Intimate Partner Violence (IPV) is defined as any physical, psychological, or sexual harm occurring within an intimate relationship, whether married, unmarried, or cohabiting.1 The Global Burden of Disease study reported that, in 2018, approximately 27% of women aged 15 to 49 who had partners experienced some form of violence within the past year.2 In Latin America, the prevalence of IPV varies from one country to another, with rates ranging from 14% in Brazil to as high as 50% in Bolivia.3 In Peru, it is estimated that around 40.1% of women of childbearing age have suffered some form of violence from their partners.4 Given these statistics, and the fact that the majority of victims are women of childbearing age, gender-based violence and IPV are considered global public health issues, with significant societal repercussions due to human rights violations.5

Possible risk factors for IPV include age, low educational attainment, tolerance of violent behavior, and substance use.6,7 Substance abuse, such as alcohol consumption and the use of various drugs, has been identified as a significant factor associated with intimate partner violence, both during episodes of violence and as a chronic pattern.8,9

However, little research has been conducted on the impact of substance use on the recurrence of violent acts in intimate relationships, and there is limited evidence on the recurrence of IPV. Physiological aspects may explain how substance abuse mediates both IPV and potential recidivism among offenders,10 or the victim’s tolerance for receiving violent treatment. Nonetheless, a more direct examination of the relationship between substance use and both new and repeat cases of IPV is warranted.

Hence, this study was undertaken to investigate the relationship between substance use (alcohol and drugs) and recidivism in cases of intimate partner violence. Establishing such a connection could provide additional support for the effective regulation of the sale and distribution of alcoholic beverages, shed light on the proportion of recurrences in IPV cases, and contribute to the Sustainable Development Goals outlined by the United.11


Ethical Considerations

This study was conducted using publicly available information from the National Observatory of Violence, as previously mentioned. The research team ensured that the data did not contain any identifying information about the victims or perpetrators. Because the data was anonymized and accessible to the general public, this study did not require approval from any institutional ethics committee.

Study Design and Data Sources

This is an analytical cross-sectional observational study that utilizes data from a secondary source. The data was obtained from the Ministry of Women and Vulnerable Populations (MIMP) through the National AURORA Program for the prevention and eradication of violence within family groups. This program collects information from reports and records submitted to the Women’s Emergency Center (CEM), which are present in all departments across Peru. Both the Peruvian National Police and the Public Ministry contribute information from the received complaints to the CEM.

Data Extraction and Cleaning

Victims of violence who report violent incidents complete a standardized registration form (Supplement 1) established by the AURORA program. This form is consistent throughout the national territory, and each CEM has trained personnel for accurate form completion. The data is available to the general public on the National Observatory of Violence’s website ( and is accessible in .sav format for IBM SPSS software. The data was downloaded and transformed for use with the STATA statistical package, where variables and their categories were recoded. Data was also cleaned based on the selection criteria detailed below.

Participants and Variables

Data from the year 2022 was obtained, and all records from that period were considered. The study included adult female victims from Peru, aged 20 to 59, whose partner or ex-partner was male. Victims of economic violence were excluded, as were those without the variables of interest (alcohol consumption and information on the recurrence of violent acts) (Figure 1). The study considered variables for both the victim and the perpetrator, including age, area of residence, marital status, educational level, employment status, alcohol or drug use during the last violent incident, and frequent alcohol or drug use (these were the independent variables of interest). For the victim, additional variables considered included pregnancy status, having children, ethnicity, disability status, specific relationship with the perpetrator, type of perceived violence, a history of previous violent incidents by the same perpetrator (dependent variable), family or friend connections, and whether the victim had filed a judicial complaint with the relevant authorities.

Figure 1
Figure 1.Flowchart of the study sample based on inclusion and exclusion criteria.

Statistical Analysis

An initial analysis was conducted to describe and summarize each variable. Relative and absolute frequencies were used for categorical variables, while measures of central tendency (mean or median) with their respective measures of dispersion (standard deviation or interquartile ranges) were employed for numerical variables. To assess the difference in proportions between the recidivism group and new cases, the Pearson chi-square test was applied, or alternatively, Fisher’s exact test when appropriate. To evaluate the association between alcohol consumption and recidivism, generalized linear models of the binomial family with a logit link function were utilized. This model yields odds ratios (ORc) as results. An adjusted model was also applied, incorporating variables with a p-value less than 0.20 in the bivariate model, and adjusted odds ratios (ORa) were reported. All analyses were deemed significant when a p-value < 0.05 was achieved, and both ORc and ORa were presented with their respective 95% confidence intervals (CI 95%). The statistical software package STATA v.17 (STATA Corp, Texas, USA) was used for these analyses.


A total of 65,290 cases of intimate partner violence were analyzed, with 93.70% (n = 61,174) of these cases being instances of recidivism by the same perpetrator. Among the most representative characteristics of the victims, the following stand out: age between 30 to 39 years (n = 23,477, 35.06%), single marital status (n = 52,290, 80.09%), not pregnant (n = 63,430, 97.15%), and completion of high school or technical education (n = 35,634, 54.58%). As for the characteristics of the aggressors, the following are notable: age group between 30 to 39 years (n = 23,173, 35.49%), secondary education or technical background (n = 39,162, 60.62%), and having a job or occupation at the time of the aggression (n = 56,736, 87.39%) (Table 1).

Table 1.General Characteristics of Victims and Perpetrators in Cases of Intimate Partner Violence in Peru, 2022.
Total New cases Recurrent cases
n % n % n % p-⁠value
Age of victims
20 to 29 years old 22106 33.86 1787 43.42 20319 33.22 <.001
30 to 39 years old 23477 35.96 1390 33.77 22087 36.11
40 to 49 years old 14805 22.68 718 17.44 14087 23.02
50 to 59 years old 4902 7.51 221 5.37 4681 7.65
Marital status of the victim
Single 52290 80.09 3515 85.42 48774 79.73 <.001
Married 12179 18.65 553 13.44 11626 19
Widowed 130 0.2 7 0.17 123 0.2
Divorced 691 1.06 40 0.97 651 1.06
Educational level of the victim
No education 7693 11.78 476 11.56 7217 11.8 .283
Elementary school completed 16619 25.45 1001 24.32 15618 25.53
High school completed or technical 35634 54.58 2289 55.61 33345 54.51
College or higher education 5344 8.19 350 8.5 4994 8.16
The victim has a job or occupation
No 30474 46.67 2085 50.9 28379 46.39 <.001
Yes 34816 53.33 2021 49.19 32795 53.61
The victim is disabled
No 64691 99.08 4083 99.2 60608 99.07 .421
Yes 599 0.92 33 0.8 566 0.03
Age of Aggressor
Younger than 30 years old 14584 22.34 1259 30.59 13325 21.78 <.001
30 to 39 years old 23173 35.49 1475 35.84 21698 35.47
40 to 49 years old 17628 27 927 22.52 16701 27.3
Older than 50 years old 9905 15.17 455 11.05 9905 15.17
Educational level of the aggressor*
No education 4845 7.5 306 7.55 4539 7.5 .054
Elementary school completed 15422 23.87 896 22.1 896 23.87
High school completed or technical 39162 60.62 2522 62.19 14526 60.62
College or higher education 5173 8.01 331 8.16 36640 8.01
The aggressor has a job or occupation *
No 8190 12.61 639 15.65 7551 12.41 <.001
Yes 56736 87.39 3444 84.35 53292 87.39

*Less than 5% of incomplete data. The chi-squared test was applied to all p-values.

Regarding the characteristics of the violent acts, there was a partner relationship in 55.44% (n = 36,194) of the cases, in 60.81% (n = 19,704) of cases, there was cohabitation between the victim and the perpetrator, physical violence was the most common type of violence at 49.17% (n = 32,106), in 29.54% of cases, the aggressor had a history of frequent alcohol consumption (n = 19,285), and only 6.11% had a history of frequent drug use (n = 3,988) (Table 2).

Table 2.Specific characteristics of intimate partner violence cases in Peru, 2022.
Total New cases Recurrent cases
n % n % n % p-⁠value
Relationship between the couple and the perpetrator
Couple 36194 55.44 2331 56.63 33863 55.36 .110*
Former partner (ex-partner) 29096 44.56 1785 43.37 27311 44.64
The victim and the perpetrator live together
No 39704 60.81 2490 60.5 37214 60.83 .668*
Yes 25586 39.19 1626 39.5 23960 39.17
Type of violence
Physical 32106 49.17 2393 58.14 29713 48.57 <.001*
Sexual 1783 2.73 357 8.67 1426 2.33
Psychological 31401 48.09 1366 33.19 30035 49.1
The perpetrator frequently consumes alcohol
No 46005 70.46 3433 83.41 42572 69.59 <.001*
Yes 19285 29.54 683 16.59 18602 30.41
The perpetrator frequently consumes drugs
No 61302 93.89 3975 96.57 57327 93.71 <.001*
Yes 3988 6.11 141 3.43 3847 6.29
The victim frequently consumes alcohol
No 65050 99.53 4098 99.56 18 0.44 .445*
Yes 240 0.37 60952 99.64 222 0.36
The victim frequently consumes drugs
No 65223 99.9 4109 99.83 7 0.17 .198**
Yes 67 0.1 61114 90.9 60 0.1
Family support for the victim
No 5182 7.94 322 7.82 4860 7.94 .780*
Yes 60108 92.06 3794 92.18 56314 92.06
Friendship support for the victim
No 61020 93.46 3833 93.12 283 6.88 .368*
Yes 4270 6.54 57187 93.48 3987 6.52

*The Pearson chi-squared test was used. **The Fisher exact test was used.

In the bivariate analysis, it was found that alcohol consumption by the aggressor was associated with the recurrence of violent acts with an ORc = 2.20 (95% CI: 2.02 – 2.39, p < 0.001), and drug use also had an association with an ORc = 1.89 (95% CI: 1.59 – 2.24, p < 0.001). In the adjusted analysis, an association was also found with frequent alcohol consumption by the aggressor, with an ORa = 2.24 (95% CI: 2.06 – 2.44, p < 0.001), and with frequent drug use, with an ORa = 2.33 (95% CI: 1.95 – 2.77, p < 0.001) (Table 3).

Table 3.Association Between Substance Use and Recurrence of Intimate Partner Violence in Peru, 2022.
cOR CI 95% p-⁠value aOR* CI 95% p-⁠value
The perpetrator frequently consumes alcohol 2.2 2.02 - 2.39 <.001 2.24 2.06 - 2.44 <.001
The perpetrator frequently consumes drugs 1.89 1.59 - 2.24 <.001 2.33 1.95 - 2.77 <.001
The victim frequently consumes alcohol .83 .51 - 1.34 .446 - - -
The victim frequently consumes drugs .58 .26 - 1.26 .168 - - -

*It was adjusted for the age of the victim, age of the perpetrator, whether the victim was pregnant, marital status of the victim, whether the victim and the perpetrator had a job or occupation, and the type of violence. cOR: Crude Odds Ratio. aOR: Adjusted Odds Ratio. CI: Confidence Interval.


The results of this research reveal that over 90% of the documented cases of violence at CEM are instances of recurrence caused by the same perpetrator. This is a significant figure that underscores the need to direct preventive strategies toward couples who have already had a history of any type of violence. It is also crucial to strengthen and implement suitable programs for the early detection of new cases. A compilation of data indicates that among aggressors, 68% are rearrested within 3 years, and 50% return to prison.12 A systematic review mentions that the recidivism rate can vary between 14% and 45% among the countries from which the figures were obtained.13 Therefore, it is essential not to underestimate cases of recurrence and to properly monitor victims who have previously reported an incident of violence.

While we found a higher frequency of recidivism in cases of psychological violence (49.1% in recidivism cases versus 33.19% in new cases), this is consistent with previously identified evidence.14 Recidivism may lead to more severe aggression, as evidenced by the fact that feminicides (the most extreme form of violence against women) are often preceded by a prior act of violence by the same aggressor or feminicide.15,16 With this premise in mind, the recurrence of IPV becomes even more significant, and reporting the initial act of violence by the victim should be encouraged.

Previous evidence suggests that despite court orders, incarcerations, or restrictions imposed on aggressors, they have a high likelihood of repeating acts of violence, regardless of variables such as substance use or the type of violence exerted.17 Continuous monitoring services and therapy for those incarcerated and prosecuted for a history of aggression and violence could likely reduce the recurrence rate,18 particularly given that a substantial portion of the cases recorded in the present results are instances of recidivism.

Implications for Public Health

The consumption of substances and acts of violence, in general, are often related, although their specific relationship in IPV is controversial. Both chronic substance use and substance abuse need to be addressed from a public health perspective. On the other hand, recurrence in cases of IPV represents a significant proportion of the presented results. From a preventive standpoint, proper monitoring of both aggressors and victims, adequate treatment or therapy,19–21 follow-up of violence cases,22 and education about gender violence prevention from an early age,23 could be useful strategies to prevent both new and recurrent cases on a national level.

In Peru, the CEM and the AURORA program were established to address the increasing cases of violence that occur daily in the country.24 However, cases of violence have been on the rise over the past five years.25 Therefore, efforts should be combined, and the strategies provided by CEM should be integrated and complemented with collaborative work with the Ministry of Health, which could also help develop appropriate strategies for alcohol consumption control.

While it could be argued that more cases are being reported due to improved surveillance, these cases should receive proper follow-up from the moment they are first recorded. IPV and alcohol consumption continue to be areas of limited understanding, and when the recurrence of IPV is added to the equation, the role of alcohol consumption becomes even more significant.

Strengths and Limitations

The analyses presented are based on records of reported incidents of perceived violence at the national level, providing a level of representativeness across the country. This information can be extrapolated to all individuals who have reported an incident of IPV. Additionally, it’s crucial to note that these are two interrelated issues, substance use, and IPV, thus offering insights into two public health problems in Peru. Another significant strength is that the information is derived from a national entity under one of the ministries of the Government of Peru, giving the collected data validity and generalizability.

Among the limitations, the most important one is working with a secondary database, which limits the ability to collect additional variables that might be of interest. Although a suitable design would be required, including variables such as the aggressor’s criminal history, prior mental health problems, and psychiatric care. Another notable limitation is selection bias since it involves working with the records of victims who reported the violent incident. Victims who choose not to report may have an even higher rate of violence recurrence, or they may be intimidated by the violence when the aggressor is under the influence of substances. Additionally, there may be information bias, as the data is collected through self-reporting by the victim. Consequently, this information can be subject to various sources of bias, such as forgetting information or avoiding answering certain questions.

Despite these limitations, this study highlights a significant relationship between two variables in a population where there is a high tolerance for gender-based violence, a high incidence of IPV, substance use, and, above all, the need to implement appropriate strategies. Generating evidence for the proper management of these issues is essential. A more comprehensive and structured approach is required to address IPV, not only to identify risk factors but also to evaluate government and national entity proposals and strategies. Generating evidence through research in this field is crucial, and it is an area that can gain greater prominence in the academic arena.


Based on the presented results, it can be concluded that there is a relationship between substance use and the risk of recurrence in cases of intimate partner violence. Despite controlling for various potentially confounding variables and the mentioned limitations, a significant relationship was found, underscoring the need for an appropriate approach to both situations. National entities play a crucial role, and it is essential for research in this area to continue.

Authors’ contributions

E M-M: Data Cleaning, Writing - Initial Draft, Writing - Revision and Editing of the Final Version.

L A R: Conceptualization, Research, Methodology, Data Cleaning, Formal Analysis, Writing - Initial Draft, Writing - Revision and Editing of the Final Version.

M K G-T: Data Cleaning, Writing - Initial Draft, Writing - Revision and Editing of the Final Version.

M L M-A: Data Cleaning, Writing - Initial Draft, Writing - Revision and Editing of the Final Version.

V R-L: Conceptualization, Research, Methodology, Data Cleaning, Formal Analysis, Writing - Initial Draft, Writing - Revision and Editing of the Final Version.

Conflict of Interest

No author declares any conflict of interest.