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Does Witnessing Family Violence Influence Sexual and Reproductive Health of Adolescents and Young Adults? A Systematic Review

Objective: Family Violence (FV) is a prevalent and important health problem worldwide. Witnessing FV has been linked to negative mental, behavioral, and physical outcomes, similar to being a direct victim of FV. This study aims to investigate the influence of witnessing FV on sexual and reproductive health of adolescents and young adults (AYAs). Method: A systematic review was performed, including original studies between 2000 and 2015, both quantitative and qualitative, found in MEDLINE, EMBASE, PsycINFO, and Web of Science. Outcomes were chosen according to the WHO indicators for sexual and reproductive health. Forty-five studies were selected. Sample sizes ranged from 20 to 12,308 participants. Critical appraisal using CASP was performed on all articles. Results: Because of a broad range of outcomes and subjects, no meta-analysis could be performed. Results were grouped into 5 outcome categories. Witnessing FV seems to have an influence on sexual risk-taking and sexual violence perpetration, comparable to the influence of direct abuse. Results on sexual victimization and adolescent pregnancy remain inconclusive. Pubertal timing appears not to be influenced by witnessing FV. Conclusions: Nine of 11 studies appraised as strong and moderate found a positive correlation between witnessing FV and the sexual or reproductive health of AYAs. Because of low study quality, more meticulous and longitudinal research is needed to adequately determine temporal sequence and causality of witnessing FV and sexual and reproductive health.