"I never told anyone until the #metoo movement": What can we learn from sexual abuse and sexual assault disclosures made through social media?

"It is in the Nature of Men": The Normalization of Non-Consensual Sex and Intimate Partner Violence Against Women with Acquired Physical Disabilities in South Africa

This study employed a cross-sectional, qualitative individual interview methodology to explore South African women with physical disabilities' experiences of intimate partner and sexual violence, inclusive of non-consensual and coerced sexual intercourse. For the participants, disability was a factor that intersected with gender norms to create vulnerability to abuse, and that patriarchal ideologies constructing how women should perform their gendered roles in marriage or sexual partnerships, as well as disability stigma, exacerbated this vulnerability. It is important to develop understandings of the different risk factors for violence - at the individual level and in the context of dyadic relationships - to develop programming to better support women.

Online Child Sexual Exploitation and the Role of Computer-Mediated Communication: A Scoping Review

The online landscape has shifted since the rise of smartphones and social media in the 2010s and altered the way children use technologies. Along with a reliance on computer-mediated communication (CMC) is the concern of online child sexual exploitation (OCSE). This scoping review provided an updated examination of the prevalence, risk factors, outcomes, and disclosures of OCSE since 2010. Systematic searches were conducted using three databases for studies published between January 2010 and January 2023. Results indicated an alarming prevalence of, and a wide range of risk factors and consequences associated with OCSE worldwide. Many young victims struggled to recognize OCSE as a serious form of abuse. The need to monitor the ever-changing Internet landscape for young users is highlighted.

Keyboard coercion: Online and face-to-face sexual aggression in a college sample

Objective: This work sought to assess relationships between sexually aggressive behavior occurring through the use of technology and social media, perceived social norms of sexually aggressive behavior, and face-to-face sexual aggression and coercion. Participants: Participants were 663 undergraduate students (73.1% Female). Methods: Participants completed measures assessing perceived social norms of sexually aggressive strategies, personal sexual strategies used, alcohol use, cyberbullying, sexual victimization, personal wellbeing, and socially desirable responding. Results: Thirty percent of participants reported engaging in some form of sexually aggressive behavior offline; 15.6% endorsed engaging in sexual cyberbullying. However, 100% of participants endorsed the belief that their peers were engaging in some form of sexually aggressive behavior either online or offline. Conditional process modeling revealed a significant indirect effect of perceived social norms of sexually aggressive behavior on face-to-face sexual aggression via sexual cyberbullying (b = .0015, p < .001, 95% CI [.0030, .0110]), indicating mediation. Conclusions: The present work highlights the importance of further research in the domain of sexual cyberbullying.

The Process of Online Disclosures of Interpersonal Victimization: A Systematic Review

Theory and research on disclosure of interpersonal victimization, including intimate partner violence, sexual assault, and child abuse, has produced rich scholarship promoting a greater understanding of the challenges and implications of disclosure for survivors. However, in the last decade, social media platforms have opened new online disclosure opportunities that diverge from and overlap with offline disclosure. This highlights the need for adaptation and elaboration of theorizing in this growing area of study. Thus, the study aimed to systematically review the studies published in scientific literature. The following databases were accessed Criminal Justice Abstracts, Medline PsychInfo, Social Work Abstracts, Sociological Abstracts, Web of Science database, and Google Scholar. Twenty-seven studies met the inclusion criteria of peer-reviewed status and focused on the disclosure process. A thematic analysis revealed that online disclosure of interpersonal victimization is a multi-phase (decision-making and disclosure aftermath) and multifactorial (individual, interpersonal, social, and technological) experience for survivors. Specifically, survivors' motivation was related to therapeutic goals, social support, and a desire to advocate for social change. Survivors faced numerous facilitators (e.g., inspiration from other online disclosures) and barriers (e.g., fear of triggering other survivors) to disclosure. The impact of online disclosure was divided into benefits (e.g., empowerment) and risks (e.g., undermining survivors' security). The conceptual and empirical limitations of the current research are discussed, including a need for quantitative methods with larger samples and longitudinal designs to better understand how survivors can best benefit from processes of online disclosure, while avoiding harm or re-traumatization.

Unveiling Child Sexual Abuse Disclosure in China: An Ecological Exploration of Survivors' Experiences

Through a thematic analysis of firsthand posts from 258 abuse survivors in online forums from 2016 to 2023, this research examines the barriers that Chinese children encounter when disclosing sexual abuse. The anonymous narratives shed light on the motives behind survivors' reluctance to reveal abuse, the outcomes following disclosure, and the wider implications for survivors and their families under culture. The findings underscore the need for early intervention upon disclosure, aiming to safeguard children from further harm and foster the development of an effective child protection framework.

The Media and Sexual Violence Among Adolescents: Findings from a Qualitative Study of Educators Across Vietnam

Growing access to technology and media has presented new avenues of influence on youth attitudes and norms regarding sexuality and sexual violence, as well as new technological pathways through which to perpetrate sexual violence. The aim of this research was to understand contextual influences on and needs for scale-up of sexual violence prevention programming in the media-violence context of Vietnam. We conducted 45 interviews with high school teachers (n = 15), university lecturers (n = 15), and affiliates from youth-focused community service organizations (n = 15) from across Vietnam. Additionally, we conducted four sector-specific focus groups with a sub-sample of interview participants (k = 4, n = 22). Media and technology were brought up consistently in relation to sexual violence prevention and sexual health information. Key informants noted that, in Vietnam, generational differences in acceptability of sex and lack of comprehensive sexuality education intersect with new technological opportunities for exposure to sexual information and media. This creates a complex landscape that can promote sexual violence through priming processes, instigate mimicry of violent media, and presents new opportunities for the perpetration of sexual violence though technology. Development of comprehensive sexual education, including violence prevention education, is imperative, with consideration of age-specific needs for Vietnamese youth.

"I Didn't Realize How Common it Was:" A Mixed-Methods Study Examining Changes in Perceptions of Sexual Assault, Sex and Consent, and Sexual Behavior as a Function of the #Metoo Movement

This mixed-methods study examined awareness and perceived legitimacy of the #MeToo movement and how #MeToo changed perceptions of sexual assault and consent, as well as sexual interactions, in the United States. Adults residing in the U.S. were recruited through CloudResearch to complete an online survey in 2021. Quantitative data from 680 participants (M age = 45.8, 60% women, 77.4% White) indicated moderate awareness and perceived legitimacy of the #MeToo movement; Black, LGBQ+, and more politically liberal respondents had greater #MeToo awareness while younger, more liberal respondents, and those with greater rejection of rape myths rated #MeToo more legitimate. Among 354 participants (M age = 45.0, 65.3% women, 76.4% White) who answered at least one open-ended question with regard to changes resulting from the #MeToo movement, thematic analysis revealed nine primary themes: (1) Describing change; (2) Change in understanding; (3) More cautious; (4) Wrong or requires reporting/punishment; (5) Gendered social norms; (6) Easier to talk about; (7) #MeToo rhetoric; (8) Consequences for survivors, and (9) Empowerment. Several sub-themes were identified among the primary themes and implications for sexual assault prevention and response were discussed. The study findings are contextualized by social constructionism, with a particular focus on gender-based power dynamics, contributing to a growing literature documenting the cultural impact of the #MeToo movement.

Social Media's Impact on Rape Myth Acceptance and Negative Affect in College Women: Examining the #MeToo and #HimToo Movement

This study examined how the #MeToo movement, and backlash against it (#HimToo), influence rape myth acceptance (RMA) and negative affect among female sexual trauma survivors and controls. We randomly assigned college women (N  =  389) to three social media conditions that either promoted RMA (#HimToo), challenged RMA (#MeToo), or did not address rape myths (general social media (GSM)). The findings demonstrated that women in the #HimToo condition reported more RMA, whereas women in the #MeToo and GSM conditions reported less negative affect. The results highlight that the way we talk about rape on social media influences momentary affect and RMA.

Disclosing Sexual Victimization Online and In-Person: An Examination of Bisexual+ and Heterosexual Survivors

Bisexual+ (bisexual, pansexual, queer, attraction to more than one gender) people are at elevated risk for sexual victimization relative to their heterosexual counterparts. Disclosure of sexual victimization and social reactions received upon disclosure can play a major role in recovery following an assault. Using an online survey, the current study examined whether bisexual+ and heterosexual survivors of sexual victimization (N = 657) varied in disclosure of victimization, the type of disclosure (in-person vs. online via #MeToo), and receipt of various social reactions to disclosure in person and online. A chi-square test examined differences in disclosure and differences in types of disclosure (in-person only vs. MeToo across sexual identity). MANOVAS were used to examine whether in-person and online reactions varied across sexual identity. Bisexual+ survivors were more likely to disclose sexual victimization relative to heterosexual survivors. Among those who disclosed, bisexual+ survivors were more likely to disclose in person only whereas heterosexual survivors were more likely to disclose online via #MeToo. Whereas we did not find any significant differences for in-person reactions, we did find significant differences for online social reactions using #MeToo. Heterosexual survivors received higher turning against reactions (e.g., avoided talking to you or spending time with you) and more unsupportive acknowledgment relative to bisexual+ participants. Whereas bisexual+ participants received less turning against reactions and unsupportive acknowledgment during #MeToo/online disclosure, they were also less likely to disclose using #MeToo. Findings suggest that bisexual+ and heterosexual people vary in the way they disclose sexual victimization, and in how they are responded to when disclosing in person and online.

Gynecological health and uptake of gynecological care after domestic or sexual violence: a qualitative study in an emergency shelter

BACKGROUND

Domestic and sexual violence have been linked to adverse gynecological and obstetric outcomes. Survivors often find it difficult to verbalize such violence due to feelings of shame and guilt. Vulnerable or socially excluded women are frequently excluded from research, particularly qualitative studies on violence. This study aimed to characterize the perceived impact of domestic or sexual violence on the gynecological health and follow-up among women with complex social situations.

METHODS

We analyzed the data following inductive thematic analysis methods.

RESULTS

Between April 2022 and January 2023, we conducted 25 semi-structured interviews, lasting on average 90 min (range: 45-180), with women aged between 19 and 52, recruited in an emergency shelter in the Paris area. The women described physical and psychological violence mainly in the domestic sphere, their altered gynecological and mental health and their perception of gynecological care. The levels of uptake of gynecological care were related to the characteristics of the violence and their consequences. The description of gynecological examination was close to the description of coerced marital sexuality which was not considered to be sexual violence. Gynecological examination, likely to trigger embarrassment and discomfort, was always perceived to be necessary and justified, and consent was implied.

CONCLUSION

This study can help question the appropriateness of professional practices related to the prevention of violence against women and gynecological examination practices. Any gynecological examination should be carried out within the framework of an equal relationship between caregiver and patient, for the general population and for women with a history of violence. It participates in preventing violence in the context of care, and more widely, in preventing violence against women.

Characteristics of Sexual Assault Among Men Receiving a Forensic Medical Examination

Sexual assault is a form of violence disproportionately perpetrated against women by men; however, men also experience high rates of sexual victimization. While recent research exploring victimization of sexual assault among men does exist, little is known about situational characteristics and consequences surrounding men's assault experiences. Therefore, the current study examines narratives of men's sexual assault to further understand the unique experiences of men receiving a sexual assault medical forensic examination. To accomplish this, we conducted a retrospective medical chart review of sexual assault narratives from N = 45 men receiving a sexual assault medical forensic examination at a large academic medical institution in the southeastern United States. Three general constructs were identified within the records: a) Perpetrator use of coercive tactics, b) Memory loss, and c) Contextual factors. Nested within these constructs, five specific themes emerged, including: a1) Use of weapons and physical force; a2) Tactical administration of alcohol and drugs; b1) Difficulties remembering assault; c1) Consensual sexual activity turned non-consensual; c2) Incarceration. Findings from the present study common identified characteristics of sexual assaults among men receiving a sexual assault medical forensic examination, including coercive tactics used by perpetrators, consequences of sexual assault, and high-risk settings for male victimization.

#MeToo and Sexual Violence Reporting in the National Crime Victimization Survey

The Me Too Movement has reshaped cultural awareness about sexual violence but little is known about how this shift may have coincided with changes in the reporting of sexual violence. The current study is the first to use the National Crime Victimization Survey to compare pre-#MeToo and post-#MeToo reports of sexual violence across three different blocks of time (Time 1: 2014-2015; Time 2: October 2017-September 2019; Time 3: October 2019-September 2021). Comparisons include prevalence rates of overall sexual violence, self-reports of sexual violence, official police reports of sexual violence, and situational characteristics of sexual violence (offender was a stranger, victim injury, victim services used). We also examine gender (women/men) and racial (White women/non-White women) differences in sexual violence reporting. Using formal comparisons, we find a significant increase in the rates of overall sexual violence as well as self-reports and stranger-offender reports of sexual violence between the pre- (Time 1) and the first post-#MeToo time point (Time 2). However, these increases are no longer evident in Time 3. In addition, the changes between the pre- (Time 1) and the first post-#MeToo time point (Time 2) are driven primarily by White women's reporting of sexual violence, and we find no significant changes in the rates of sexual violence experienced by men nor non-White women during these time periods.

Stereotypical Victims: Visibility of #MeToo Disclosures on Twitter

The #MeToo movement has brought greater visibility to the topic of sexual assault in public discourse. We analyzed a dataset of 1,070 Twitter #MeToo self-disclosures to examine the relationship between online visibility (retweets and favorites) and the content of victim-survivors' self-disclosures such as victim's gender, relationship to the perpetrator, and the emotions expressed in the tweet. The visibility of sexual assault self-disclosures was shaped by the extent to which they align with stereotypical misconceptions of victimization. These findings carry significant implications for understanding patterns of victimization, and for identifying whose voices are being amplified or not on Twitter.

Cross-sectional examination of correlates of sexual victimization disclosure via #MeToo

Background: Sexual victimization is a serious public health problem, with a range of negative impacts on mental and physical health. Responses that individuals get to disclosure of sexual victimization play an important role in recovery. With the increased use of social media, more survivors are talking about their experiences of sexual victimization online. Research is needed to document the correlates of online disclosure of sexual victimization.Objective: The current study examined the role of demographic characteristics, assault severity, coping strategies, and social isolation as putative correlates of disclosing sexual victimization online via the hashtag #MeToo.Methods: A sample of 637 adults recruited via social media who reported a history of sexual victimization since the age of 14 completed self-report surveys using online survey software to assess disclosure of sexual victimization, assault severity, coping strategies, and social isolation.Results: Multivariate analyses suggest that levels of emotion-focused coping were positively associated with the disclosure of sexual victimization online via #MeToo. Further, individuals who had experienced completed rape by verbal coercion were less likely to disclose via #MeToo, compared to individuals who experienced other forms of assault.Conclusion: Coping strategies and assault severity play an important role in determining whether survivors disclose sexual victimization online via #MeToo. Findings suggest that individuals may disclose via #MeToo to seek support or express their emotions. Further, individuals whose sexual victimization experiences do not conform to 'typical' sexual victimization experiences are less likely to disclose via #MeToo.

Understanding how peers respond to online child maltreatment disclosures: A qualitative content analysis of family violence discussions on social media

BACKGROUND

Positive, supportive responses to child maltreatment disclosure are critical for victims to receive appropriate resources and support for healing. Young people often prefer to disclose to their peers, frequently on social media platforms.

OBJECTIVE

We assessed young people's use of TalkLife, an online peer-to-peer support platform, to respond to the disclosure of child maltreatment.

METHODS

We conducted a qualitative content analysis of 1090 comments on childhood maltreatment-related posts on TalkLife between 2013 and 2020. We used an iterative, team-based qualitative content analysis approach to understand how peers responded to maltreatment disclosure.

FINDINGS

Peer responses tended to be supportive, including asking questions about the abuse and offering advice, emotional support, and other positive responses. Most commonly, peers advised the victim to report, focus on their strengths instead of the abuse, reach out to adults for more support, or confront the perpetrator. On occasion, however, peers began an irrelevant discussion, joked about the situation, or even directly attacked the discloser.

CONCLUSIONS

Learning about child maltreatment disclosures on social media builds the foundation for research to assist in identifying and applying interventions on online platforms. Further, these findings can inform programs that teach how to provide healthy responses to child maltreatment disclosures.

Alcohol Use, Rape Myth Acceptance, Rape Empathy, and Sexual Assault History Influence the Believability of a Hypothetical Victim's Report of Sexual Assault

College sexual assault is a common problem, and survivors often do not report their experience to college campus officials or law enforcement for fear of not being believed. This study examined how contextual factors such as alcohol use and whether the perpetrator was described as a student-athlete or student, and rater characteristics, such as the history of sexual assault and attitudes toward rape, influenced college students' perceptions of the believability of a hypothetical victim's sexual assault account. In all, 449 (N = 449) undergraduates read a vignette describing a hypothetical sexual assault and were assigned randomly to one of four conditions with varying contextual features: college athlete-no alcohol, college athlete-alcohol, college student-no alcohol, or college student-alcohol. They then rated how much they believed the victim in the vignette had been raped (0 [not at all] to 100 [completely]). The presence of alcohol use in the vignette was associated with lower ratings of believability, and participants who were higher in rape myth acceptance and lower in rape empathy rated the hypothetical victim's rape account as less believable. In addition, women who had been raped previously rated the victim in the vignette as more believable than women with no history of sexual assault. Implications for how college campuses might respond more effectively to reported sexual assaults are discussed.

"One Day It Will Be Over, and You Will See Other Landscapes. . . You Are Not Alone": Adult Survivors' Messages to Children Undergoing Child Sexual Abuse

Child sexual abuse (CSA) has received considerable attention from scholars, contributing to policy, intervention, and prevention efforts worldwide. However, survivors' involvement in this research is limited. This study was designed to delve into the messages of adult CSA survivors to abused children. In all, 371 written testimonies were provided to the Israeli Independent Public Inquiry on CSA by survivors from diverse communities in Israel. The Inquiry aimed to promote change in policies related to CSA. The testimonies were analyzed using the qualitative thematic analysis method. The results revealed five main messages emphasized by survivors to children experiencing CSA: (a) transferring the responsibility and guilt from children to perpetrators and society; (b) turning toward the light and continuing on; (c) disclosure is essential; (d) a happy life is possible; and (e) together we can survive. The discussion emphasizes how various systems in survivors' lives have profound impacts following the abuse. Although survivors were from diverse backgrounds, their messages to abused children were consistent. Through their messages to the children, the survivors emphasized their wish to transfer responsibility and guilt from children experiencing abuse to the society that is supposed to see, listen, protect, and validate. Implications for practice are discussed, focusing on the importance of making room for survivors' voices and experiences in the processes of shaping policies in the area of CSA. Moreover, the survivors' desire to be there for the children emphasized the urgent need to promote the perception of survivors as key stakeholders in the field of child abuse and to integrate their experiences and perceptions into the formal and informal systems for children.

Where do those experiencing sexual violence seek help and is routine enquiry acceptable within a sexual healthcare setting? Findings from a population-based survey

OBJECTIVES

Most sexual violence (SV) remains undisclosed to healthcare professionals. The aims of this study were to identify where support would be sought after SV and whether routine enquiry about SV was acceptable in a sexual healthcare setting.

DESIGN

An online population-based survey collected data on a history of SV and preferences on support after SV, in addition to sociodemographic data. Respondents' views on being routinely asked about SV were sought.

SETTING AND PARTICIPANTS

This online survey was based in England, UK. There were 2007 respondents.

RESULTS

The police were the most frequent first choice for support after experiencing SV (n=520; 25.9%); however, this was less common in individuals in younger age groups (p<0.001) and in those with a history of SV (17.2% vs 29.9%, p<0.001). For the 27.1% (532 of 1960) of respondents who reported a history of SV, the first choice of place for support was Rape Crisis or similar third-sector organisation. The majority of respondents supported routine enquiry about SV during Sexual and Reproductive Health Service (SRHS) consultations (84.4%), although acceptability was significantly lower in older age groups.

CONCLUSIONS AND STUDY IMPLICATIONS

A greater awareness of the influence of sociodemographic factors, including ethnicity, age, gender, disability and a history of SV, when planning and delivering services for those who have experienced SV is needed. A history of SV is common in the general population, and a 'one-size-fits-all' approach to encourage disclosure and access to support is unlikely to be optimal. Routine enquiry about SV is highly acceptable in an SRHS setting and likely to improve disclosure when appropriately implemented.

The Influence of Deny, Attack, Reverse Victim and Offender and Insincere Apologies on Perceptions of Sexual Assault

DARVO (deny, attack, reverse victim and offender) is a response exhibited by perpetrators to deflect blame and responsibility. When using DARVO, perpetrators deny their involvement in wrongdoing, attack their victims' credibility, and argue that they are the real victims. The purpose of this study was to measure the influence of DARVO and another manipulative tactic-insincere perpetrator apologies-on observers' judgments of a victim and perpetrator in a fictional sexual violence scenario. Perpetrator DARVO was experimentally manipulated via fictional vignettes to measure their impact on perceived perpetrator and victim abusiveness, responsibility, and believability. Data from 230 undergraduate students revealed that participants who were exposed to perpetrator DARVO rated the perpetrator as less abusive (η p 2 = . 09 , 90% CI [0.04, 0.15]), less responsible for the sexual assault (η p 2 = . 02 , [0.001, 0.06]), and more believable compared (η p 2 = . 03 , [0.002, 0.07]) to participants who were exposed to a perpetrator who did not use DARVO. DARVO-exposed participants rated the victim as more abusive (η p 2 = . 09 , [0.04, 0.14]) and less believable (η p 2 = . 08 , [0.03, 0.14]), and also expressed less willingness to punish the perpetrator and greater willingness to punish the victim. Insincere apologies had minimal impact on ratings. By promoting distrust in victims and less punitive views of perpetrators, DARVO might contribute to rape-supporting outcomes such as victim blaming, greater victim distress, and low rates of rape reporting and perpetrator prosecution.

Differential Profiles of Sexually Abused Adolescent Boys

Victims of child sexual abuse (CSA) are a heterogeneous population. Several characteristics may influence the outcomes associated with this adverse childhood experience, including personal (e.g. age) and CSA characteristics (e.g. relationship to the perpetrator). This study relied on a person-centered approach to account for this heterogeneity and focused on adolescent boys, an understudied population. Data were drawn from a representative sample of high school students aged 14 to 18 years old in Quebec, Canada. A total of 3.9% (n = 138) of boys reported CSA. Various CSA characteristics (severity, relationship to the perpetrator, and number of events) were used as indicators to derive classes. A four-class solution emerged from the latent class analysis: CSA in a sports context (6%), intrafamilial CSA (8%), extrafamilial CSA (52%) and multiple CSA (34%). The multiple CSA profile included boys who were sexually abused in multiple situations by different perpetrators and who were victims of acts involving penetration. The exploration of correlates associated with class membership revealed that adolescent boys included in the multiple CSA profile were distinguished by higher rates of delinquent behaviors and alcohol and drug use. They were more likely than members of other latent classes to belong to sexual minorities. This exploratory study sheds light on sexually victimized adolescent boys and the deleterious consequences that may affect them, particularly boys who have experienced multiple CSA events. We conclude that prevention efforts should focus on the demystification of sexual trauma among boys and on using trauma-informed care approaches for adolescent externalizing behaviors.

Perception of the Presumption of Innocence in the Context of Media Depictions of Violence: The Role of Participant's Gender, Type of Crime, and Defendant's Socioeconomic Status

The #MeToo movement has provoked a worldwide discussion about sexual violence. Some critics of the movement argue that it violates the presumption of innocence. In the current study, we investigated the determinants of the perception of the presumption of innocence in the context of media depictions of violence. We took into account previous studies that suggest that people view more favorably defendants in rape trials than they do men accused of other crimes and that people view more favorably defendants with a high socioeconomic status than they do those with a low socioeconomic status. The current study investigated whether the perception of the presumption of innocence is related to the type of crime (sexual vs. nonsexual assault) or to the socioeconomic status of the defendant (a famous writer vs. a maintenance worker). We conducted a vignette-based study with a sample of Polish people (N = 158). The type of crime did not influence the perception of the presumption of innocence; however, women who participated in the study endorsed the presumption of innocence to a greater extent when the defendant had a high socioeconomic status. The theoretical and practical implications of these results are discussed.

Using Twitter-Based Data for Sexual Violence Research: Scoping Review

BACKGROUND

Scholars have used data from in-person interviews, administrative systems, and surveys for sexual violence research. Using Twitter as a data source for examining the nature of sexual violence is a relatively new and underexplored area of study.

OBJECTIVE

We aimed to perform a scoping review of the current literature on using Twitter data for researching sexual violence, elaborate on the validity of the methods, and discuss the implications and limitations of existing studies.

METHODS

We performed a literature search in the following 6 databases: APA PsycInfo (Ovid), Scopus, PubMed, International Bibliography of Social Sciences (ProQuest), Criminal Justice Abstracts (EBSCO), and Communications Abstracts (EBSCO), in April 2022. The initial search identified 3759 articles that were imported into Covidence. Seven independent reviewers screened these articles following 2 steps: (1) title and abstract screening, and (2) full-text screening. The inclusion criteria were as follows: (1) empirical research, (2) focus on sexual violence, (3) analysis of Twitter data (ie, tweets or Twitter metadata), and (4) text in English. Finally, we selected 121 articles that met the inclusion criteria and coded these articles.

RESULTS

We coded and presented the 121 articles using Twitter-based data for sexual violence research. About 70% (89/121, 73.6%) of the articles were published in peer-reviewed journals after 2018. The reviewed articles collectively analyzed about 79.6 million tweets. The primary approaches to using Twitter as a data source were content text analysis (112/121, 92.5%) and sentiment analysis (31/121, 25.6%). Hashtags (103/121, 85.1%) were the most prominent metadata feature, followed by tweet time and date, retweets, replies, URLs, and geotags. More than a third of the articles (51/121, 42.1%) used the application programming interface to collect Twitter data. Data analyses included qualitative thematic analysis, machine learning (eg, sentiment analysis, supervised machine learning, unsupervised machine learning, and social network analysis), and quantitative analysis. Only 10.7% (13/121) of the studies discussed ethical considerations.

CONCLUSIONS

We described the current state of using Twitter data for sexual violence research, developed a new taxonomy describing Twitter as a data source, and evaluated the methodologies. Research recommendations include the following: development of methods for data collection and analysis, in-depth discussions about ethical norms, exploration of specific aspects of sexual violence on Twitter, examination of tweets in multiple languages, and decontextualization of Twitter data. This review demonstrates the potential of using Twitter data in sexual violence research.

Male Victims of Sexual Assault: A Review of the Literature

Compared to female rape victims, the literature addressing male rape victims remains a growing area of interest for counselors and scholars. This article aims to review the growing literature on male sexual assault victims. Specifically, the review will examine the literature on male victims of sexual assault in nine sections: (a) an overview of male sexual assault, (b) male rape myths, (c) prevalence, (d) responses to male victimization, (e) populations and perpetrators of male victimization, (f) risk factors, (g) reporting, (h) the impact of sexual assault on men, (i) help-seeking, and (j) implications for counseling. Empirical studies, case reports, and books are included in the review.

Harnessing Machine Learning in Tackling Domestic Violence-An Integrative Review

Domestic violence (DV) is a public health crisis that threatens both the mental and physical health of people. With the unprecedented surge in data available on the internet and electronic health record systems, leveraging machine learning (ML) to detect obscure changes and predict the likelihood of DV from digital text data is a promising area health science research. However, there is a paucity of research discussing and reviewing ML applications in DV research.

METHODS

We extracted 3588 articles from four databases. Twenty-two articles met the inclusion criteria.

RESULTS

Twelve articles used the supervised ML method, seven articles used the unsupervised ML method, and three articles applied both. Most studies were published in Australia (n = 6) and the United States (n = 4). Data sources included social media, professional notes, national databases, surveys, and newspapers. Random forest (n = 9), support vector machine (n = 8), and naïve Bayes (n = 7) were the top three algorithms, while the most used automatic algorithm for unsupervised ML in DV research was latent Dirichlet allocation (LDA) for topic modeling (n = 2). Eight types of outcomes were identified, while three purposes of ML and challenges were delineated and are discussed.

CONCLUSIONS

Leveraging the ML method to tackle DV holds unprecedented potential, especially in classification, prediction, and exploration tasks, and particularly when using social media data. However, adoption challenges, data source issues, and lengthy data preparation times are the main bottlenecks in this context. To overcome those challenges, early ML algorithms have been developed and evaluated on DV clinical data.

Using Social Media Data to Investigate Public Perceptions of Cannabis as a Medicine: Narrative Review

BACKGROUND

The use and acceptance of medicinal cannabis is on the rise across the globe. To support the interests of public health, evidence relating to its use, effects, and safety is required to match this community demand. Web-based user-generated data are often used by researchers and public health organizations for the investigation of consumer perceptions, market forces, population behaviors, and for pharmacoepidemiology.

OBJECTIVE

In this review, we aimed to summarize the findings of studies that have used user-generated text as a data source to study medicinal cannabis or the use of cannabis as medicine. Our objectives were to categorize the insights provided by social media research on cannabis as medicine and describe the role of social media for consumers using medicinal cannabis.

METHODS

The inclusion criteria for this review were primary research studies and reviews that reported on the analysis of web-based user-generated content on cannabis as medicine. The MEDLINE, Scopus, Web of Science, and Embase databases were searched from January 1974 to April 2022.

RESULTS

We examined 42 studies published in English and found that consumers value their ability to exchange experiences on the web and tend to rely on web-based information sources. Cannabis discussions have portrayed the substance as a safe and natural medicine to help with many health conditions including cancer, sleep disorders, chronic pain, opioid use disorders, headaches, asthma, bowel disease, anxiety, depression, and posttraumatic stress disorder. These discussions provide a rich resource for researchers to investigate medicinal cannabis-related consumer sentiment and experiences, including the opportunity to monitor cannabis effects and adverse events, given the anecdotal and often biased nature of the information is properly accounted for.

CONCLUSIONS

The extensive web-based presence of the cannabis industry coupled with the conversational nature of social media discourse results in rich but potentially biased information that is often not well-supported by scientific evidence. This review summarizes what social media is saying about the medicinal use of cannabis and discusses the challenges faced by health governance agencies and professionals to make use of web-based resources to both learn from medicinal cannabis users and provide factual, timely, and reliable evidence-based health information to consumers.

The Legacy of Shame following Childhood Sexual Abuse Disclosures

Shame has been recognized as a barrier to child sexual abuse (CSA) disclosures, but there has been less focus on the impact of shame on post-disclosure. This study explores how shame is experienced by CSA survivors following disclosure. Semi-structured interviews were conducted with eleven CSA survivors aged 14-25 years on their CSA disclosure experiences. Thematic analysis of the transcripts produced four themes that highlight the various impacts of shame post-disclosure: 1) struggles with identifying as a sexual abuse survivor; 2) manifestations of shame; 3) shaming responses to disclosures; and 4) strategies to overcome shame. Clinical implications are presented using a social ecological perspective.

Rape Victim Advocates' Perceptions of the #MeToo Movement: Opportunities, Challenges, and Sustainability

Awareness of the frequency of sexual victimization has been promoted through the #MeToo movement that opened the floodgates for survivors of sexual harassment, victimization, and violence to disclose their victimization. This research explores 41 rape victim advocates' perceptions of the #MeToo movement and concludes that they recognize its strengths and weaknesses. They credit the movement for: empowering survivors to disclose their experience possibly due to reduced stigma surrounding sexual victimization given the number of disclosures, providing support through social media from other survivors, and increasing societal awareness of the prevalence of sexual victimization. Those interviewed fault the movement for: giving the false perception that since so many survivors are stepping forward then reports must be fabricated, pressuring victims to support the movement through disclose and criticizing those who do not disclose, and hindering survivors' ability to escape media and social media coverage of sexual victimization. Advocates perceived #MeToo to be more of a "movement" rather than a "moment." However, to sustain its progress advocates suggested that action must be taken to create change for survivors and to reduce the occurrence of sexual victimization through policy/legal change and perpetrator accountability.

Who posted #MeToo, why, and what happened: A mixed methods examination

Objectives

The #MeToo social media campaign raised awareness about sexual harassment. The purpose of the current study was to address three unexplored research questions. First, what factors influenced whether a person posted #MeToo? Second, how did posting (or not) influence participants' wellbeing? Finally, what motivated participants' posting (or not) #MeToo?

Method

This mixed-methods study explores how #MeToo was experienced by full-time employees (N = 395) who could have posted #MeToo (i.e., experienced a sexual harassment event), whether or not they did so. Participants completed surveys in July of 2018 assessing social media use, sexual harassment history, relational variables such as relative power and social support, and job and life satisfaction. Participants also responded to open-ended survey questions about the context of and decisions about #MeToo posting.

Results

Quantitative results indicated that sexual harassment history was the most powerful predictor of #MeToo posting, while power and interpersonal contact also contributed. Qualitative analyses (N = 74) using a grounded theory approach indicated themes associated with decisions to disclose, including feeling a responsibility to post, need for support, and affective benefits. Decisions not to disclose were event-related negative affect, posting-related negative affect, timing of the event, fit with the #MeToo movement, privacy concerns, and fear of consequences.

Conclusion

This study contributes to the literature on sexual harassment disclosure by focusing on informal means of disclosure and drawing on comparisons to formal reporting and implications for workplaces. Online sexual harassment disclosure, in many ways, reflects the impediments to formal reporting procedures. Given the increased use of social media for purposes of disclosure, these findings suggests that organizations should recognize the legitimacy of sexual harassment reports made online and consider the possible failings of their formal reporting systems as reasons for online disclosure.

Understanding Discussions of Sexual Assault in Young Women on a Peer Support Mental Health App: A Content Analysis

Trauma narratives may have been influenced by the Me Too movement, with thousands of individuals disclosing sexual violence stories online. Youth, the largest demographic of online users, may prefer the anonymity of the Internet to discuss experiences of sexual assault. Understanding the ways that young women, especially those experiencing mental health difficulties, discuss their experiences is important as they are at higher risk of revictimization and continued poor mental health. We searched for terms related to acts of sexual assault on a mental health peer-support app, TalkLife, and compared the number of posts during the initial wave of the Me Too movement (October 2017-March 2018) to the same time period in the previous year (October 2016-March 2017). We found a significant increase in posts related to sexual assault of 49.7% between the Pre and Post Me Too time periods (p < .001), controlling for a general increase in posts. A content analysis of 700 randomly selected posts found that a substantial number of young women used TalkLife to discuss their experiences of sexual assault, and these self-disclosures were mostly hopeless or depressing in tone. Additionally, neither the nature nor the number of self-disclosures varied across time points. The negative tone of the self-disclosures in the current study is worrying because the way women talk about their trauma can shape how they understand it, which could lead to negative self-appraisal and continued mental health difficulties. Online spaces have the potential to support young women and facilitate help-seeking, but we must be attentive to how they are used.

Prevalence of Maltreatment Among Canadian National Team Athletes

This study assessed the prevalence of maltreatment experienced by Canadian National Team athletes. In total, 995 athletes participated in this study, including current athletes and athletes who had retired in the past 10 years. An anonymous online survey was administered, consisting of questions about experiences of psychological, physical, and sexual harm, and neglect, as well as questions about identity characteristics, when the harm was experienced, and who perpetrated the harm. Neglect and psychological harm were most frequently reported, followed by sexual harm and physical harm. Female athletes reported significantly more experiences of all forms of harm. Retired athletes reported significantly more neglect and physical harm. Athletes reportedly experienced more harmful behaviors during their time on the national team than before joining a national team. Coaches were the most common perpetrators of all harms except for sexual harm, which was most frequently perpetrated by peers. This study highlighted the prevalence with which Canadian National Team athletes reportedly experience harmful behaviors in sport, suggesting the need for preventative and intervention initiatives.

Understanding Sexual Harassment Through an Individual and Relational Lens: Are Risk Factors the Same for Female and Male Perpetrators?

Given widespread recognition of sexual violence as a public health concern, sexual harassment has garnered considerable attention from researchers and the public. Yet research with adolescent samples has typically focused on the experiences of victims rather than perpetrators, and males as perpetrators and females as victims. In the current article, we consider whether risk and protective factors operate similarly within and across sex assigned at birth. A national sample of youth, ages 14 and 15, were recruited via social media and surveyed online (N = 1,981). At the individual level, girls who sexually harassed others, were more likely to have a propensity to respond to stimuli with anger compared to boys who sexually harassed. At the relational level, girls who sexually harassed were more likely to be victims of sexual harassment compared to boys, and having a negative peer environment (have delinquent peers, seen someone get attacked, and know someone who has been sexually assaulted) was of particular importance in understanding why girls harass others. For boys who harass, family relations, having seen or heard about peer physical or sexual assault and bullying perpetration were important for contextualizing boys' sexual harassment. As empathy increased, the relative odds of sexually harassing decreased for girls. Future research should explore motivations for perpetrating sexual harassment, bystander interventions, and longitudinal frameworks to identify causal patterns to determine which factors inhibit or facilitate sexual harassment.

"A Little Bit of Light Dispels a Lot of Darkness": Online Disclosure of Child Sexual Abuse by Authority Figures in the Ultraorthodox Jewish Community in Israel

Social media sites such as Facebook have become popular platforms for promoting public awareness of sexual abuse by encouraging user engagement around this issue. There is, therefore, currently emerging research on the functions and implications of social media as a platform for sexual abuse disclosure. However, as yet, no study has examined this phenomenon specifically through a religious-cultural lens. This study explores perceptions of, barriers to, and motives underlying online disclosure of child sexual abuse (CSA) by religious authority figures (RAFs) in ultraorthodox Jewish society in Israel. The data were gleaned from the popular Facebook page of a nonprofit devoted to raising awareness of CSA in the ultraorthodox community. The analysis was based on admins' posts, anonymous and nonanonymous survivors' shares, users' comments, and in-depth interviews of eight page users. The findings suggest a culture-oriented model of online CSA disclosure (OCSAD), identifying four primary factors (safety, benefit, relevance, and legitimacy) that, weighed against cultural barriers, influence the decision to engage in online CSA disclosure. This context-informed understanding highlights the importance of social media as an alternative platform for CSA disclosure in an isolated but changing cultural arena such as the ultraorthodox community in Israel. The theoretical model is of international interest for its conceptualization of the unique characteristics and perceptions of OCSAD within religious-cultural contexts.

A Review of Undergraduate Student Disclosures of Sexual Violence

INTRODUCTION

Sexual violence (SV) has been a prevalent issue on college campuses for decades. Researchers, universities, and legislators have tried to understand and prevent it. Despite these efforts, 25% of female and 6% of male undergraduate students will experience a nonconsensual sexual experience (NSE) as a student. An immense amount of research has been conducted on the prevalence, effects, resources for, and outcomes of SV over the last few decades.

OBJECTIVES

The current paper aims to compile and summarize the extant literature on undergraduate student disclosures of sexual violence. The objective is to provide a comprehensive review of the research.

METHODS

A literature search was performed using the terms sexual violence, NSE, undergraduate students, informal and formal reporting, and disclosure.

RESULTS

Disclosure patterns and outcomes for survivors vary widely based on individual factors including type of disclosure source (ie, informal or formal reporting), disclosure recipient response, previous history of NSEs, and personal identity (ie, gender identity, sexual orientation, race/ethnicity). Though there are many formal resources (ie, police, Title IX), the majority of survivors report to informal sources (ie, family or friends). In addition to researching survivors' experiences and rates of disclosures, research also evaluates how disclosure recipients perceive their response to a survivor's disclosure, their likelihood of receiving a disclosure based on their own individual identities, and how the disclosure impacts the recipient and their relationship with the survivor.

CONCLUSION

The individualized response and decision to report SV has made prevention and the creation of effective resources difficult. As there are so many individual factors to consider when evaluating how or whether a NSE will be disclosed, future research should consider these individual differences and use them to create more effective reporting sources and resources. Sears-Greer MA, Friehart BK, Meston CM. A Review of Undergraduate Student Disclosures of Sexual Violence. Sex Med Rev 2022;XX:XXX-XXX.

Perceptions of a Hypothetical Sexual Assault: The Impact of the Interrelationships Between Eight Situational Factors

The current research examined the interactions between various factors that contribute to perceptions of a woman's sexual assault. Participants read a vignette about an assault in which we varied eight factors. We assessed the impact of these factors and their interactions on participants' perceptions of the assault. Participants' perceptions were more driven by the characteristics of the victim rather than the perpetrator. The factor that had the most overall impact on perceptions of the sexual assault was whether the victim explicitly agreed to go to the perpetrator's home. Implications of our results are discussed in various contexts.

Masochist or Murderer? A Discourse Analytic Study Exploring Social Constructions of Sexually Violent Male Perpetrators, Female Victims-Survivors and the Rough Sex Defense on Twitter

“Rough sex” can be considered an act of sexual violence that is consensual or non-consensual, often resulting in bodily harm and in rare cases, fatalities. The rough sex defense is typically advanced by male perpetrators in an effort to portray a sexual encounter as consensual, to avoid criminal sanctions for causing injury or death. Public attitudes toward this defense are often reflected on social media following high profile cases and appear to echo dominant discourses that reinforce widely held sexual violence stereotypes. Therefore, this study aims to deconstruct public attitudes surrounding the rough sex defense. Namely, how female victims/survivors and male perpetrators of sexual violence are constructed online, whilst exploring the wider implications upon society. NVivo12 NCapture software was used to collect a sample of 1000 tweets mentioning the terms “rough sex” or “rough sex defense.” Data were examined using Feminist Critical Discourse Analysis (FCDA), underpinned by a social constructionist perspective, to elicit emergent discourses. Findings indicate that Twitter allowed women to resist harmful victim-blaming discourses and constrained binary identities. Opposingly, men were constructed as sexually entitled predators, yet resisted these subject positions by advocating support for male victims/survivors. Additional analyses examine account holders’ constructions of British Parliamentarians (MP’s) and their campaigns against the rough sex defense. These constructions demonstrated a cultural, heteronormative and victim-blaming understanding of sexual violence, which calls for legislative clarity.

Self-affirmation and False Allegations: The Effects on Responses to Disclosures of Sexual Victimization

The rise of the #MeToo movement highlights the prevalence of sexual victimization and gives a voice to victims who may have been silent before. Nevertheless, survivors or victims of sexual violence who come forward may be blamed or not believed. These reactions are evident both with adult and child victims. Further, fears about false accusations of sexual misconduct may negatively impact responses to disclosures. This study aimed to examine gender differences in perceptions toward the #MeToo movement, and the extent to which these translate into a skeptical response to disclosure. Further, we wanted to explore whether proximity to false allegations of sexual violence was linked with more negative responses and whether use of self-affirmations may decrease the likelihood of such a response. Through an online survey (N = 235) on Amazon's Mechanical Turk, we assessed participants' exposure to and perceptions of the #MeToo movement. Further, we asked them about their proximity to sexual violence (victimization or perpetration) and to false allegations. Using a threat manipulation (news article about false accusation) and a self-affirmation exercise, we studied the effects of both variables on responses to disclosure. Results indicated that after reading an article about a false accusation, male participants were more likely to blame a victim of childhood sexual abuse and to perceive the abuse as less harmful, compared with female participants. Further, we found that self-affirmation was linked with more supportive responses to a disclosure. These findings highlight the threatening nature of false accusations of sexual violence for men, and how this threat may shape the narrative regarding sexual violence. Opportunities to use self-affirmation to change this narrative to a more supportive one are discussed.

Demographic Representation and Collective Storytelling in the Me Too Twitter Hashtag Activism Movement

The #MeToo movement on Twitter has drawn attention to the pervasive nature of sexual harassment and violence. While #MeToo has been praised for providing support for self-disclosures of harassment or violence and shifting societal response, it has also been criticized for exemplifying how women of color have been discounted for their historical contributions to and excluded from feminist movements. Through an analysis of over 600,000 tweets from over 256,000 unique users, we examine online #MeToo conversations across gender and racial/ethnic identities and the topics that each demographic emphasized. We found that tweets authored by white women were overrepresented in the movement compared to other demographics, aligning with criticism of unequal representation. We found that intersected identities contributed differing narratives to frame the movement, co-opted the movement to raise visibility in parallel ongoing movements, employed the same hashtags both critically and supportively, and revived and created new hashtags in response to pivotal moments. Notably, tweets authored by black women often expressed emotional support and were critical about differential treatment in the justice system and by police. In comparison, tweets authored by white women and men often highlighted sexual harassment and violence by public figures and weaved in more general political discussions. We discuss the implications of this work for digital activism research and design, including suggestions to raise visibility by those who were under-represented in this hashtag activism movement. Content warning: this article discusses issues of sexual harassment and violence.

#Me2PT: A qualitative analysis of a social media network campaign to raise awareness of the consequences of childhood sexual abuse

BACKGROUND

Childhood sexual abuse (CSA) is a highly prevalent and serious stressor, linked to short- and long-term psychopathology and to posttraumatic stress disorder (PTSD) specifically. The hashtag #Me2PT, which stands for "me-too-post-trauma," was created in order to raise awareness of the longitudinal consequences of sexual abuse, as specifically manifested in symptoms of PTSD or complex PTSD. It was disseminated on social media networks during 2019 and offered a platform for CSA survivors to share their own personal experience of living with CSA-related posttraumatic symptoms.

OBJECTIVE

The current study was designed in order to examine the way survivors conveyed their experiences and perceptions with response to the invitation of the hashtag #Me2PT. All the posts were written in the Hebrew-language, and thematic analysis was carried on all the written narratives.

PARTICIPANTS AND SETTING

40 Posts that were written in the Hebrew language under the hashtag campaign of #Me2PT.

METHODS

Thematic analysis was carried on the 40 posts by two of the authors. Shenton four criterions for qualitative study trustworthiness were employed with peer discussion on main results were discussed with the leaders of the campaign, survivors of CSA.

RESULTS

The authors identified four main themes within the written narratives of the survivors: (1) why am I writing, (2) my personal PTSD, (3) between life and death, and (4) post-trauma as 'a bleeding wound'.

CONCLUSIONS

These findings exemplify the constant mental pain and struggle that survivors deal with, but at the same time demonstrate the importance of hope, the comfort found in being understood, and the wish to live a meaningful life despite the pain. This paper may contribute to the understanding of survivors' experiences of living with CSA-related posttraumatic symptoms, as conveyed by them spontaneously and authentically, potentially informing best practice for professionals working with this population.

[Sexual health information on social media: a systematic scoping review]

BACKGROUND

Information on sexual and reproductive health is increasingly disseminated via social media and reaches a large audience.

RESEARCH AIM

Against this background, the aim of this paper is to systematically summarize the international state of research on sexual health information on social media for the first time with a scoping review. Seven research questions were explored, relating to the amount (F1), methods (F2: content analysis, F3: quality analysis), and results (F4: providers, F5: target groups, F6: topics, F7: quality of information) of previous studies.

MATERIALS AND METHODS

The study follows the PRISMA framework for scoping reviews as well as the Open Science approach. It is preregistered, and all materials (codebook with reliability coefficients) and data (list of identified studies and coding of studies) are available on the Open Science Foundation server.

RESULTS

A total of 69 studies with 72 data sets were identified, with more than half of the publications referring to YouTube (F1). Qualitative and quantitative methods of content analysis are used equally (F2) and quality analyses are rare (F3). Health laypersons dominate as the information providers (F4). The target groups are mostly unspecified (F5). The health information on social media examined in the previous studies covers a broad range of topics (F6). Where quality assessments were made, they tended to be negative (F7).

DISCUSSION

More research is needed to better understand sexual and reproductive health information on social media and to promote its quality and constructive use.

#MeToo Online Disclosures: A Survivor-Informed Approach to Open Science Practices and Ethical Use of Social Media Data

With social media data widely available, researchers are increasingly incorporating tweets, posts, and blogs in their work. While easily accessible, the use of “public” posts raises important questions about the ethics of mining, storing, analyzing, and reporting publicly available social media data—especially when gathering sensitive information such as sexual violence disclosures. Online movements including #MeToo and #WhyIDidntReport emerged to shed light on gender-based violence. These movements generate large quantities of data with little consistency and oversight across research groups, disciplines, and review boards on data ethics. With the recent push in social science to publish data to open science databases, the concerns of feminist psychologists and ethical concerns of social media research with survivors have become more salient. In this article, we describe and address these ethical issues by reviewing existing social media sexual assault disclosure research and make concrete recommendations for authors seeking to use social media data. We also seek to address these ethical concerns by noting the work of some feminist researchers, but also by pushing researchers to do more for survivors through a survivor-informed approach to this research in an open science context. We propose four survivor-informed recommendations for research with this vulnerable population: (a) get input from survivors, (b) update ethics review boards, (c) maximize benefits to participants, and (d) utilize study-appropriate datasets with informed consent.

#patientstoo - Professional sexual misconduct by healthcare professionals towards patients: a representative study

AIMS

Sexual border violations are a severe problem in the healthcare system. Studies using non-probability samples indicate a high prevalence of professional sexual misconduct (PSM) towards patients. However, valid prevalence rates are lacking.

METHODS

We did a cross-sectional, observational study in Germany from February to April 2020. By different sampling steps, a probability sample of the German population above the age of 14 was generated. The final sample consisted 2503 persons (50.2% female, mean age: 49.5 years). Participants were asked about sexual contacts with and sexual harassment by healthcare professionals. Using descriptive statistics, prevalence rates of PSM were estimated.

RESULTS

PSM was reported by 56 (4.5%) female and 17 (1.4%) male participants. In detail, 28 (2.2%) female and 10 (0.8%) male participants reported sexual contacts with healthcare professionals. One third of these sexual contacts took place before the age of 18 and one third against the will of the patients. 40 (3.2%) female and 8 (0.6%) male participants reported unnecessary physical examinations, 31 (2.5%) female and 7 (0.6%) male participants reported sexual harassment. The majority of perpetrators were male.

CONCLUSIONS

Our data provide an important first insight into the prevalence of PSM by healthcare professionals towards patients in a representative sample. Results suggest a high prevalence of PSM in the general population of Germany. Preventive measures to increase awareness of PSM and concepts for protection of patients are needed.

Trends in victim, incident and care characteristics of a Dutch sexual assault center

Worldwide, one in three women have experienced sexual violence, causing various physical and mental health problems such as depression, posttraumatic stress disorder and medically unexplained symptoms. Much has changed in the last decade. The use of the Internet, smartphones and apps has increased enormously, sexual violence is discussed more and more openly in the media. These changes have provided a platform for victims of sexual violence which has profoundly influenced the disclosing process and the victims' help-seeking behavior. Nevertheless, the question remains whether the number of victims seeking help from a professional institution has gone up. Therefore, our study aims to investigate if there have been changes in victim, incident and care characteristics among victims of a Dutch Center for Sexual Violence. We used data of victims attending the center between 2013 and 2020, including registered police file registrations instead of victim's reporting statements. Victims were divided into a cohort of early years (2013-2016) and recent years (2017-2020). In 2017-2020, a total of 270 victims attended the center compared to 83 victims in 2013-2016. The percentage of self-referrers increased from 10% to 30% in recent years; the use of psychotropic drugs among victims decreased from 24% to 11%; and more victims were willing to receive psychosocial follow-up care (64% versus 79%). The percentage of male victims remains low at approximately 5% of all victims in both cohorts. Background characteristics such as age and mental disability have hardly changed between 2013 and 2020. The proportion of known perpetrators remains high with approximately 80% in both cohorts, and the proportion of perpetrators who met victims on the Internet remains unchanged with approximately 6% in both cohorts. To improve our understanding of the influence of societal changes on help-seeking behavior, the monitoring of victim, incident and care characteristics remains crucial in the future.

Sexual assault reporting amongst users of online sexual health services

Sexual assault (SA) survivors often attend sexual health clinics (SHC) for care relating to their assault. Reported rates of SA amongst SHC attendees can be high. Online sexual health services are becoming increasingly popular. Sexual Health London (SHL) is a large online sexual transmitted infection (STI) screening service. Between 1.1.20– 8.2.20, 0.5% (242/45841) (54% female, 45.6% male) of adults disclosed a recent SA when ordering an online STI testing kit. 79% (192/242) users engaged in a call back discussion initiated by the SHL team: 45% (87/192) users confirmed a SA had occurred and 53% (101/242) users denied an assault (particularly men) stating they had reported this in error. 18% (16/87) users had already reported their SA to the police/sexual assault centre, and one user accepted an onward referral. This study found a low reporting rate of SA amongst SHL users, but despite a high response rate to call backs, >50% cited they reported in error, 25% (22/87) didn’t want to discuss their SA and few accepted onward referrals. Using e-triage to screen for SA followed by service-initiated telephonic support to everyone who discloses, may not be acceptable or offer utility to all. Further evaluation of ways to engage these individuals is required.