IPV was quite rampant amongst female undergraduates in this study, with a prevalence rate of (51.2%). This suggests that more than half of Female Undergraduates in Abia State have been abused by their partners with its attendant consequences on their emotional, physical and sexual health. This is higher than that reported in a similar study conducted in Ibadan Nigeria amongst female students [7]. A similar study conducted amongst undergraduate students in Northern Nigeria by Iliyasu et al. [13] showed a higher prevalence of IPV at 58.8% among females. In addition, student nurses were studied in Abakaliki, southeastern part of Nigeria and the prevalence of IPV although reported to be lower than our findings (48.7%) was still high amongst the respondents [14]. This calls for a need for a thorough history and examination of female undergraduates presenting to the hospital with unexplained injuries or conditions. In addition, another study from Africa, Zambia to be precise, reported a prevalence of 53.5% which is very close to the prevalence reported in this study [15] This suggests that IPV is not peculiar to Nigeria alone and some common characteristics may exist between countries in the same continent to explain this occurrence. There is need for campaigns to mitigate this burning issue amongst African females both at the individual and at higher level. The prevalence reported in this study is higher than what was reported in Spain (19.2%) [16]. The lower prevalence rates of IPV in Europe compared to this study and the above reviewed studies in Africa may also be due to better law enforcement against IPV perpetrators serving as a deterrent to others in more advanced countries of Europe.

Our study revealed that forms of IPV were 78.9%, 42.0% and 30.8% for emotional, physical and sexual violence respectively amongst our respondents. This corroborates with the study done at Ibadan [7] and is slightly similar in pattern to what was reported in the NDHS 2013 study for Abia State differing only in which form was the commonest [5]. From the 2013 NDHS, a prevalence of 12.9%, 21.2% and 5.5% for emotional, physical and sexual abuse respectively were reported in Abia State [5]. Both studies agreed that the least common form of abuse amongst women in Abia State is sexual abuse but differed in findings for the commonest form. Our study was restricted to female undergraduates in Abia State while the NDHS surveyed all women in Abia state and this may account for the disparity in prevalence and commonest patterns reported. The pattern of IPV reported in this study is also very similar to the patterns reported in other studies from other parts of Nigeria [7, 12, 13, 17–19]. It is seen that studies from other parts of Africa showed a different pattern of IPV occurrence amongst women [6, 20]. To be more elaborate, studies from Ethiopia, Namibia and Tanzania all reported the prevalence of physical, sexual and emotional violence as 48.7%, 58.6% and 9.2% respectively, 30.6%, 16.5% and 8.4% respectively and 46.7%, 30.7% and 15.3% respectively [6]. This pattern reported in these countries suggest that emotional violence is the least common form of IPV amongst the three studied forms of IPV which is different from what was reported in this study. Cultural differences, different levels of patriarchy and legalization of male roles across the different countries and regions in Africa may be responsible for this deviation in pattern.

In Europe, studies from Spain showed a similar pattern of IPV to that reported in this study [16]. While this study was not on students, they had comparable age incidence with our respondents. The Public health significance of increased forms of IPV amongst female undergraduates are vast and range from non-adherence to medications, poor academic performance, reduced health seeking actions, increased associated morbidities and so on and all these may increase mortality and reduce productivity in the society [21]. We reported a wide range of the consequences of IPV, with the commonest being bruises (29.9%), fractures and chest injuries (16.4%), unwanted pregnancies(9.4%), eating/sleeping disorders (16.4%), feeling of shame (12.5%), low self-esteem and anxiety (13.3%) as well as suicidal thoughts (8.6%). This is in keeping with reports from other studies [22–24].

Individual factors are factors peculiar to the individual and they have been found to be risk factors for IPV [2, 25]. This study reported that females who witnessed domestic violence as children were over 3 times more likely to experience IPV later in life. This is congruent with the finding from Ibadan Nigeria where it was reported that students who had exposure of inter-parental violence were significantly associated with experiencing IPV later in life [7]. Witnessing abuse as children especially amongst parents may have a profound normalization effect on the child. Future abuse may not be seen for what it is due to the numbing effect that her childhood experience has had on her psyche thus making her more vulnerable to abuse [26]. This mindset may also be transferred down to their children thereby resulting in inter-generational normalization of abuse and various forms of violence [26].

Partner frequent use of alcohol is another individual factor associated with IPV amongst female undergraduates in this study where it was reported that females whose partners use alcohol frequently were at least five times at risk of experiencing IPV. The disinhibition associated with alcohol use may result in heightened response of the victim’s partner to minimal provocation from the victim. Frequent alcohol use by partner may also be his adaptation mechanism to the numerous societal and/or economic challenges facing the nation, for example owed salaries, downturn in business fortunes, academic problems and so on. The 2013 NDHS corroborated this finding as it reported that women whose husbands or partners get drunk often were more likely to report IPV than women whose husbands drink minimally or don’t drink at all [5]. This is also in keeping with findings from other related studies from [7, 13, 19, 27], . Female smokers of cigarette or marijuana were also reported in this study to be eleven times at risk of experiencing IPV. This is very similar to what was reported in a study done in Ibadan Nigeria amongst female students where it was reported that there was a higher rate of IPV amongst students who were smokers than amongst those who were not smokers [7]. This was also supported by other studies carried out on young adults in the United States [28, 29]. Cigarette and marijuana use can influence the occurrence of IPV the same way alcohol does. Both agents lead to dependence and disinhibition which may alter the partners sensorium and lead to violent responses to provocation, responses which may not have occurred had the substances not been used.

We reported that female undergraduates who received/earned more than their partners monthly were at least twice at risk of experiencing IPV. Earning more than one’s partner in a patriarchal/male dominated society may lead to IPV as the men may not be comfortable with knowing their partners earn more than they do and are financially superior. This may lead to inferiority complex problems on the man’s part and tension build-up, which may eventually lead to violence. This finding was congruent with other studies [30, 31].

Contrary to our findings, Iliyasu et al. [8] reported that religious affiliation, ethnicity, indigeneship, marital status, campus residence and faculty affiliation were significant predictors of GBV. This further shows the impact of religion as well as environmental factors on IPV. Interventions geared towards reducing knowledge of IPV in females has been shown to be impactful [32]. It is therefore essential that such interventions be incorporated into the guidance and counselling units in the tertiary institutions.

In conclusion, IPV was prevalent amongst over half of female undergraduates in Abia State, with, emotional abuse being the commonest form of abuse while sexual abuse was the least common. Female undergraduate earning/receiving more than male partner monthly, male (partner) alcohol consumption, female smoker and having witnessed domestic violence as a child were all significant predictors of IPV amongst female undergraduates.

We therefore recommend that primary and secondary prevention interventions targeted at curbing the identified risk factors of IPV be instituted for both young men and women in Abia state tertiary institutions. Additionally, there is need for institutions to implement adequate reporting and effective response mechanisms to assist victims and mitigate the myriad of negative outcomes.

The major strength of this study is that it was among the first studies in South Eastern region of Nigeria to explore IPV holistically amongst female undergraduates to the best of our knowledge. Secondly, having used two major tertiary institutions within the state, we got a good representative spread of undergraduate respondents which validates generalization of the study. Finally, both online and physical questionnaires were used to reduce the possibility of selection bias and restricting respondents to only those with access to smart devices (phones and tablets) connected to the internet.

Limitations of this study is that there may not have been full disclosure from the respondents, considering the fact that IPV is a very sensitive issue. Some people may be guarded about providing information on abuse and some may have recall bias of some events or not want to talk about it at all. Also, due to the cross-sectional design of this study, only associations of IPV could be tested for and this study was unable to determine causal relationships or describe temporal associations between some of the factors associated with experience of violence. Some of the above limitations were mitigated by assuring respondents of full confidentiality of their responses, advising them to fill the questionnaire (either online or physical) in a private space with little distractions, advising them in the introductory section of the questionnaire not to proceed if some of the questions may cause them any form of distress and providing the researchers’ contact for easy accessibility incase the respondent needed any form of psychosocial support or help with reporting recent or ongoing abuse.