Importance: The significance of empirical studies on Intimate Partner Violence (IPV) in Chinese populations is underscored. Early prevention and intervention for Adverse Childhood Experiences (ACE) can effectively lower the rate of IPV victimization in adulthood. However, the mechanisms connecting ACEs to IPV exposure remain unclear, with male victims frequently overlooked in previous IPV studies.

Objective: The study aimed to investigate the prevalence of ACE and IPV using a large representative Chinese sample, explore the association mechanism between ACE and adult exposure to IPV, and to examine gender differences.

Design: Cross-sectional study

Setting: This study utilized data from the Psychology and Behavior Investigation of Chinese Residents (PBICR) conducted between June 20, 2023, and August 20, 2023.

Participants: 30,504 individuals in China.

Exposures: IPV was assessed using a 5-item questionnaire developed by the PBICR project team.

Main Outcomes and Measures: logistic regression model was used to analyze the association between ACE and the risk of IPV exposure in adulthood. Principal component analysis was used to extract the main patterns of ACEs in the Chinese population. Network analyses were employed to identify the most critical types of Adverse Childhood Experiences (ACEs) and Intimate Partner Violence (IPV), analyze the association mechanisms between ACEs and IPVs, explore gender differences in this association, and compare gender differences in the severity of IPVs experienced in adulthood.

Results: Guizhou is the province in China with the highest prevalence of ACE, IPV, and the highest prevalence of ACE combined with IPV. ACE increases the risk of victims' exposure to IPV in adulthood, and participants who experienced at least one ACE event had a 215% increased risk of IPV, compared to participants who did not have an ACE. Participants who experienced at least one ACE event had a 215.5% increased risk of IPV compared to those without ACE. In the population-wide ACE pattern and IPV network, the ACE and IPV nodes with the highest expected influence were ACE1 and IPV5, respectively. positive correlations were found between ACE1-IPV3, ACE4-IPV1, and ACE2-IPV2, which were the three edges with the highest edge weight values in the ACE pattern and IPV edges. The ACE and IPV nodes with the highest EI in the male and female networks are also ACE1 and IPV5. ACE1-IPV3, ACE2-IPV2, ACE4-IPV1 in the male network, and ACE1-IPV3, ACE4-IPV1, ACE3-IPV1 in the female network are the three edges with the highest edge weights among the ACE and IPV edges in their networks, respectively. three edges, and all of them are positively correlated. The strength of IPV3 was higher in the male network than in the female (male = 0.821, female = 0.755, p = 0.002). The edge weight values of ACE3-IPV1 (P=0.043), and ACE4-IPV1 (P=0.032) were greater for female participants than for male participants.

Conclusion: Guizhou has the highest prevalence of Adverse Childhood Experiences (ACE) and Intimate Partner Violence (IPV) in China. The most common type of ACE in the Chinese population is verbal violence combined with physical violence, while the predominant type of IPV is verbal violence. Males experience higher levels of emotional neglect from their partners compared to females. The association between witnessing physical violence in childhood and experiencing physical violence from a partner in adulthood is stronger in females than in males. The homotypic continuum between ACE and IPV is a crucial mechanism in understanding intergenerational domestic violence. Focus on high ACE prevalence areas in China, enhance economic and educational levels, promote correct parenting concepts, reduce child abuse, establish accurate perceptions of intimate relationships, eliminate shame about violence, and further advance gender equality. These efforts are vital for reducing IPV prevalence and breaking the cycle of violence in victims' lives.