Intimate Partner Violence (IPV) and Anxiety Symptoms Among Currently Married Women In Zambia

Background and Purpose: Intimate partner violence (IPV) is a widespread public health and human rights issue that adversely affects women’s mental health. In Zambia, married women may be particularly vulnerable to IPV due to gender inequalities and ongoing partner-related stressors. Anxiety symptoms can impair daily functioning and well-being, and are increasingly recognized as a key mental health outcome associated with IPV. However, limited nationally representative studies have examined the relationship between IPV and anxiety symptoms among married women in Zambia. Therefore, this study examined the association between IPV and anxiety symptoms among currently married women in Zambia.

Methods: This cross-sectional study used data from the 2024 Zambia Demographic and Health Survey (ZDHS), a nationally representative survey of currently married women aged 15–49 years who completed the Generalized Anxiety Disorder scale (GAD-7) and the domestic violence module (N≈5,904). The outcome variable included anxiety symptoms, measured using the GAD-7 and dichotomized as none/minimal (0–4) versus mild-to-severe (5–21) symptoms during the past two weeks. The primary independent variable included IPV (emotional, physical, and/or sexual violence) experienced during the past 12 months (yes/no). Covariates included women’s characteristics (age group, marital duration, education level, work status, household wealth index, residence type, health status, health insurance, media exposure, and region) and partner’s characteristics (age group, education, work status, and alcohol use). Weighted descriptive statistics were used to calculate the frequencies and percentages, and multivariate logistic regression analyses were conducted to assess the association between IPV and anxiety symptoms, while adjusting for potential confounder using SPSS v. 31.0 (p<.05).

Results: Among 5,904 currently married women, 11.7% reported mild-to-severe anxiety symptoms during the past two weeks; 20.2% experienced any emotional violence; 27.8% experienced any physical violence; 9.2% experienced any sexual violence; and 36.6% experienced any IPV during the past 12 months. After adjusting for other factors in the regression model, women who were currently married and experienced emotional violence (OR=0.53; p<.001) or sexual violence (OR=0.66; p<.001) had lower odds of reporting anxiety symptoms during the past two weeks compared to those without these IPV-related exposures. However, experiencing physical violence was not significantly associated with anxiety symptoms during the past two weeks (OR=0.57; p=.817). In addition, women who experienced any of these forms of IPV had lower odds of reporting anxiety symptoms during the past two weeks (OR=0.57; p<.001).

Conclusions and Implications: IPV is highly prevalent among currently married women in Zambia, yet its connection with anxiety symptoms appears complex and varies by type of IPV. Although emotional and sexual violence were associated with lower reported odds of anxiety symptoms, these counterintuitive findings may reflect reporting biases, coping mechanisms, or unmeasured contextual factors influencing the outcome. This study underscores the need to disaggregate IPV types and to interpret associations cautiously. Social work practice should continue to prioritize IPV screening alongside culturally responsive, validated mental health measurement tools and support services. Finally, future research should focus on developing culturally adapted anxiety measurement tools, addressing underreporting, and strengthening integrated IPV and mental health interventions in Zambia.