Experiences of Intimate Partner Violence for Women Living with Alcohol-Using Husbands In Zambia

Background and Purpose: Intimate partner violence (IPV) remains an important public health and human rights issue in sub-Saharan Africa, including Zambia, where women continue to experience high levels of physical, emotional, and sexual abuse in their communities. IPV is associated with numerous adverse physical, mental, and reproductive health outcomes and is shaped by multiple socioecological factors. Partner alcohol use has been identified as a major behavioral risk factor for IPV, as it may increase aggression, impair judgment, and intensify household conflict. Despite growing attention to this issue, limited studies have linked the intricate connection between alcohol use and IPV using recent nationally representative sample in Zambia. Therefore, we hypothesize that women whose husbands uses alcohol will be associated with higher likelihood of experiencing IPV compared to those with non-alcohol using husbands.

Methods: This study used cross-sectional data from the 2024 Zambia Demographic and Health Survey (ZDHS), a nationally representative survey of married women aged 15–49 years who completed the domestic violence module in Zambia (N ≈ 5,904). The four primary outcomes included experiencing physical violence, emotional violence, and/or sexual violence, and any form of IPVs during the past 12 months, and were dichotomously coded as yes or no. The primary independent variable included husband/partner alcohol use during the past 12 months (yes/no). Covariates included women’s age, religion, residence, household wealth index, work status, education, media exposure, husband’s age, and husband’s education and work status. Four logistic regression models were conducted to assess the association between husband’s alcohol use and IPV while adjusting for potential confounders using SPSS vs.31.0.

Results: Out of 5904 married women, 34.2% had husbands who used alcohol during the past 12 months, 36.6% experienced any form of IPV, while 9.2% experienced sexual violence, 20.2% experienced emotional violence, and 27.8% experienced physical violence. After controlling for confounding factors in the regression model, women whose husbands used alcohol during the past 12 months had higher odds of experiencing any IPV (OR=3.76; P<.001), sexual violence (OR=2.45; P<.001), physical violence (OR=3.56; P<.001), and emotional violence (OR=3.47; P<.001) compared to women whose husbands had never used alcohol during the past 12 months.

Conclusions and Implications: This study demonstrates that women living with alcohol-using husbands experience significantly higher risks of physical, emotional, and sexual IPV, and cumulative IPV underscoring husbands’ alcohol use as a major and modifiable risk factor. This further emphasizes the need for comprehensive, multi-level interventions that can be used to combine IPV prevention with alcohol reduction strategies in communities, schools and healthcare settings. Government should clearly implement robust policy efforts to regulate alcohol use in the communities (e.g., availability time and pricing), increase routine IPV screening, and support survivor-centered services within health and social systems. Finally, future studies should focus on intervention studies to guide evidence-based policies and scalable prevention programs in Zambia.