Differences in Intimate Partner Violence Screening, Violence Exposure, and Risk of Lethality Among Veterans with...

Intimate partner violence (IPV) is a serious public health concern linked with adverse health consequences such as posttraumatic stress disorder, depression, and anxiety. Although substance use disorders (SUDs) have been associated with IPV, there is limited research on IPV screening and disclosure among health care patients with SUDs, particularly veterans.

To examine the rates of IPV screening and disclosure among veterans with alcohol use disorder (AUD) and opioid use disorder (OUD) and to identify IPV subtypes and lethality risks, disaggregated by sex and SUD type.

This study analyzed IPV screening and disclosure rates among veterans in the Veterans Health Administration (VHA) diagnosed with AUD and/or OUD from January 2016 to December 2021.

790,384 veterans diagnosed with AUD, OUD, or both in VHA electronic health records.

Data included rates of IPV screening, rates of positive IPV screens (IPV+), IPV subtypes (psychological, physical, sexual), and risk of IPV-related lethality (escalation, strangulation, belief of being killed).

In our sample, 22.36% (n = 176,739) were screened for IPV, with 12.24% (n = 16,086) of those with a valid administration, screening positive. Female veterans had higher rates of being screened for IPV and positive IPV disclosures than males. Veterans with co-occurring AUD and OUD were more likely to screen positive for IPV than those with only AUD or OUD. Female veterans, particularly those with co-occurring AUD and OUD, were more likely to report high-lethality IPV compared to male veterans with AUD only.

Approximately 1 in 5 veterans in the cohort were screened for IPV. Female veterans with co-occurring AUD and OUD had the highest screen positive rate and severity of IPV. These findings highlight the need for routine IPV screening in VHA, tailored interventions, and integrated treatments addressing both SUD and IPV to improve health outcomes.