Drought, Extreme Heat, and Intimate Partner Violence in Low- and Middle-Income Countries.

IMPORTANCE

Recent evidence has shown that elevated temperatures are associated with a higher risk of intimate partner violence (IPV), a serious violation of human rights. However, it remains unclear whether drought also heightens the risk and whether drought and extreme heat jointly affect IPV.

OBJECTIVE

To investigate the interactive association between drought, extreme heat, and IPV in 42 low- and middle-income countries (LMICs).

DESIGN, SETTING, AND

PARTICIPANTS

This cross-sectional study included women answering multicluster surveys in sub-Saharan Africa, South and Southeast Asia, Latin America, and the Caribbean between 2003 and 2020. The analysis was conducted from January to July 2024.

EXPOSURES: Drought was measured by the standardized precipitation evapotranspiration index at a timescale of 1, 3, 6, or 12 months. Extreme heat days were defined as days with maximum temperature above the 90th, 92.5th, 95th, or 97.5th percentile of the cluster-specific distribution. The respective numbers of extreme heat days and drought months were calculated to evaluate the interaction between drought and extreme heat.

MAIN OUTCOMES AND MEASURES: IPV against women experienced in the past 12 months before the survey, including emotional, physical, and sexual violence.

RESULTS

Among a total of 494 471 women (mean [SD] age, 32.1 [8.5] years) surveyed, the prevalence for any, emotional, physical, and sexual IPV was 28.3% (139 901 women), 16.8% (83 100 women), 19.5% (96 531 women), and 7.4% (36 804 women), respectively. Overall drought exposures at all timescales were associated with increased IPV risk, with the largest effect size at the 12-month scale (relative risk [RR], 1.07 [95% CI, 1.06-1.09]), where mild (RR, 1.08 [95% CI, 1.06-1.09]) and severe (RR, 1.06 [95% CI, 1.04-1.08]) drought were also associated with any IPV. When stratifying violence IPV by type, the largest effect sizes were observed for overall drought with emotional violence at the 1-month scale and with physical violence at the 12-month scale. When estimating relative excess risk due to interaction in 2 ways, there was a negative and significant interaction between drought and extreme heat, defined using the threshold of the 97.5th percentile of the distribution.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study of 42 LMICs, drought conditions with various durations were associated with increased IPV risk. Given the increasing extreme events under climate change, there is a pressing need for enhanced initiatives to prevent domestic violence.