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Dlamini NS, Masango BZ, Chiao C, Lin WH. Associations between forced non-consensual first-sex and HIV among sexually active women in the Kingdom of Eswatini. AIDS Care 2024; 36:87-97. [PMID: 37187024 DOI: 10.1080/09540121.2023.2206099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
Studies continue to underscore the profound impact of sexual violence on women's health. Yet, little is known about the impact, via a complex matrix of behavioural and social factors, of first intercourse, namely forced non-consensual on HIV status, particularly among sexually active women (SAW) in low-income countries where HIV prevalence remains high. Using a national sample from Eswatini, we employed multivariate logistic regression modelling to estimate the associations between forced first-sex (FFS), subsequent sexual behaviour and HIV status among 3555 SAW aged from 15 years to 49 years. The results found that women who experienced FFS had a greater number of sexual partners compared to those who had never experienced FFS (aOR = 2.79, p < .01), although there were no significant differences in condom use, early sexual debut and casual sex involvement between these two groups. FFS remained significantly associated with a higher risk of having HIV (aOR = 1.70, p < .05) even after controlling for risky sexual behaviours and various other factors. These findings further reinforce the relationship between FFS and HIV, and suggest that addressing sexual violence is a critical component of HIV prevention among women in low-income countries.
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Affiliation(s)
- Nompilo Sibonakele Dlamini
- International Health Program, College of Medicine, Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, R.O.C
- Department of Community Health Nursing Science, Faculty of Health Sciences, University of Eswatini, Mbabane, Eswatini
| | | | - Chi Chiao
- International Health Program, College of Medicine, Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, R.O.C
- College of Medicine, Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan, R.O.C
| | - Wen-Hsu Lin
- College of Medicine, Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan, R.O.C
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Alexander KA, Mpundu G, Duroseau B, Osian N, Chambers S, McCree D, Tobin KE, Willie TC. Intervention Approaches to Address Intimate Partner Violence and HIV: a Scoping Review of Recent Research. Curr HIV/AIDS Rep 2023; 20:296-311. [PMID: 37768511 DOI: 10.1007/s11904-023-00668-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE OF REVIEW Intimate partner violence (IPV) remains a critical challenge to HIV prevention and treatment efforts across the globe. We examined recently published (January 9, 2017-January 9, 2023) integrated behavioral interventions designed to address IPV and HIV across the care continuum. RECENT FINDINGS Fifteen studies (involving n = 10,947 participants) met the inclusion criteria for this review. Majority (n = 13) of studies focused on IPV and HIV prevention whereas two studies addressed IPV and HIV care engagement among women living with HIV. Ten studies were conducted on the African continent representing 5 countries. Most interventions (n = 11) focused on individual-level outcomes among cisgender women although two involved male partners. About half of the interventions reviewed (n = 8) showed effectiveness on both IPV and HIV outcomes compared to control groups. Integrated HIV/IPV interventions are needed to address the synergistic nature of these epidemics among marginalized populations. Future studies should focus on developing and implementing strength-based interventions among people living with HIV, men, transgender people, and Black women in the USA. Additionally, researchers and program managers should consider addressing structural and internalized stigma as potential behavioral mechanisms for improving health among people simultaneously experiencing or at-risk for HIV and IPV.
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Affiliation(s)
- Kamila A Alexander
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, N430G, Baltimore, MD, 21213, USA.
| | - Gloria Mpundu
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, N430G, Baltimore, MD, 21213, USA
| | - Brenice Duroseau
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, N430G, Baltimore, MD, 21213, USA
| | - Nkemakolem Osian
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Shadae Chambers
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, N430G, Baltimore, MD, 21213, USA
| | - DaJaneil McCree
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, N430G, Baltimore, MD, 21213, USA
| | - Karin E Tobin
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Tiara C Willie
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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ODACI H, TÜRKKAN T. Treatment Issues While Addressing Child Sexual Abuse: A Review. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1181095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Child sexual abuse is a traumatic life event that has social, psychological, political and cultural dimensions which is observed in many societies. Sexual abused children are at risk of developing behavioral, emotional, cognitive and physical health problems throughout their lives, and are especially vulnerable when their current condition is combined with other risk factors, such as poverty. In the relevant literature, it is reported that these children have a greater risk of having psychological problems and require treatment. There is evidence that psychotherapeutic treatments have beneficial effects, including ensuring the physical and emotional safety of victims, helping to relieve trauma symptoms, improving quality and functioning of life, and preventing recurrence of abuse. In this review, some of the most common treatment issues for sexual abused children are presented. The appropriateness of the treatment issues and proposed interventions addressed may vary for each victim. These treatment issues and interventions are designed not only to remedy any harm that may have occurred, but also to minimize the negative consequences of experiences of child abuse and prevent future recurrence of maltreatment.
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Tsuyuki K, Chan E, Lucea MB, Cimino A, Rudolph AE, Tesfai Y, Campbell JC, Catabay CJ, Stockman JK. Characterising a syndemic among black women at risk for HIV: the role of sociostructural inequity and adverse childhood experiences. Sex Transm Infect 2023; 99:7-13. [PMID: 35595503 PMCID: PMC9887352 DOI: 10.1136/sextrans-2021-055224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/13/2022] [Indexed: 02/03/2023] Open
Abstract
Objectives Black women disproportionately experience STIs (including HIV/AIDS), gender-based violence, substance misuse and mental health conditions. Addressing a gap in syndemic research, we characterised comorbidity overlap within the context of sociostructural inequities and adverse childhood experiences (ACEs) among black women in Baltimore, Maryland. Methods Between 2015 and 2018, black women (n=305) were recruited from STI clinics in Baltimore, Maryland. Among those with complete survey data (n=230), we conducted a latent class analysis to differentiate women based on their profile of the following syndemic comorbidities: STIs, adult sexual victimisation, substance misuse and mental health disorders. We then examined the association between ACEs and syndemic latent class membership. Results Thirty-three percent of women experienced three to nine ACEs before age 18 years, and 44% reported four to six comorbidities. The two-class latent class solution demonstrated the best fit model, and women were categorised in either class 1 (past-year STI; 59%) or class 2 (syndemic comorbidities; 41%). Women in class 2 were more likely to report unstable housing (10% vs 3%) and identify as bisexual/gay (22% vs 10%) than women in class 1. ACEs were significantly associated with an increased likelihood of class 2 membership. Conclusions This study reinforces the importance of screening for ACEs and offering trauma-informed, integrated care for black women with syndemic comorbidities. It also highlights the critical nature of tailoring interventions to improve sociostructural equity, preventing and reducing syndemic development.
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Affiliation(s)
- Kiyomi Tsuyuki
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Erica Chan
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | | | - Andrea Cimino
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Abby E Rudolph
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Yordanos Tesfai
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | | | - Christina J Catabay
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Jamila K Stockman
- Department of Medicine, University of California San Diego, La Jolla, California, USA
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Kumar B, Prasad I, Priyambda P, Goel N. Child sexual abuse laws in India; failure of implementation - a case report. Med Leg J 2022; 90:234-237. [PMID: 36151763 DOI: 10.1177/00258172221114991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Child sexual abuse (CSA) is a worldwide problem with girls most affected even allowing for the possibility that boys are less likely to report it. In India there is strict anti-CSA legislation like the Protection of Children from Sexual Offences (POCSO) Act, but enforcement falls short due to poor socioeconomic conditions, low education levels, and insensitive actions and responses.
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Affiliation(s)
- Binay Kumar
- Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, India
| | - Indira Prasad
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, India
| | - Priyanka Priyambda
- Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, India
| | - Nikhil Goel
- Department of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, India
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Guyon R, Fernet M, Hébert M. Relational and Sexual Experiences of Betrayal From the Point of View of Sexually Victimized Young Women. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP11506-NP11530. [PMID: 31766936 DOI: 10.1177/0886260519888197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Worldwide, it is estimated that one in five women have reported being sexually victimized before the age of 18. Girls are particularly at risk of sexual abuse at the end of adolescence and are more vulnerable to revictimization during this period. However, there is a paucity of findings related to the relational and sexual impacts of child sexual abuse among young women. The traumagenic dynamics model, proposed by Finkelhor and Browne, postulates that the consequences of sexual abuse can be analyzed in light of four distinct dynamics: traumatic sexualization, betrayal, powerlessness, and stigmatization. Among the four postulated dynamics, betrayal appears to be a key element to gain insight on the relational challenges experienced by victims, as betrayal situations can recur in romantic relationships. The present study aimed to describe, from the point of view of young women victims of child sexual abuse, the issues related to betrayals in their relational and sexual experiences. Semi-structured interviews were conducted with 19 young women aged 18 to 25 years old who had reported sexual victimization. Two main conceptual categories emerged from the narratives of the participants: (a) relational situations that echo the betrayal dynamic and (b) strategies to cope with relational situations involving betrayal: protection, reparation, and the use of both strategies, which leads to ambivalence. Findings highlight the importance of addressing the traumagenic dynamic of betrayal in interventions with sexually abuse youths, given their likelihood to experience betrayal in the context of romantic relationships and their increased risk of revictimization.
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Ferragut M, Ortiz-Tallo M, Blanca MJ. Victims and Perpetrators of Child Sexual Abuse: Abusive Contact and Penetration Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189593. [PMID: 34574520 PMCID: PMC8472568 DOI: 10.3390/ijerph18189593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/10/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
Child sexual abuse (CSA) includes abusive contact experiences, which habitually impact the victim's whole life. This study aims to analyze the characteristics of six CSA experiences with physical contact, including penetration, in a representative sample of the Spanish population. Participants were 1071 Spanish adults (53% males; Mage: 45.37) who completed the Child Sexual Abuse Experiences Questionnaire. The victim's age at the first episode, the perpetrator's characteristics, and the number of times that each experience occurred were analyzed, taking into account gender differences. Results were reported for every experience independently. The most prevalent age at the first experience was from 6 years old onwards, but with differences in some experiences. The abuses usually happened more than once, committed by the same person. The most prevalent perpetrator is a male, although a female perpetrator is more prevalent in male victims. Most of the abuses were committed by an adult acquaintance, a strange adult, and other minors, with some gender differences. The implications of the results concerning every CSA experience are discussed, highlighting their value for future research and practice, the design of preventive programs, and early detection of CSA.
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Affiliation(s)
- Marta Ferragut
- Faculty of Psychology, University of Málaga, 29071 Málaga, Spain; (M.O.-T.); (M.J.B.)
- Correspondence:
| | - Margarita Ortiz-Tallo
- Faculty of Psychology, University of Málaga, 29071 Málaga, Spain; (M.O.-T.); (M.J.B.)
- Con.Ciencia Association, 29016 Málaga, Spain
| | - Maria J. Blanca
- Faculty of Psychology, University of Málaga, 29071 Málaga, Spain; (M.O.-T.); (M.J.B.)
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Profiling Children Sexual Abuse in a Sample of University Students: A Study on Characteristic of Victims, Abusers, and Abuse Episodes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094610. [PMID: 33925293 PMCID: PMC8123693 DOI: 10.3390/ijerph18094610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/20/2021] [Accepted: 04/25/2021] [Indexed: 12/28/2022]
Abstract
Because of its prevalence and its potential negative consequences, child sexual abuse (CSA) is a public health problem in every country in the world. Knowledge of the characteristics of abuse episodes (victim, abuser, relationship between them, type of sexual contact, duration, threat and/or use of force) is essential to specify the contents of intervention programs for the detection and reduction of the negative consequences of CSA. Starting with an initial sample of 1605 university students of both sexes (70.9% women, 29.1% men), aged between 18 and 26 years (M = 21.1, SD = 2.2), 90 participants who had suffered an episode of CSA up to age 16 were selected (84.4% women, 15.6% men; Mage = 21.1, SD = 2.2). It was found that: (1) there was a higher prevalence of CSA among women and that the victims’ average age when they suffered abuse was around 11 years; (2) the abusers were mostly male, close to the victims, and with an average of slightly less than 30 years; and (3) there was a significant proportion (25.6%) of CSA cases with penetration and in which force was used or threatened. These results are relevant, as they show that there is still a noteworthy prevalence of CSA cases on university campuses that needs to be addressed. Knowing the characteristics of these episodes is critical to implementing more effective interventions.
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Brewer A, Colbert AM, Sekula K, Bekemeier B. A need for trauma informed care in sexually transmitted disease clinics. Public Health Nurs 2020; 37:696-704. [PMID: 32776628 DOI: 10.1111/phn.12784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/16/2020] [Accepted: 07/19/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This review examines trauma from violence as a risk factor for sexually transmitted diseases (STDs) among women attending STD clinics. The review also aims to suggest trauma informed care (TIC) integrated into STD clinics might more effectively address traumatic effects of violence linked to sexual risk behaviors among this population. DESIGN AND SAMPLE A systematic literature review was conducted to identify empirical studies examining the relationship between multiple forms of violence and sexual risk behaviors among women attending STD clinics. RESULTS All studies found high rates of violence including childhood sexual abuse, intimate partner violence, and/or community violence associated with high rates of sexual risk behaviors among women attending these settings. Researchers recommend screening for multiple forms of violence, interdisciplinary STD clinic services, and more trauma informed sexual risk reduction interventions to address multiple forms of violence found prevalent among this population. CONCLUSION Women attending STD clinics very often experience multiple forms of violence during their lifetime. TIC to address traumatic effects of violence might reduce sexual risk behaviors and sexually transmitted disease rates for improved health outcomes among this population.
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Castro Á, Ibáñez J, Maté B, Esteban J, Barrada JR. Childhood Sexual Abuse, Sexual Behavior, and Revictimization in Adolescence and Youth: A Mini Review. Front Psychol 2019; 10:2018. [PMID: 31543854 PMCID: PMC6728807 DOI: 10.3389/fpsyg.2019.02018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/19/2019] [Indexed: 11/24/2022] Open
Abstract
Childhood sexual abuse (CSA) is considered as an activity aimed at providing sexual pleasure, stimulation, or sexual gratification to an adult who uses a minor for this purpose, taking advantage of the situation of superiority. CSA can have devastating consequences for the child. Previous studies have concluded that those who suffer an episode of CSA perform more risky sexual behaviors and are more likely to experience further episodes of sexual victimization during adolescence and early youth. There are two theoretical contributions that, although they offer partial views, can help to understand the association between CSA, sexual behavior, and revictimization in adulthood: the traumagenic dynamics model and the information-motivation-behavioral skills model. This short review provides an overview of the problems and theoretical explanations that have been presented up to the present, underlining the importance of prevention and sex education as of childhood, as well as the need to continue investigating in order to develop specific theoretical models that help to understand and prevent CSA and its consequences.
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Affiliation(s)
- Ángel Castro
- Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain
| | - Javier Ibáñez
- Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain
| | - Berta Maté
- Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain
| | - Jessica Esteban
- Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain
| | - Juan Ramón Barrada
- Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain
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