What is intimate partner violence?

Intimate partner violence (IPV) is abuse or aggression that occurs in a romantic relationship. “Intimate partner” refers to both current and former spouses and dating partners. IPV can vary in how often it happens and how severe it is. It can range from one episode of violence that could have lasting impact to chronic and severe episodes over multiple years. IPV can include any of the following types of behavior:

• Physical violence is when a person hurts or tries to hurt a partner by hitting, kicking, or using another type of physical force.
• Sexual violence is forcing or attempting to force a partner to take part in a sex act, sexual touching, or a non-physical sexual event (e.g., sexting) when the partner does not or cannot consent.
• Stalking is a pattern of repeated, unwanted attention and contact by a partner that causes fear or concern for one’s own safety or the safety of someone close to the victim.
• Psychological aggression is the use of verbal and non-verbal communication with the intent to harm a partner mentally or emotionally and/or to exert control over a partner.

IPV is connected to other forms of violence and is related to serious health issues and economic consequences. However, IPV and other forms of violence can be prevented. For more information about IPV definitions please see Intimate Partner Violence Surveillance: Uniform Definitions and Recommended Data Elements, Version 2.0. [3.04 MB, 164 Pages, 508].

How big is the problem?

IPV is common.  It affects millions of people in the United States each year. Data from CDC’s National Intimate Partner and Sexual Violence Survey (NISVS) indicate: 

• About 41% of women and 26% of men experienced contact sexual violence, physical violence, and/or stalking by an intimate partner and reported an intimate partner violence-related impact during their lifetime. Injury, posttraumatic stress disorder (PTSD) symptoms, concern for safety, fear, needing help from law enforcement, and missing at least one day of work are common impacts reported.
• Over 61 million women and 53 million men have experienced psychological aggression by an intimate partner in their lifetime.

IPV starts early and continues throughout people’s lives. When IPV occurs in adolescence, it is called teen dating violence (TDV). TDV affects millions of U.S. teens each year. About 16 million women and 11 million men who reported experiencing contact sexual violence, physical violence, or stalking by an intimate partner in their lifetime said that they first experienced these forms of violence before the age of 18. While violence impacts all people in the United States, some individuals and communities experience inequities in risk for violence due to the social and structural conditions in which they live, work, and play. Youth from groups that have been marginalized, such as sexual and gender minority youth, are at greater risk of experiencing sexual and physical dating violence.

What are the consequences?

IPV is a significant public health issue that has many individual and societal costs. About 75% of female IPV survivors and 48% of male IPV survivors experience some form of injury related to IPV. IPV can also result in death. Data from U.S. crime reports suggest that about 1 in 5 homicide victims are killed by an intimate partner. The reports also found that over half of female homicide victims in the United States are killed by a current or former male intimate partner.

Many other negative health outcomes are associated with IPV. These include a range of conditions affecting the heart, muscles and bones, and digestive, reproductive, and nervous systems, many of which are chronic. Survivors can experience mental health problems such as depression and PTSD symptoms. They are at higher risk for engaging in behaviors such as smoking, binge drinking, and sexual risk activity. People from groups that have been marginalized, such as people from racial and ethnic minority groups, are at higher risk for worse consequences.

Although the personal consequences of IPV are devastating, there are also many costs to society. The lifetime economic cost associated with medical services for IPV-related injuries, lost productivity from paid work, criminal justice and other costs, is $3.6 trillion. The cost of IPV over a victim’s lifetime was $103,767 for women and $23,414 for men.

How can we stop it before it starts?

Intimate partner violence is preventable. A number of factors may increase or decrease the risk of perpetrating and experiencing intimate partner violence. To prevent intimate partner violence, we must understand and address the factors that put people at risk for or protect them from violence. Promoting healthy, respectful, and nonviolent relationships and communities can help reduce the occurrence of IPV. It also can prevent the harmful and long-lasting effects of IPV on individuals, families, and communities. CDC developed a resource, Preventing Intimate Partner Violence Across the Lifespan: A Technical Package of Programs, Policies, and Practices[5 MB, 64 Pages, 508], to help communities take advantage of the best available evidence to prevent intimate partner violence. This resource can be used as a tool in efforts to impact individual behaviors, as well as family, community, and society factors that influence risk and protective factors for intimate partner violence.

Different types of violence are connected and often share root causes. Intimate partner violence is linked to other forms of violence through shared risk and protective factors. Addressing and preventing one form of violence may have an impact on preventing other forms of violence.

In a close relationship, it can be difficult to know whether you are being abused, especially if your partner says they love you, gives you a lot of attention, or pays for the groceries or rent. People who are abusive sometimes act loving and supportive as a way to keep you in the relationship. A partner's loving behavior does not make their abusive behavior OK. Forced sex and cruel or threatening words are forms of abuse. Learn more about how to recognize abuse.

Signs of abuse

There are many types of violence and abuse. Some of these signs are signs of physical abuse or domestic violence. Some are signs of emotional and verbal abuse or sexual abuse.

Signs of abuse include:

• Keeping track of everything you do
  • Monitoring what you’re doing all the time or asking where you are and who you’re with every second of the day
  • Demanding your passwords to social media sites and email accounts
  • Demanding that you reply right away to texts, emails, or calls
  • Preventing or discouraging you from seeing friends or family
  • Preventing or discouraging you from going to work or school
• Being jealous, controlling, or angry
  • Acting very jealous, including constantly accusing you of cheating
  • Having a quick temper, so you never know what you will do or say that may cause a problem
  • Controlling how you spend your money
  • Controlling your use of medicines or birth control
  • Making everyday decisions for you that you normally decide for yourself (like what to wear or eat)
• Demeaning you
  • Putting you down, such as insulting your appearance, intelligence, or activities
  • Humiliating you in front of others
  • Destroying your property or things that you care about
  • Blaming you for his or her violent outbursts
• Physically hurting or threatening to hurt you or loved ones
  • Threatening to hurt you, the children, or other people or pets in your household
  • Hurting you physically (such as hitting, beating, pushing, shoving, punching, slapping, kicking, or biting)
  • Using (or threatening to use) a weapon against you
  • Threatening to harm himself or herself when upset with you
  • Threatening to turn you in to authorities for illegal activity if you report physical abuse
• Forcing you to have sex or other intimate activity
  • Forcing you to have sex when you don’t want to through physical force or threats
  • Assuming that consent for a sex act in the past means that you must participate in the same acts in the future
  • Assuming that consent for one activity means consent for future activity or increased levels of intimacy (for example, assuming that kissing should lead to sex every time)

If you think someone is abusing you, get help. Abuse can have serious physical and emotional effects.

Signs of an unhealthy relationship

Sometimes a romantic relationship may not be abusive but may have serious problems that make it unhealthy. If you think you might be in an unhealthy relationship, try talking with your partner about your concerns. If that seems difficult, you might also talk to a trusted friend, family member, counselor, or religious leader.

You might be in an unhealthy relationship if you:

• Focus all your energy on your partner
• Drop friends, family, or activities you enjoy
• Feel pressured or controlled by this person
• Have more bad times than good in the relationship
• Often feel sad or scared when with this person
• Know that this person does not support you and what you want to do in life
• Do not feel comfortable being yourself or making your own decisions
• Cannot speak honestly to work out conflicts in the relationship
• Cannot talk about your needs or changes in your life that are important

Risk factors are linked to a greater likelihood of intimate partner violence (IPV) perpetration. They are contributing factors, but might not be direct causes. A combination of individual, relational, community, and societal factors contribute to the risk of becoming a perpetrator of IPV. Understanding these multilevel factors can help identify various opportunities for prevention.

Risk Factors for Intimate Partner Violence Perpetration

Individual Risk Factors

• Low self-esteem
• Low education or income
• Young age
• Aggressive or delinquent behavior as a youth
• Heavy alcohol and drug use
• Depression and suicide attempts
• Anger and hostility
• Lack of nonviolent social problem-solving skills
• Antisocial personality traits and conduct problems
• Poor behavioral control and impulsiveness
• Traits associated with borderline personality disorder
• History of being physically abusive
• Having few friends and being isolated from other people
• Economic stress (e.g., unemployment)
• Emotional dependence and insecurity
• Belief in strict gender roles (e.g., male dominance and aggression in relationships)
• Desire for power and control in relationships
• Hostility towards women
• Attitudes accepting or justifying violence and aggression
• History of physical or emotional abuse in childhood

Relationship Factors

• Relationship conflicts including jealousy, possessiveness, tension, divorce, or separations
• Dominance and control of the relationship by one partner over the other
• Families experiencing economic stress
• Unhealthy family relationships and interactions
• Association with antisocial and aggressive peers
• Parents with less than a high-school education
• Witnessing violence between parents as a child
• History of experiencing poor parenting as a child
• History of experiencing physical discipline as a child

Community Factors

• Communities with high rates of poverty and limited educational and economic opportunities
• Communities with high unemployment rates
• Communities with high rates of violence and crime
• Communities where neighbors don’t know or look out for each other and there is low community involvement among residents
• Communities with easy access to drugs and alcohol
• Weak community sanctions against IPV (for example, unwillingness of neighbors to intervene in situations where they witness violence)

Societal Factors

• Traditional gender norms and gender inequality (for example, the idea women should stay at home, not enter the workforce, and be submissive; men should support the family and make the decisions)
• Cultural norms that support aggression toward others
• Societal income inequality
• Weak health, educational, economic, and social policies or laws

Protective Factors for Intimate Partner Violence Perpetration

Relationship Factors

• Strong social support networks and stable, positive relationships with other

Community Factors

• Neighborhood collective efficacy, meaning residents feel connected to each other and are involved in the community
• Coordination of resources and services among community agencies
• Communities with access to safe, stable housing
• Communities with access to medical care and mental health services
• Communities with access to economic and financial help

Whether you suspect that a friend or family member is being abused or you witnessed someone being abused, you can take steps to help.

What are signs that someone may be abused?

According to the National Domestic Violence Hotline, some warning signs include the following:

• Their partner insults them in front of other people.
• They are constantly worried about making their partner angry.
• They make excuses for their partner’s behavior.
• Their partner is extremely jealous or possessive.
• They have unexplained marks or injuries.
• They’ve stopped spending time with friends and family.
• They are depressed or anxious, or you notice changes in their personality.

If you think your friend or family member is being abused, be supportive by listening to them and asking questions about how they’re doing. The person being abused may not be ready or able to leave the relationship right now.

How can I help someone who is being abused?

Knowing or thinking that someone you care about is in a violent relationship can be very hard. You may fear for her safety — and maybe for good reason. You may want to rescue her or insist she leave, but every adult must make her own decisions.

Each situation is different, and the people involved are all different too. Here are some ways to help a loved one who is being abused:

• Set up a time to talk. Try to make sure you have privacy and won’t be distracted or interrupted. Visit your loved one in person if possible.
• Let her know you’re concerned about her safety. Be honest. Tell her about times when you were worried about her. Help her see that abuse is wrong. She may not respond right away, or she may even get defensive or deny the abuse. Let her know you want to help and will be there to support her in whatever decision she makes.
• Be supportive. Listen to your loved one. Keep in mind that it may be very hard for her to talk about the abuse. Tell her that she is not alone and that people want to help. If she wants help, ask her what you can do.
• Offer specific help. You might say you are willing to just listen, to help her with child care, or to provide transportation, for example.
• Don’t place shame, blame, or guilt on her. Don’t say, “You just need to leave.” Instead, say something like, “I get scared thinking about what might happen to you.” Tell her you understand that her situation is very difficult.
• Help her make a safety plan. Safety planning might include packing important items and helping her find a “safe” word. This is a code word she can use to let you know she is in danger without an abuser knowing. It might also include agreeing on a place to meet her if she has to leave in a hurry.
• Encourage her to talk to someone who can help. Offer to help her find a local domestic violence agency. Offer to go with her to the agency, the police, or court. The National Domestic Violence Hotline, 800-799-SAFE (7233); the National Sexual Assault Hotline, 800-656-HOPE (4673); and the National Teen Dating Abuse Helpline, 866-331-9474, are all available 24 hours a day, 7 days a week. They can offer advice based on experience and can help find local support and services.
• If she decides to stay, continue to be supportive. She may decide to stay in the relationship, or she may leave and then go back many times. It may be hard for you to understand, but people stay in abusive relationships for many reasons. Be supportive, no matter what she decides to do.
• Encourage her to do things outside of the relationship. It’s important for her to see friends and family.
• If she decides to leave, continue to offer help. Even though the relationship was abusive, she may feel sad and lonely once it is over. She may also need help getting services from agencies or community groups.
• Let her know that you will always be there no matter what. It can be very frustrating to see a friend or loved one stay in an abusive relationship. But if you end your relationship, she has one less safe place to go in the future. You cannot force a person to leave a relationship, but you can let them know you’ll help, whatever they decide to do.

How do I report domestic violence or abuse?

If you see or hear domestic violence or child abuse in your neighborhood or in a public place, call 911. Don’t worry about whether the couple or person will be angry with you for calling. It could be a matter of life and death, and it’s better to be safe than sorry. You don’t have to give your name if you are afraid for your own safety.

If you want to report abuse but there is no immediate danger, ask local police or child/adult protective services to make a welfare check. This surprise check-in by local authorities may help the person being abused.

Abuse can be difficult to see, especially when it’s in your own relationship. It can start slowly, and it’s not always physical. You may not realize that the small comments a loved one makes to you are doing harm. You may even make excuses for them. They’re stressed from work or the pandemic.

But abuse takes many forms. It can be physical, like slapping, punching, or kicking. It can involve sexual violence. For many, it’s psychological—making someone feel worthless or isolating them from friends and family. Sometimes it includes stalking.

All these behaviors are forms of domestic violence. This is sometimes called intimate partner violence. At least 25% of women and 10% of men are estimated to have experienced intimate partner violence.

“Intimate partner violence is about power and control,” says Dr. Eve Valera, an expert on domestic violence and brain injury at Harvard Medical School and Massachusetts General Hospital. “It’s any type of physical, emotional, or psychological violence from a partner or spouse, husband, a wife—or even an ex.”

Some people experience one act of partner violence. Others suffer repeated abuse over years. The effects from either can be long-lasting.

Researchers are working to understand and prevent intimate partner violence and learn how to help those who have been affected.

Signs of Partner Abuse

It’s important to recognize the signs of an abusive relationship. Controlling behavior is a common sign. Your partner may monitor where you are and how much you see friends and family. They might decide what you wear or eat or how you spend your money.

Verbal threats are also common. Other warning signs include name calling, humiliating someone in front of others, or blaming someone else for their own violent outburst.

Intimate partner violence affects the whole family. Children in homes where a parent is abused may be fearful and anxious. They can be afraid of conflict. They may also often be on guard, waiting for violence to break out.

“The repercussions of intimate partner violence are huge. It’s just devastating to homes,” says Dr. Ted George, an NIH expert on alcohol and violence.

Heavy drinking is one risk factor for intimate partner violence. Studies show that partner abuse is much more likely on days of heavy alcohol use.

George studies the brain areas involved in loss of control and violence. His work has found that some people who commit domestic violence have fewer connections in the brain that slow down the fight response.

Interventions that help people pause before they react may help prevent violence, says George. His findings also suggest that drinking may increase the risk of partner violence by affecting these same brain areas.

Other factors are also linked to committing partner violence. These include harmful use of drugs, having a personality disorder, and having abused a previous partner.

Understanding the Harms

The harm from domestic violence isn’t always visible. Experiencing it puts you at higher risk for a range of health conditions. These include heart disease, high blood pressure, digestive problems, and reproductive issues.

Intimate partner violence is linked to several mental health conditions like depression, post-traumatic stress disorder, and suicide. People who experience intimate partner violence are also more likely to binge drink and misuse other drugs.

Studies show that many people may suffer brain injuries as a result of physical abuse. Valera’s research suggests that traumatic brain injuries are common. This is especially true for mild ones called concussions. They can have long-lasting effects on brain function.

Her team uses interviews, brain scans, and lab tests to look at abuse-related brain injury. They’ve found a relationship between the number of brain injuries and brain function. Brain injuries were linked with learning and memory problems and mental distress.

Valera notes that there are likely more women who sustain traumatic brain injuries from their partners than those with brain injuries from being an athlete or in the military. But these injuries usually go undiagnosed.

“The repetitive traumatic brain injuries that women often receive may not even be recognized as brain injuries, and are certainly not given appropriate care or treatment,” she says.

Domestic violence can escalate with tragic results. In the U.S., women are more likely to be killed by a current or former intimate partner than by someone else.

If you’re experiencing intimate partner violence, help is available. The Wise Choices box shows some of your options.

Preventing Partner Violence

So what’s the best way to prevent intimate partner violence? Learn what to look for in a healthy relationship and how to build healthy relationship skills. It’s important to start early.

People who have violent relationships as teens are more likely to have them as adults. Dr. Jeff Temple, an expert on teen dating violence at the University of Texas Medical Branch, teaches youth about building healthy relationships in a school-based program. He’s been studying how well the program works.

In the program, students build relationship skills through role playing. They practice how to handle real-life situations, like apologizing or breaking up.

“Practice is huge for when they get into that situation in real life,” Temple says. “What the research tells us is that kids who are able to resolve conflicts and manage their emotions are less likely to be in violent relationships later on.”

He notes that no one is really taught how to be in a healthy relationship, even though it’s a basic part of being human. We practice reading, writing, sports—everything except relationships.

“So we learn about relationships through friends, which is sometimes okay, oftentimes poor. We learn from the media, which is not that great,” Temple says.

Ultimately, most of us learn about relationships through trial and error. Programs like the one Temple is studying can teach teens to build healthy, happy relationships.

But learning about healthy relationships can help at any age. Read more about building relationships.

Getting Help

If there is immediate danger, call 911. If there’s no immediate danger, consider these options:

• Get medical care. If you have been injured or sexually assaulted, go to a local hospital emergency room or urgent care center.
• Find out where to get help in your community. Visit www.thehotline.org/get-help/local-resources.
• Call a helpline for free, anonymous help. Call the National Domestic Violence Hotline at 800-799-SAFE (7233) or 800-787-3224 (TDD). They can help you develop a safety plan. They also offer guidance on how to keep children safe and can help you find legal advice.
• Talk to someone. Reach out to someone you trust for emotional support.