Intimate partner violence (IPV) affects millions of Americans across all demographics, yet many healthcare workers struggle to recognize and respond appropriately to survivors in their care. About 1 in 4 women and 1 in 10 men will experience IPV during their lifetime, according to the Centers for Disease Control and Prevention (CDC). More alarming, over 43.5 million women and 20.7 million men have experienced physical violence, sexual violence, or stalking by an intimate partner during their lifetime in the United States.

The stakes are extraordinarily high. Homicide is the third leading cause of death for women in the United States, and IPV accounts for a large proportion of female homicide victims, with over half of women murdered by a current or former partner. Beyond the immediate physical danger, survivors of IPV utilize healthcare services at substantially higher rates, including emergency department visits, mental health care, and pregnancy-related complications.

What Exactly Is Intimate Partner Violence?

IPV encompasses far more than physical assault. The CDC defines it as abuse or aggression that occurs in a current or previous dating relationship, and it can affect people in heterosexual and same-sex relationships across all ages, races, and identities. The behaviors that constitute IPV include:

• Physical Violence: The deliberate use of physical force such as hitting, slapping, kicking, biting, strangling, or using a weapon that results in physical harm, injury, disability, or death.
• Sexual Violence: Forced or coerced sexual activity without the victim's consent, including situations where someone cannot consent due to fear, intoxication, or unconsciousness. Reproductive coercion, such as sabotage of birth control methods or control over pregnancy decisions, also falls under this category.
• Stalking: Unwanted, repeated attention or contact that causes the victim to feel scared or unsafe, including GPS location tracking, excessive texting, or social media monitoring.
• Psychological Aggression: Communication, verbal or nonverbal, that intimidates, manipulates, isolates, or controls another person, including verbal threats, gaslighting, constant criticism, or withholding money, medications, or transportation.

IPV is typically an escalating process. It often begins with threats, name-calling, and damage to objects or pets, then may progress to restraining, pushing, slapping, pinching, or biting, and eventually evolve into life-threatening behaviors like punching, kicking, choking, breaking bones, and using weapons.

How Can Healthcare Professionals Better Support Survivors?

Healthcare professionals are uniquely positioned to intervene because survivors often seek care in clinics and hospitals. However, many providers lack training in trauma-informed approaches. Continuing education programs now emphasize several critical competencies that healthcare workers need to develop:

• Identification and Assessment: Learning to recognize signs of IPV, including physical injuries, behavioral patterns, and psychological symptoms, while understanding that survivors may appear high-functioning despite being controlled through psychological means.
• Trauma-Informed Communication: Using appropriate language and approach that avoids re-traumatization, respects the survivor's autonomy, and demonstrates empathy and privacy throughout the interaction.
• Safety Planning and Documentation: Helping victims develop individualized safety plans, documenting findings properly, and providing referrals to advocacy resources and support services.
• Understanding Coercive Control: Recognizing that IPV extends beyond physical violence to include patterns of domination using fear, intimidation, and isolation that strip away a person's sense of self and independence.
• Lethality Assessment: Using structured screening tools to assess risk of serious injury or death, including questions about access to firearms, strangulation events, and threats to kill.

The role of the healthcare professional extends beyond clinical care. Providers serve as key intervention points for survivors, many of whom can be seen in clinics or hospitals and appear high-functioning due to their clothing and verbal compliance, but in reality are being held hostage through psychological means.

Why Does This Matter for Public Health?

The economic and social burden of IPV is staggering. The total lost productivity, healthcare, and criminal justice involvement due to IPV exceeds $5.8 billion each year in the United States. Beyond the financial cost, IPV creates ripples throughout communities and affects not only the survivors but also their families, workplaces, and social networks.

Professional nursing organizations now recognize IPV screening and response as a core competency. The United States Preventive Services Task Force (USPSTF) updated its 2025 recommendations to emphasize the importance of screening and intervention. Training programs emphasize culturally sensitive documentation, especially in cases where survivors initially deny abuse, and provider resilience to prevent secondary trauma among healthcare workers who regularly encounter IPV survivors.

For healthcare professionals seeking to improve their practice, specialized continuing education courses now cover the full spectrum of IPV care, from initial screening through safety planning and follow-up. These programs equip providers with the knowledge and skills needed to identify, assess, and develop appropriate care plans for patients experiencing any type of domestic violence, ultimately improving outcomes for millions of survivors who pass through healthcare settings each year.