Current study findings indicate that TDV perpetration and involvement in neighborhood violence were highly prevalent and correlated among this young clinic-based sample of urban adolescent males. TDV perpetration was particularly prevalent among those who reported having had sex (45%) and largely determined by the high proportion of boys reporting sexual violence perpetration (42%), particularly forced/coerced vaginal sex (37%). Our measures for identifying sexual violence perpetration were developed as a result of previous qualitative work among a similar sample of urban adolescent males.27
However, the prevalence reported in our sample using these measures was much higher than reported elsewhere. Thus, more work is needed to confirm this high prevalence of sexual violence perpetration among urban adolescent males and to ensure the consistent use of measures tailored for this population of males. These findings may also highlight the need for future research and prevention efforts to further consider TDV perpetration among boys who report having sex; our findings suggest that not only are boys who report having ever had sex more likely to report forcing/coercing sexual activity but that these boys are also more likely to report other forms of TDV perpetration as well.
Notably, to our knowledge, this study is among the first quantitative assessments to show the relevance of TDV perpetration to boys’ gender attitudes and perceptions of violence within peer and neighborhood contexts among a sample of urban adolescent males. While an increasing number of studies have utilized multilevel methods to examine the link between partner violence perpetration and actual
levels of neighborhood violence (or other neighborhood-related factors),39,40
the current study builds on such work and measured boys’ perceived
violence in both neighborhood and peer contexts, given that such perceptions of violence may be most directly influencing their attitudes and behaviors toward violence. Such analyses appear critical, given the high rates of beliefs regarding peer involvement in perpetration of TDV (20%) as well as perceptions of violent activity characterizing boys’ neighborhoods (76%) reported in this sample.
The finding that TDV perpetration is associated with involvement in neighborhood violence is consistent with previous work among adolescent males.15–18
While more work is needed to identify temporality of such an association (i.e., whether one type of violence has an influence on the initiation of the other), it appears that boys who engage in violence perpetration in one context are likely to also report violence perpetration across other contexts. Much of the existing literature as well as programming to address violence perpetration often focuses on a single type of violence (e.g., school programs that address TDV, community programs that address neighborhood or gang violence); however, our study findings suggest that research and programming is needed that considers multiple forms of violence perpetration simultaneously (e.g., to have community- or neighborhood-based programs that address gang violence and neighborhood violence, as well as TDV perpetration all within the same program).
Findings of the current study indicating the contribution of both boys’ perceptions of peer TDV perpetration and perceptions of neighborhood violence to boys’ own TDV perpetration are congruent with previous work highlighting the influence of social and contextual norms in determining violence perpetration, particularly among adolescent boys.23–25,31
Such findings suggest that perceptions regarding violence occurring in environmental contexts are linked to boys’ own behaviors; however, violent behaviors may also influence boys’ perceptions of their context as well. More work is needed to understand these interrelations in order to best inform prevention and intervention approaches. However, this preliminary work further suggests the need for approaches that address TDV perpetration by altering environmental influences, particularly those that are most pertinent to urban contexts. Our findings suggest that future programs might benefit from taking a community-based approach and addressing an array of concerns affecting boys’ life contexts
, particularly in such urban environments often plagued with high levels of violence, both at home and on the street.
The finding that TDV perpetration is linked to boys’ greater support of traditional gender norms, particularly norms related to relationships and sex, is also consistent with previous work among adult and non-urban adolescent samples.31,41
In contrast with recent studies negating the role of gender norms in conceptualizing TDV perpetration, this finding supports the need for a gendered approach within prevention programming (e.g., tailoring components by gender, focusing on social norms associated with boys’ attitudes toward gender—particularly attitudes supportive of gender inequities). Additional related research on TDV is required to further inform a gender-based conceptual framework for ongoing work to address this issue. Notably, supportive attitudes toward traditional male gender norms are also linked to a range of high-risk health behaviors among boys and threaten the lives of boys in immense ways (e.g., boys have greater rates of substance and tobacco use,42–44
homicide, other injuries),47
further showcasing the need to address social norms related to gender. These statistics related to poor morbidity and mortality among boys and men, as well as the current study findings linking such norms to TDV perpetration, together, indicate that more work is needed to address gender norms, particularly within the context of urban populations of male adolescents where support of more traditional gender norms often appears exacerbated.
Given study findings from the fully adjusted models, which highlight the relevance of boys’ own neighborhood violence involvement as well as support of traditional gender norms to TDV perpetration (above and beyond other perceptions of violence in boys’ environment), the current study supports interventions that focus efforts (1) to prevent multiple types of violent behaviors among boys across contexts and (2) to address inequitable gender attitudes. Such components appear to be particularly essential for the reduction of male perpetration of TDV and the multitude of negative health outcomes associated with such violence. Many of the existing programs are limited to TDV education or intervention counseling (e.g., school-based education/prevention programs, batterer’s intervention programs working to reduce TDV perpetration among boys who have already perpetrated TDV) have addressed the issue of TDV using an individual-level approach; however, altogether, current findings highlight the potential utility of addressing this issue at the community/neighborhood level as well (e.g., developing interventions to change environmental factors that promote violence involvement, alleviating problematic social norms related to violence or gender).
These findings should be interpreted in light of several limitations. Our data rely on self-reported responses, and thus, items related to TDV perpetration as well as other items that may be considered stigmatizing may be underreported; despite this limitation, a high prevalence of each type of violence perpetration was observed. Additionally, prior studies on sensitive topics have found that ACASI improved reliability and accuracy in self-reported data collection.34,35
Furthermore, because a subset of analyses were limited to 134 boys who had reported sex, we had reduced statistical power to conduct these regression analyses; however, despite limited statistical power, we found extremely strong associations between multiple variables of interest. While the findings from the fully adjusted models in Table may be influenced by collinearity between variables, we did conduct relevant tests to ensure that such analyses were suitable; however, more work is needed to confirm such findings related to TDV perpetration. Furthermore, clinics for this study were all selected from a single urban metropolitan area, and these sites primarily serve clients from low-income communities; thus, findings are most generalizable to lower income urban populations residing in similar metropolitan areas.
These limitations notwithstanding, the high prevalence of both TDV perpetration and involvement in neighborhood violence in this sample of male adolescents, particularly among boys who report having had sex (with almost half reporting TDV perpetration and almost 40% reporting neighborhood violence involvement), illustrates the critical nature of this problem across boys’ life contexts, particularly within the context of urban neighborhoods. Our findings highlight the need for additional studies to further investigate the environmental factors (especially those that pertain to urban neighborhood contexts) that influence TDV perpetration among male adolescents. Findings suggest that community-based interventions addressing neighborhood-level factors
are needed to reduce boys’ behaviors related to perpetration of multiple forms
of violence as well as an array of other problematic aspects of boys’ life contexts, including explicit efforts to reduce violence as a norm as well as problematic gender attitudes (e.g., increasing support for gender equity) among boys. In this way, study findings support the need for future programs to focus on preventing the perpetrating behavior
in dating relationships (in addition to focusing on education about victimization
as a way to prevent TDV, as often found in current published and evaluated TDV programs).51,52
While this approach has been widely instituted among non-TDV-related intervention efforts (e.g., addressing gang violence, violence between peers, bullying), more work is needed to incorporate an approach focused on changing or preventing
the perpetrating behavior with the issue of partner violence as well—with an approach that addresses multiple forms
of violence perpetration and exposures in boys’ life contexts. Neighborhood- or structural-level interventions may likely be critical in order to address exposures to violence within varied contexts (e.g., peer, neighborhood) and related social norms that may be influencing boys’ behaviors around violence involvement among such urban populations of adolescent boys.