Income Areas of Greater Mumbai

Authors: Marlene J. Berg, David Kremelberg, Purva Dwivedi, Supriya Verma, Jean J. Schensul, Kamla Gupta, Devyani Chandran, S. K. Singh

Published in: AIDS and Behavior | Special Issue 1/2010

Abstract

Gender-based violence rooted in norms, socialization practices, structural factors, and policies that underlie men’s abusive practices against married women in India is exacerbated by alcohol. The intersection of domestic violence, childhood exposure to alcohol and frustration, which contribute to drinking and its consequences including forced sex is explored through analysis of data obtained from 486 married men living with their wives in a low-income area of Greater Mumbai. SEM shows pathways linking work-related stress, greater exposure to alcohol as a child, being a heavy drinker, and having more sexual partners (a proxy for HIV risk). In-depth ethnographic interviews with 44 married women in the study communities reveal the consequences of alcohol on women’s lives showing how married women associate alcohol use and violence with different patterns of drinking. The study suggests ways alcohol use leads from physical and verbal abuse to emotional and sexual violence in marriage. Implications for gendered multi-level interventions addressing violence and HIV risk are explored.

Child marriage in India, while prohibited by law since 1929, and steadily declining is still a reality in India particularly in rural and semi-urban areas. UNICEF recognizes child marriage as a violation of human rights as young girls are not yet-physically, mentally and emotionally ready to perform the obligations of marriage and are often unprepared to protect themselves against violence and exploitation (www.unicef.org/india/child_protection.Feb.2010_1536.htm).

As Levine's test of the homogeneity of variances was found to be significant at the .05 alpha level, the Games-Howell post hoc test was used, as it does not assume the equality of variances.

Chi-square difference tests were used to make the determination of whether the unconstrained or a constrained model would be used. Here, the unconstrained model refers to a model in which all parameters are estimated separately for both groups, while in the constrained model, one or more sets of parameters are constrained to be equal between the two groups. If a constrained model does not have significantly worse model fit, it is preferred over an unconstrained or less constrained model as constrained models are simpler, or more parsimonious. A chi-square difference test revealed the unconstrained model to be preferred over any of the constrained models, suggesting the use of two separate structural equation models, one including respondents who drink at home, the other including respondents who primarily drink at other locations.

Initially, the following variables were included in the model predicting violence: region of residence, religion, the difference in education between husband and wife, the difference in age between husband and wife, the hypermasculinity scale, the work related stress scale, number of partners, relationship with wife scale, years married, whether the respondent has children, the index of childhood exposure to alcohol, alcohol total, and pattern of drinking. The finalized models, presented in this paper, were determined after a series of revisions. The majority of the variables removed from the model were removed as they were not found to directly or indirectly affect violence.

Direct effects are defined as those influences (factors/independent variables) that are unmediated by any other variable in the model. They are specified as coefficients in the SEM matrix and displayed on the line linking one variable to another in the figure depicting the model. Indirect effects are mediated by at least one intervening variable. They are determined by subtracting the direct effects from the total effects [28].

In the remaining seven cases violence had ended; in two instances the women had fled the situation through divorce or separation; in one case the husband had stopped drinking; in another instance the intervention of friends and neighbors resulted in an end to the violence and in the remaining three cases the violence ended although the drinking did not.

Jeyaseelan L, Kumar S, Neelakantan N, Peedicayil A, Pillai RND. Physical spousal violence against women in India: some risk factors. J Biosoc Sci. 2007;39(5):657–70.CrossRefPubMed

Duvvury N, Nayak MB, Allendorf K. Links between masculinity and violence: aggregate analysis. Domestic violence in India: exploring strategies, promoting dialogue. Men, masculinity and domestic violence in India. Summary report of four studies. Emeryville, CA: Alcohol Research Group at the Public Health Institute; 2002.

Ackerson LK, Subramanian SV. Domestic violence and chronic malnutrition among women and children in India. Am J Epidemiol. 2008;167(10):1188–96.CrossRefPubMed

Solomon S, Subbaraman R, Solomon SS, et al. Domestic violence and forced sex among the urban poor in South India: implications for HIV prevention. Violence Against Women. 2009;15(7):753–73.CrossRefPubMed

Poonacha V. Exploring differences: an analysis of the complexity and diversity of the contemporary Indian women’s movement. Aust Feminist Stud. 1999;14(29):195–206.CrossRef

Ackerson LK, Subramanian SV. Domestic violence and chronic malnutrition among women and children in India. Am J Epidemiol. 2008;167(10):1188–96.

Agarwal B, Panda P. Toward freedom from domestic violence: the neglected obvious. J Human Develop. 2007;8(3):359–88.CrossRef

Dworkin SL, Ehrhardt AA. Going beyond “ABC” to include “GEM”: critical reflections on progress in the HIV/AIDS epidemic. Am J Public Health. 2007;97(1):13–8.CrossRefPubMed

Gupta GR. Globalization, women and the HIV/AIDS epidemic. Peace Rev. 2004;16(1):79–83.CrossRef

10.

Parker RG, Easton D, Klein CH. Structural barriers and facilitators in HIV prevention: a review of international research. AIDS. 2000;14:S22–32.CrossRefPubMed

11.

Go VF, Sethulakshmi CJ, Bentley ME, et al. When HIV-prevention messages and gender norms clash: the impact of domestic violence on women’s HIV risk in slums of Chennai, India. AIDS Behav. 2003;7(3):263–72.CrossRefPubMed

12.

Krishnan S. Do structural inequalities contribute to marital violence? Ethnographic evidence from rural South India. Violence Against Women. 2005;11(6):759–75.CrossRefPubMed

13.

George WH, Stoner SA. Understanding acute alcohol effects on sexual behavior. Ann Rev Sex Res. 2000;11:92–124.

14.

Dolezal C, Carballo-Diéguez A, Nieves-Rosa L, Díaz F. Substance use and sexual risk behavior: understanding their association among four ethnic groups of Latino men who have sex with men. J Subst Abuse. 2000;11(4):323–36.CrossRefPubMed

15.

Windle M. The trading of sex for money or drugs, sexually transmitted diseases (STDs), and HIV-related risk behaviors among multisubstance using alcoholic inpatients. Drug Alcohol Depend. 1997;49(1):33–8.CrossRefPubMed

16.

Stanley S. Interpersonal violence in alcohol complicated marital relationships (a study from India). J Fam Violence. 2008;23(8):767–76.CrossRef

17.

Silverman JG, Decker MR, Saggurti N, Balaiah D, Raj A. Intimate partner violence and HIV infection among married indian women. JAMA. 2008;300(6):703–10.

18.

Chandrasekaran V, Krupp K, George R, Madhivanan P. Determinants of domestic violence among women attending and human immunodeficiency virus voluntary counseling and testing center in Bangalore, India. Indian J Med Sci. 2007;61(5):253–62.

19.

Go VF, Johnson SC, Bentley ME, et al. Crossing the threshold: engendered definitions of socially acceptable domestic violence in Chennai, India. Cult Health Sex. 2003;5(5).

20.

Campbell JC, Baty ML, Ghandour RM, Stockman JK, Francisco L, Wagman J. The intersection of intimate partner violence against women and HIV/AIDS: a review. Int J Injury Control Safety Promotion. 2008;15(4):221–31.CrossRef

21.

George A, Jaswal S. Understanding sexuality: an ethnographic study of poor women in Bombay, India. Washington, DC: International Center for Research on Women; 1995. p. 12.

22.

Santhya KG, Dasvarma GL. Spousal communication on reproductive illness among rural women in southern India. Cult, Health & Sex. 2002;4(2):223–36.CrossRef

23.

Jejeebhoy SJ, Koenig MA, Elias C, NetLibrary I. Investigating reproductive tract infections and other gynaecological disorders a multidisciplinary research approach. 2003.

24.

Green J, Plant MA. Bad bars: a review of risk factors. J Subst Use. 2007;12(3):157–89.CrossRef

25.

Sharma K. Behind closed doors: domestic violence in India. Feminist Review. 2006;83(1):169–71.CrossRef

26.

Heise LL. Violence against women: an integrated, ecological framework. Violence Against Women. 1998;4(3):262–90.CrossRefPubMed

27.

Saggurti N, Malviya A. HIV transmission in intimate partner relationships in India. New Delhi, India: UNAIDS; 2009.

28.

Bollen KA. Total, direct, and indirect effects in structural equation models. Sociol Methodol. 1987;17:37–69.CrossRef

29.

International Institute for Population Sciences (IIPS) and Macro International. 2007. National family health survey (NFHS-3), 2005–2006: India, Domestic violence. Vol, 1, Chap. 15. Mumbai: IIPS.

Title: The Effects of Husband’s Alcohol Consumption on Married Women in Three Low-Income Areas of Greater Mumbai
Authors: Marlene J. Berg
David Kremelberg
Purva Dwivedi
Supriya Verma
Jean J. Schensul
Kamla Gupta
Devyani Chandran
S. K. Singh
Publication date: 01-08-2010
Publisher: Springer US
Published in: AIDS and Behavior / Issue Special Issue 1/2010
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-010-9735-7

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The Effects of Husband’s Alcohol Consumption on Married Women in Three Low-Income Areas of Greater Mumbai

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Special Issue 1/2010

Two Sides of the Same Story: Alcohol Use and HIV Risk Taking in South India

Spatial Dimensions of Research on Alcohol and Sexual Risk: A Case Example from a Mumbai Study

Feasibility and Effectiveness of HIV Prevention Among Wives of Heavy Drinkers in Bangalore, India

Alcohol Use, Sexual Risk Behavior and STIs Among Married Men in Mumbai, India

The Use of Qualitative Comparative Analysis for Critical Event Research in Alcohol and HIV in Mumbai, India

Alcohol and Sexual Risk Behavior among Migrant Female Sex Workers and Male Workers in Districts with High In-Migration from Four High HIV Prevalence States in India

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page