Intimate Partner Sexual Violence: An Often Overlooked Problem

Nonstranger and Stranger Sexual Homicides in Mainland China: Comparing the Modus Operandi of Male Sexual Murderers

Although studies have been made of different subtypes of individuals who committed sexual homicides, the research into nonstranger and stranger sexual homicides remains limited. This study therefore aimed to examine whether those who sexually murder nonstrangers differ from those who kill strangers. Data derived from police records, court documents, and published case reports spanning a 31 year period (1988-2018) in mainland China were used to examine the modus operandi of 127 males who committed sexual homicides (45 nonstranger and 82 stranger cases). Relative to nonstranger sexual homicides, stranger sexual homicides were more likely to have been committed by individuals with a previous sexual offense conviction and the victims were more likely to have been single and employed at the time of the offense. Furthering the analysis, a logistic regression found that individuals who targeted strangers were significantly more likely to have committed their homicide at an outdoor location, to have been sexually motivated, and to have used murder weapons that required more physical strength than those who killed nonstranger victims. These findings can be informative to law enforcement agents and security professionals in their investigative processes.

Intimate Partner Sexual Violence in Emerging Adulthood: Exploring Sexual Consent Attitudes as a Target for Sexual Coercion Prevention

While intimate partner violence is now recognized as a major societal and international issue, sexual violence between partners remains understudied despite its significant prevalence rates and the specific contexts in which it occurs. The aim of this study was to analyze the links between different dimensions of sexual consent and sexual coercion experienced within intimate relationships in order to identify targets for prevention campaigns. The study was carried out during a time of transition in the sociopolitical and legislative context in Belgium linked to the implementation of a reform to the sexual criminal law, which has made the expression of sexual consent central to the qualification of sexual offenses. A total of 431 young adults (88.40% female; Mage = 22.19 years; SDage = 1.79) were recruited from the general population through an online survey to analyze the links between attitudes and beliefs toward sexual consent, attachment style, mental health, and sexual victimization between partners. Results showed that a lack of perceived behavioral control over establishing sexual consent, as well as the avoidance of intimacy, predicted sexual victimization. The clinical implications of these findings are discussed and potential public policy responses for prevention and awareness are suggested. Future research should further investigate and conceptualize sexual consent as it relates to sexual coercion in a more representative sample from an intersectional perspective.

Trend and spatial pattern of intimate partner rape notifications against women in Northeast Brazil (2013-2022)

OBJECTIVE

To analyze the trend and spatial pattern of intimate partner rape reports against women in Northeast Brazil.

METHODS

Ecological time-series study and spatial analysis with secondary data from the Notifiable Diseases Information System between 2013 and 2022. Gross rape rates were calculated by type of intimate partner and by age group of the victim. Prais-Winsten regression was used to calculate the trend, and the global and local Moran indices were used for spatial analysis.

RESULTS

A total of 5,542 cases of intimate partner rape were reported. Spousal rates ranged from 0.34/100,000 women in 2013 to 0.51/100,000 in 2017, with greater increases between 2018 (1.04/100 thousand) and 2022 (1.28/100 thousand). There was an upward trend in the Northeast as a whole (APC=19.47; 95%CI 15.88-23.22) and in almost all states, except Paraíba and Sergipe. Cases perpetrated by boyfriends (APC=23.90; 95%CI 12.80-36.09) and among women aged 15 to 19 years (APC=22.63; 95%CI 4.18-44.35) showed the highest annual variation. A concentration of high rates was observed in several municipalities in the northwest of Ceará and southeast of Pernambuco.

CONCLUSION

The trend in intimate partner rape rates against women increased in the Northeast, especially among younger women and by boyfriends, with a greater agglomeration of notifications in Ceará and Pernambuco.

Intimate Partner Sexual Violence: An Exploratory Study on Sexual Victimization Profiles Among Survivors of Intimate Partner Violence in France

Intimate partner sexual violence (IPSV) is a common form of intimate partner violence (IPV). This study aimed to (a) identify a typology of intimate partner sexual victimization among French women victims of IPV on the basis of the frequency of various forms of sexual violence and (b) evaluate whether these profiles differ in several clinical characteristics. A total of 93 women consulting a specialized hospital service were recruited. Cluster analyses suggested four profiles: highly frequent rapes (5.4%), predominant sexual coercion (20.4%), medium frequency of all forms (20.4%), and low frequency of all forms (19.4%). Further person-centered research focusing on IPSV is warranted.

Intimate Partner Sexual Violence: A Phenomenological Interpretative Analysis Among Female Survivors in France

Despite its prevalence, intimate partner sexual violence (IPSV) remains a concealed and poorly understood form of violence against women. Although it is associated with numerous detrimental effects on mental health, very little is known about the subjective meaning of IPSV for survivors. This study addresses this gap by exploring IPSV from the perspective of female survivors within the context of their relationship with a male partner, using interpretative phenomenological analysis. This study seeks to provide a detailed examination of the personal experience of IPSV and to illuminate its meaning from a personal standpoint. We conducted in-depth interviews with seven IPSV survivors who were recruited after filing a complaint for intimate partner violence (IPV) in France. In total, five superordinate themes were identified: (a) "Setting the stage" describes how the complex dynamics preceding IPSV influence self-representation; (b) "Feeling like I'm nothing" describes the emotional experience of IPSV; (c) "Trying to get it, not getting it" describes how IPSV generates intense cognitive load; (d) "Looking back, developing a theory" describes how IPSV is interpreted retrospectively after breaking up with a violent partner; and (e) "Today: living with it" describes how IPSV affects the present. This study highlights how emotional distress and cognitive uncertainty are present on the way to IPSV, through IPSV, and even after filing charges and separating from the violent partner. Additionally, it shows that survivors attribute IPSV to a sense of individual vulnerability related to romantic love, hope, and traumatic childhood history. This study presents unique findings as it is the first one to explore the lived experience of IPSV among a sample of French IPV survivors.

Experiences of intimate partner violence (IPV) among females with same-sex partners in South Africa: what is the role of age-disparity?

BACKGROUND

South African women have been exposed to epidemic proportions of intimate partner violence (IPV) amongst heterosexual relationships but not much is known about same-sex partnerships. Sexual minorities are excluded from research but are subject to intimate partner violence as much as heteronormative persons. The purpose of this study is to determine the association between age-disparity and IPV outcomes among females with same-sex partners in South Africa.

METHODS

A cross-sectional study of the nationally representative South African National HIV Prevalence, Incidence, Behaviour and Communication Survey (SABSSM 2017) is used. A weighted sample of 63,567 female respondents identified as having a same-sex partner are analysed. IPV is measured as ever been physically and/ or sexually abused. Any experience of IPV is included in the dependent variable of this study. Descriptive and inferential statistics are used to estimate the relationship between demographic, socioeconomic, age-disparity and IPV.

RESULTS

Almost 16% of females in same-sex relationships experienced IPV and about 22% from younger partners. In female same-sex partnerships, partner age-disparity (OR: 1.30, CI: 1.18 - 1.51), type of place of residence (OR: 2.27, CI: 1.79 - 3.79), highest level of education (OR: 1.07, CI: 0.97 - 1.17), marital status (OR: 1.60, CI: 1.37 - 1.88), and race (OR: 1.47, CI: 1.41 - 1.54) are associated with an increased likelihood of violence.

CONCLUSION

IPV programs that are specifically targeted for non-heteronormative orientations are needed. These programs should promote health equity and safety for non-confirmative sexual identities in the country.

Rape and Sexual Coercion Related Pregnancy in the United States

INTRODUCTION

Sexual violence is a major public health problem in the U.S. that is associated with numerous health impacts, including pregnancy. U.S. population-based estimates (2010-2012) found that three million women experienced a rape-related pregnancy during their lifetimes. The current study presents more recent estimates of rape and sexual coercion-related pregnancy and examines prevalence by demographic characteristics.

METHODS

Data years 2016/2017 were pooled from the National Intimate Partner and Sexual Violence Survey, a random-digit-dial telephone survey of U.S. non-institutionalized adults 18 years and older. The analysis, conducted in 2023, examined lifetime experience of rape-related pregnancy, sexual coercion-related pregnancy, or both among U.S. women. Authors calculated prevalence estimates with 95% CIs and conducted pairwise chi-square tests (p-value<0.05) to describe experiences by current age, race/ethnicity, and region of residence among U.S. women overall and among victims.

RESULTS

One in 20 women in the U.S., or over 5.9 million women, experienced a pregnancy from either rape, sexual coercion, or both during their lifetimes. Non-Hispanic Multiracial women experienced a higher prevalence of all three outcomes compared with non-Hispanic White, non-Hispanic Black, and Hispanic women. Among victims who experienced pregnancy from rape, 28% experienced a sexually transmitted disease, 66% were injured, and over 80% were fearful or concerned for their safety.

CONCLUSIONS

Pregnancy as a consequence of rape or sexual coercion is experienced by an estimated six million U.S. women. Prevention efforts may include healthcare screenings to identify violence exposure and use of evidence-based prevention approaches to reduce sexual violence.

Negative Associations between Minority Stressors and Self-Reported Health Status among Sexual Minority Adults Living in Colombia

Colombia has extensive laws prohibiting discrimination against sexual minority people. However, violence and discrimination toward sexual minorities are still frequent. While a growing body of research shows that sexual minority people experience elevated rates of discrimination and domestic abuse globally, little research has been conducted on these issues affecting sexual minorities in Colombia specifically. Using minority stress theory as a conceptual framework, this paper aims to fill this gap by examining the prevalence of experiencing intimate partner violence (IPV) and witnessed discrimination and the relationship of these stressors to self-reported health among a national sample of sexual minority Colombians. We found that bisexual individuals experienced higher rates of physical and sexual IPV, compared to lesbian and gay individuals. Additionally, sexual minority Colombians who experienced IPV and witnessed discrimination were more likely to report having poorer health, compared to those who had not. We discuss the implications of our findings for future research and clinicians working with sexual minority clients.

Violent Partners or a Specific Class of Offenders? A Criminal Career Approach to Understanding Men Involved in Intimate Partner Sexual Violence

The current study investigates the criminal career of individuals involved in intimate partner sexual violence (IPSV). Specifically, the goal is to determine whether men who engage in IPSV can be distinguished from those who engage in intimate partner non sexual violence (IPNSV) only and whether criminal trajectories in the resulting subgroup are heterogeneous. The sample comes from a Canadian database including a total of 12,458 individuals involved in IPSV and 32,474 individuals involved in IPNSV). Bivariate and multivariate analyses are performed to examine the differences in the two groups while latent profile analysis allows examining the heterogeneity of characteristics of men who engaged in IPSV. Findings indicate that the criminal career of men who engage in IPSV follows a pattern that is clearly distinct from that of men who engage in IPNSV only and is more specialized in terms of sexual offenses. Results also show that the criminal trajectories followed by the men who engage in IPSV are heterogeneous. Four profiles of different trajectories were identified. Both theoretical and practical implications are discussed.

Intimate Partner Sexual Violence, Gender, and Psychological Distress Among Northern Irish University Students

While substantial prevalence rates of intimate partner sexual violence (IPSV) have been found among university students for decades in North America, there is a specific gap in published studies on this issue in the United Kingdom and Ireland. The present analysis used data from a larger survey study of students in one Northern Irish university. The analyses reported here were used to examine relationships among IPSV victims, gender (males and females only), unhealthy alcohol use, and psychological distress among university students (n = 654) since the age of 16 and during the previous year. The results of this study are consistent with previous research indicating that women (n = 248) experience IPSV more often than men (n = 37; 50% vs. 23%, respectively). Nonetheless, IPSV is experienced by both men and women with statistically significant associations with alcohol use, posttraumatic stress, depression, and generalized anxiety compared with those who did not report any IPSV experience.

The association between intimate partner violence type and mental health in migrant women living in Spain: findings from a cross-sectional study

Introduction

The association between intimate partner violence (IPV) and mental health has been clearly established in the literature, however the differential associations between IPV type and mental health are less well understood, particularly in migrant groups who are at increased risk of both IPV and poor mental health. Under-studied and emerging forms of violence such as economic abuse and technology-facilitated abuse must be considered alongside more traditionally studied forms of IPV in order to fully understand the complex nature of violence. This study makes a novel contribution to the literature by assessing multiple forms of IPV including psychological, physical, sexual, economic and technology-facilitated IPV and their relationship with symptoms of depression and anxiety in migrant women, disaggregated by IPV type.

Methods

A cross-sectional survey of migrant women living in the Valencian Community of Spain was conducted, to assess experiences of IPV and symptoms of mental health. Regression analysis from the Bayesian perspective was performed.

Results

1,998 women accessed the survey. They had an average age of 37, and came predominantly from Europe (49%), namely Western Europe, followed by Latin America (38%). The majority had been in Spain between 1 and 3 years, and 80% had resident status. A total of 1,156 responded to questions on violence and mental health. Results showed that the prevalence of IPV was high, with 59% of women reporting any experience of violence. Economic abuse was the most commonly reported form of violence, and showed the strongest relationship with symptoms of depression. Sexual violence was the strongest predictor of anxiety. In both cases, in the presence of violence, the odds of having more severe symptoms of depression and anxiety increases by over 2.25. Technology-facilitated abuse was as detrimental to women's mental health as face-to-face violence.

Discussion

The findings from the study are relevant to researchers, policy-makers and service providers. They highlight the complex nature of IPV experiences faced by migrant women and the importance of understanding how different types of IPV can impact migrant mental health, in order to ensure survivors receive adequate care.

Resources and Obstacles of a Maternity Staff Facing Intimate Partner Violence during Pregnancy-A Qualitative Study

INTRODUCTION

Intimate partner violence occurring during pregnancy has a similar prevalence as usual obstetrical disorders that are routinely screened for. Referenced publications insist on the importance of adequate screening, but the proper course of action has yet to be defined.

AIM OF STUDY

We qualitatively explored the different resources and concepts that emerge from the discourse of maternity staff across professions.

MATERIAL AND METHODS

We led a semi structured interview with professionals, which included following their involvement with preselected patients. Nine professionals provided a sample of 19 interviews. The data was analysed using IPA methodology. Results We highlight the investigative importance of navigating the patient's initial demand or lack thereof and the baby's importance within, while identifying mechanisms of maternal disqualification. Creating an atmosphere prone to patient empowerment was the final theme to emerge from the study as the most beneficial tactic both in the short and long term.

CONCLUSIONS

HCPs need to enable patients' trust on a personal and an institutional level, as well as empowering the patient in the moment and respecting their values and choices. HCPs also convey the stability of the institution that has become a reference of refuge and assistance for patients from their pregnancy onwards.

Sexual violence against women remains problematic and highly prevalent around the world

BACKGROUND

Sexual violence is far more prevalent in most societies than is usually suspected in daily life. However, no study has systematically summarized the global prevalence rate and the major outcomes of sexual violence against women.

METHODS

We directed a wide-raging search in the PubMed, Embase, and Web of Science, catalogs since the beginning to December 2022 for relevant reports about the incidence of sexual fighting touching females. The occurrence frequency was assessed with a random-effects model. The heterogeneity was estimated with I 2 values. Differences by research features were assessed over subgroup evaluation and meta-regression.

RESULTS

A total of 32 cross-sectional studies were included (a total of 19,125 participants). The pooled sexual violence rate was 0.29 (95% CI = 0.25-0.34). Subgroup analyses found that there was a higher rate of sexual violence against women in 2010-2019 period (0.33, 95% CI = 0.27-0.37), developing countries (0.32, 95% CI = 0.28-0.37), and interview (0.39, 95% CI = 0.29-0.49). The analysis found that more than half of women (0.56, 95% CI = 0.37-0.75) had post-traumatic stress disorder (PTSD) after experiencing sexual violence, and only a third of women considered seeking support (0.34, 95% CI = 0.13-0.55).

CONCLUSIONS

Nearly one out of every three (29%) women around the world has been a victim of sexual violence in their life. This current study investigated the status and characteristics of sexual violence against women, which could provide an important reference for police and emergency health services management.

Emotion Regulation and Intimate Partner Violence Perpetration in Undergraduate Samples: A Review of the Literature

Intimate partner violence (IPV) perpetration increases throughout young adulthood and is particularly widespread among college students, resulting in mental health and academic consequences. Deficits in emotion regulation (ER) are an important factor associated with IPV perpetration; the developmental tasks and challenges associated with college, including relationship stressors and hazardous alcohol use, implicate ER as a particularly relevant risk factor for IPV perpetration. Thus, college presents an important opportunity for intervention in order to change the trajectories of IPV perpetration across young adulthood. The purpose of this review was to synthesize findings regarding ER and psychological, physical, and sexual IPV perpetration among college students. Twenty-one articles met inclusion criteria. Studies were organized into five categories: (a) direct associations of ER with IPV perpetration, (b) qualitative assessment of ER and IPV, (c) ER in indirect effects models, (d) ER in moderation models, and (e) experiments with ER instructional sets. Overall, ER emerged as an important inhibiting factor for IPV perpetration, particularly impulse control and access to ER strategies. ER deficits in the context of impelling (e.g., negative affect, trauma history) and instigating (e.g., provocation) factors emerged as consistent predictors of psychological and physical IPV perpetration for both male and female students. Deficits in ER were associated with sexual IPV perpetration among men; however, very few studies examined sexual IPV. Experimental paradigms suggest cognitive reappraisal may reduce IPV perpetration, while suppression may, in some contexts, increase perpetration. Methodological strengths and weaknesses and implications for IPV prevention and interventions programming for college students are discussed.

Relationship between Sexual Violence and the Health of Spanish Women-A National Population-Based Study

BACKGROUND

Health consequences are likely to be different when sexual violence is analysed independently from other types of violence. It is also likely that different health consequences will result in the cases of partner or ex-partner sexual violence, non-partner sexual violence and sexual harassment.

METHODS

This study is based on the 2019 Macro-survey of Violence against Women conducted by the Spanish Ministry of Equality on a sample of 9568 women aged 16 years or older. Odds ratios were calculated, and multinomial logistic regression analyses were performed.

RESULTS

The present study estimates that 4 out of 10 surveyed women had experienced some form of sexual violence in their lifetime. Sexual harassment is the most frequently reported form of this violence, while intimate partner sexual violence is the form with the most unfavourable sociodemographic characteristics and the worst health impact indicators, such as a greater likelihood of suicidal behaviour.

CONCLUSIONS

Sexual violence is a widespread, under-studied problem with negative health impacts. Women exposed to intimate partner violence are the most vulnerable and at risk. It is advised that responses and comprehensive care plans be developed that place special emphasis on the protection of victims' mental health.

Accelerating UN Sustainable Development Goals with AI-Driven Technologies: A Systematic Literature Review of Women's Healthcare

In this paper, we critically examine if the contributions of artificial intelligence (AI) in healthcare adequately represent the realm of women's healthcare. This would be relevant for achieving and accelerating the gender equality and health sustainability goals (SDGs) defined by the United Nations. Following a systematic literature review (SLR), we examine if AI applications in health and biomedicine adequately represent women's health in the larger scheme of healthcare provision. Our findings are divided into clusters based on thematic markers for women's health that are commensurate with the hypotheses that AI-driven technologies in women's health still remain underrepresented, but that emphasis on its future deployment can increase efficiency in informed health choices and be particularly accessible to women in small or underrepresented communities. Contemporaneously, these findings can assist and influence the shape of governmental policies, accessibility, and the regulatory environment in achieving the SDGs. On a larger scale, in the near future, we will extend the extant literature on applications of AI-driven technologies in health SDGs and set the agenda for future research.

Help-Seeking and Barriers to Care in Intimate Partner Sexual Violence: A Systematic Review

Intimate partner sexual violence (IPSV) is a prevalent phenomenon, yet an under-researched topic. Due to the complex nature of balancing love and fear, individuals who experience IPSV have unique needs and face unique barriers to seeking care. The purpose of this systematic review was to examine the literature on help-seeking and barriers to care in IPSV. Articles were identified through PubMed, CINAHL, PsycINFO, and Web of Science. Search terms included terms related to IPSV, intimate partner violence (IPV), domestic violence, sexual assault, and rape. The review was limited to the United States, and articles that were included needed to specifically measure or identify sexual violence in an intimate relationship and analyze or discuss IPSV in relation to help-seeking behaviors or barriers to care. Of the 17 articles included in this review, 13 were quantitative studies and four were qualitative studies. Various definitions and measurements of IPSV across studies included in this review make drawing broad conclusions challenging. Findings suggest that experiencing IPSV compared to experiencing nonsexual IPV (i.e., physical or psychological IPV) may increase help-seeking for medical, legal, and social services while decreasing help-seeking for informal support. Help-seeking can also reduce risk of future IPSV and decrease poor mental health outcomes. Barriers to seeking care in IPSV included social stigma, fear, and difficulty for individuals in identifying IPSV behaviors in their relationships as abuse. More inclusive research is needed among different populations including men, non-White individuals, nonheterosexual, and transgender individuals. Suggestions for research, practice, and policies are discussed.

Stigma and Mental Health of Sexual Minority Women Former Victims of Intimate Partner Violence

Sexual minority women (SMW) are at high risk of experiencing stigma, mental health problems, and being victims of intimate partner violence (IPV). This vulnerability can be explained by the sexual and gender minority stress model, stating that sexual and gender minority people suffer from specific stress factors added to general stressors, leading to more mental health and relationships problems.

OBJECTIVE

The main goal of this study was to assess the impact of minority stress factors and former IPV victimization on the current mental health of Canadian SMW, as a function of their sexual and gender identity.

METHOD

In total, 209 individuals identifying as women (M age = 33.9), living in Canada and who lived in a past violent relationship with a woman responded to an online survey. Well-validated questionnaires assessed sexual orientation and gender identity, former IPV behaviors, minority stress factors, depression, and anxiety.

RESULTS

Hierarchical regressions showed that past psychological aggression was positively associated with anxiety symptoms and past sexual coercion with depressive symptoms. Not being monosexual was also associated more severe symptoms of depression and age was negatively associated with the severity of anxiety symptoms. After controlling for age, race/ethnicity, sexual and gender identity and former IPV victimization, having negative feelings about being a SMW was strongly associated with both depression and anxiety symptoms.

CONCLUSION

These results provide new information on the interconnected associations between former IPV, minority stress and SMW's mental health. Findings highlight the need to adapt clinical interventions to help buffer against victimization faced by IPV victims who identify as sexual and gender minorities.

Traumatic Injuries in Sexual Assault Patients in the Emergency Department

Introduction

The emergency department (ED) is at the forefront for treatment of sexual assault patients. Many require treatment for injuries sustained during the assault, ranging from mild to severe. Our objective in this study was to characterize types of injuries associated with sexual assault and identify associated factors.

Methods

We reviewed ED charts from an inner-city trauma center and nearby community hospital from 2019–2020 for patients age ≥13 years with a chief complaint of sexual assault. We used descriptive statistics, chi square, and logistic regression to characterize demographics and identify factors associated with trauma.

Results

A total of 157 patients met inclusion criteria. The mean age was 27.9 years old (range 13–79 years) and 92.4% were female. Adult patients (age >18 years) comprised 77.5% of assaults vs adolescents (age 13–18 years) at 22.3%. Most patients presented to the trauma center compared to the community hospital (69.4% vs 30.6%). The assailants were reported as 61.2% acquaintance, 22.9% stranger, and 15.9% intimate partner. A forensic rape kit was performed in 92 (58.6%) cases. The patient was intoxicated with alcohol in 39 (24.8%) cases, and 22 (14%) patients reported drug-facilitated assault where an unknown substance was given to them. Alcohol (P = 0.95) and drug-facilitated assault (P = 0.64) did not change the occurrence of injuries. Fifty-seven (36.3%) patients exhibited physical trauma on presentation. Forty-five (28.6%) patients had minor injuries of abrasions, lacerations, or contusions. Major trauma was defined as fracture, brain injury, hemorrhage, strangulation, or injury requiring surgical consultation. There were 12 patients with major trauma consisting of fracture injury or nonfatal strangulation. None of the patients required admission. Sexual assault by an intimate partner (odds ratio [OR] 2.6; 95% CI: 1.1–6.5) and being an adult patient compared to adolescent (OR 3.0; 95% CI, 1.1–7.7) was significantly associated with physical trauma. Sexual assault by an intimate partner was also associated with nonfatal strangulation (OR 4.0; 95% CI, 1.1–15.4).

Conclusion

Physical injuries that resulted from sexual assault were mostly minor and occurred in 36% of rape victims. Intimate partner violence was found to be associated with physical trauma as well as nonfatal strangulation. Overall, this study helps us to understand key factors associated with sexual violence.

Knowledge of gynecologists in the public health system care of women victims of violence

OBJECTIVE:

This study aimed to evaluate the knowledge of the obstetricians and gynecologists in the care of women victims of violence in the public health system and the existence of institutional mechanisms to support them.

METHODS:

A cross-sectional and observational study was conducted with an electronic questionnaire by physicians who provided care in the obstetrics and gynecology emergency unit of the public health system. This study aimed to identify the care for victims of violence who received the institutional mechanisms of support, the difficulties encountered in determining the appropriate care, and estimates of the prevalence of violence against women.

RESULTS:

Notably, 92 physicians responded to the questionnaire. Of these, 85% had already provided care in one or more cases of violence, and 60% believed that <20% of the women received adequate care in these cases, mainly due to the short-time frame of the consultation, lack of team preparation, and lack of institutional resources. A total of 61% of the participants believed that they were not prepared to provide adequate care in those cases.

CONCLUSIONS:

Most of the physicians interviewed, although reported to have sufficient knowledge to adequately treat victims of violence, did not provide such care due to lack of institutional support.

Frequency, Types, and Manifestations of Partner Sexual Violence, Non-Partner Sexual Violence and Sexual Harassment: A Population Study in Spain

Background: This study analyzes the frequency and sociodemographic characteristics associated with sexual violence by a partner/ex-partner (PSV), someone other than a partner or ex-partner (NPSV), or sexual harassment (SH). Methods: The study is based on the 2019 Macro-survey of Violence against Women conducted by the Spanish Ministry of Equality among a sample of 9568 women age 16 or more years. Odds Ratios were calculated and multinomial logistic regression analyses were performed. Results: Forty-four women had suffered some kind of sexual violence over their lifetime, 9.2% had experienced PSV, 6.5% NPSV and 40.4% SH. More than 7% of women had been raped by a partner and 2.2% by another man. In the three groups, violence was associated with lower age and having a certified disability. NPSV and SH were significantly associated with a higher education and internet use. In NPSV, 9.2% of cases were reported to the police and 3.9% were reported to the courts. In SH, 91.7% of women told a family member or a close friend and 4.2% reported it to the police or the courts. Conclusions: A greater emphasis needs to be placed on reporting sexual violence in its various forms. Rape within intimate partnerships ought to be investigated and studied in greater depth.

The Effect of Adverse Mental Health and Resilience on Perceived Stress by Sexual Violence History

Sexual violence, including nonconsensual sexual initiation and rape, remains pervasive, with impacts including adverse mental health and dysregulated stress response. Resilience is a promising interventional target. To advance the science, we examined the potential for resilience as an interventional tool by estimating associations between resilience, adverse mental health, and perceived stress among women by sexual violence history and partner perpetration. We analyzed 2018−2020 baseline survey data from 65 women enrolled in a prospective case-control study of sexual violence and HIV susceptibility in San Diego, CA. Multiple linear regressions were performed to examine associations, stratified by sexual violence history. About half of women experienced nonconsensual sexual initiation and/or rape; half of rapes were partner-perpetrated. Post-traumatic stress disorder (PTSD) was significantly associated with perceived stress among survivors (in regressions with depression and resilience, nonconsensual initiation: β = 6.514, p = 0.003, R2 = 0.616; rape: β = 5.075, p = 0.030, R2 = 0.611). Resilience was associated with lower perceived stress for all women; the effect appeared stronger among survivors of sexual violence (nonconsensual initiation: β = −0.599, p < 0.001 vs. β = −0.452, p = 0.019; rape: β = −0.624, p < 0.001 vs. β = −0.421, p = 0.027). Partner perpetration of rape was not associated with perceived stress. Our findings support leveraging resilience and addressing PTSD to reduce perceived stress among women with lifetime experiences of sexual violence.

Characteristics of Sexual Violence Against Adolescent Girls: A 10 Years' Retrospective Study of 731 Sexually Abused Adolescents

Introduction

Sexual violence against young girls is a pervasive multifaceted phenomenon which embraces several different forced sexual acts, including attempted and/or completed rape, sexual coercion and harassment, and sexual contact with force or threat of force. The aim of this study is to evaluate the characteristics of sexual violence in adolescent girls, by a retrospective analysis of 731 consecutive cases of sexually abused girls.

Materials and Methods

We analyzed demographic characteristics, risk factors for rape, and the eventual subsequent presence and type of ano-genital lesions.

Results

We found that sexual violence with penetration was perpetrated in 591 (80%) cases. Vulnerability factors related with a major risk of rape were age >17 years old and consumption of alcohol and/or other drugs. About 196 (55%) victims had at a least one genital lesion.

Conclusion

A prompt identification of red flags of sexual violence may help physicians in suspecting and managing cases of sexual assault in adolescent girls, even in the absence of typical lesions.

Gender roles and intimate partner violence among female university students in Spain: A cross-sectional study

BACKGROUND

Traditional gender roles (GRs) have a considerable influence on relationships among couples. These can lead to negative health effects in women; however, their impact on intimate partner violence (IPV) has been less explored, especially among younger women.

OBJECTIVE

To explore the association between traditional GRs and several indicators of IPV on a sample of Spanish female university students involved in heterosexual dating relationships.

METHODS

A cross-sectional study involving female university students (n = 1,005) pursuing ten degrees (four Health Science degrees and six Social Sciences degrees). Data were collected using two validated scales: 1) the Questionnaire on the Gender Determinants of Contraception (COGANT), used to examine four traditional GRs (submissive, blind, and passive attitudes of female students, and male dominance), and 2) the Dating Violence Questionnaire-R (DVQ-R) scale, used to measure five types of IPV-behaviors (coercion, detachment, humiliation, sexual violence, and physical violence), perceived fear, entrapment, and abuse. Logistic and linear regressions were conducted to study the association between GR and a series of IPV indicators in dating relationships.

RESULTS

Traditional GRs were highly prevalent (57.0% submissive, 52.0% blind attitude, 75.7% passive, and 31.7% identified their boyfriend as being dominant). Up to 66.3% experienced some type of violent behavior. All GRs were significantly associated with IPV indicators. A submissive attitude in female students was the GR that was most strongly associated to total IPV-behavior (adjusted odd ratio [OR] = 3.18; 95% confidence interval [CI]: 2.29-4.42), followed by male dominance (OR = 2.79: 95% CI:1.71: 4.54). Both GRs were also highly associated with perceived fear, entrapment, and abuse.

CONCLUSIONS

A high presence of traditional GRs was found in the relationships held by female university students, which was significantly associated with IPV indicators. Universities must adopt policies for gender equality and raise awareness on dating violence.

Analysis of a Modification to the Sexual Experiences Survey to Assess Intimate Partner Sexual Violence

Greater accuracy is needed in the assessment of sexual victimization that occurs in intimate relationships. Existing assessment strategies in the literature often represent two distinct approaches - intimate partner violence specific strategies vs. sexual violence specific strategies. The current study compared multiple distinct strategies for assessing intimate partner sexual victimization (IPSV) and evaluated a modification that optimizes intimate partner and sexual violence specific strategies. Two samples of undergraduate women were recruited. Sample 1 (N = 236) completed the Severity of Violence Against Women Scales (SVAWS) and a modified version Sexual Experiences Survey-Short Form Victimization (SES-SFV) in which participants were cued to respond both for romantic partners and non-partners (referred to as the SES-RP/NP). Sample 2 (N = 206) completed the SVAWS and was randomized to either the traditional SES-SFV or the SES-RP/NP. Across samples, the prevalence of IPSV varied based on the measure used (SVAWS = 11.7%; SES-SFV = 17.0%; SES-RP/NP = 25.4%). The SES-RP/NP identified significantly more IPSV than the SES-SFV, SVAWS, and prior studies. Both the SES-SFV and the SES-RP/NP were positively and significantly associated with the SVAWS. The results suggested that optimal measurement of IPSV would consider both intimate partner and sexual violence strategies.

Sexual violence and cardiovascular disease risk: A systematic review and meta-analysis

BACKGROUND

Cardiovascular disease (CVD) is a leading cause of death among adults. Over 35% of women worldwide report lifetime exposure to sexual violence. While psychosocial factors broadly have been linked to CVD risk, it is unclear if a history of sexual violence is associated with increased risk for CVD. This study employed quantitative meta-analysis to investigate the association between sexual violence and CVD risk.

METHODS

PubMed and PsycINFO databases were searched through March 1, 2021. Included articles had a measure of sexual violence and at least one cardiovascular outcome (i.e., clinical CVD, subclinical CVD, select CVD risk factors) in women and men aged 18 years or older. Data were expressed as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI) extracted from fully-adjusted models. OR and HR effects were pooled separately, given the inability to statistically harmonize these effects and differences in interpretation, using random effects meta-analysis. Heterogeneity of effects was tested using Cochran's Q test.

RESULTS

Overall, 45 articles based on 830,579 adults (77.1% women) were included (113 individual effects expressed as OR and 9 individual effects expressed as HR). Results indicated that sexual violence was related to adult CVD risk (OR [95%CI] = 1.25 [1.11-1.40]; HR [95%CI] = 1.17 [1.05-1.31]). Results varied by outcome type and measurement, and timing of violence.

CONCLUSIONS

Adults with a history of sexual violence demonstrate greater CVD risk relative to those without this history. The results highlight the importance of addressing sexual violence in CVD risk reduction efforts.

Nonfatal Strangulation During Domestic Violence Events in New South Wales: Prevalence and Characteristics Using Text Mining Study of Police Narratives

Nonfatal strangulation (NFS) is a common form of domestic violence (DV) that frequently leaves no visible signs of injury and can be a portent for future fatality. A validated text mining approach was used to analyze a police dataset of 182,949 DV events for the presence of NFS. Results confirmed NFS within intimate partner relationships is a gendered form of violence. The presence of injury and/or other (non-NFS) forms of physical abuse, emotional/verbal/social abuse, and the perpetrator threatening to kill the victim, were associated with significantly higher odds of NFS perpetration. Police data contain rich information that can be accessed using automated methodologies such as text mining to add to our understanding of this pressing public health issue.

Intimate partner violence types and symptoms of common mental disorders in a rural community of Chiapas, Mexico: Implications for global mental-health practice

This paper examines the scope and characteristics of male-to-female intimate partner violence in southern rural Chiapas, Mexico, and its association with depression and anxiety symptoms, highlighting the role of partner controlling behaviors. Participants were selected by random sampling. One-hundred and forty-one women >15 years participated in the study. Data was obtained through an adapted version of the National Survey of the Dynamics of Household Relationships (ENDIREH) intimate partner violence scale, the Patient Health Questionnaire-9 for depression symptoms and the Generalized Anxiety Disorder-7 for anxiety symptoms. Quantitative results indicated a 66.4% lifetime prevalence of physical and/or sexual IPV among ever-partnered women 15 years or older (95% CI: 57.5-74.5%). Forty percent (95% CI: 32.0-49.7%) of them reported having experienced physical and/or sexual violence with high partner control (HC-IPV), and 25.8% (95% CI: 18.5-34.3%) reported having experienced physical and/or sexual violence with low or moderate partner control (MC-IPV). Lifetime experience of HC-IPV was significantly associated with moderate-severe depression symptoms (RR = 5.8) and suicidality (RR = 2.08). While partner alcohol abuse was associated with a 3.06 times higher risk of lifetime physical and/or sexual IPV, 30.9% of women mentioned that their partners were never drunk when violence occurred. Interestingly, high partner alcohol abuse was more frequent among women who reported HC-IPV compared to MC-IPV. Implications for global mental health practice are discussed.

Examining Relationship and Abuse Tactics Associated with Nonfatal Strangulation Experiences Before and After a Protective Order

Nonfatal strangulation is associated with significant physical harm and lethal violence. The overall objective of this study was to examine relationship and abuse tactics for women with (n = 369) and without (n = 276) nonfatal strangulation experiences the year before, and the year after, a civil protective order (PO) against an abusive (ex)partner was obtained. Furthermore, this study sought to examine which abuse tactics, including nonfatal strangulation, were associated with mental health status at follow-up. In the year before the PO, 57% of women experienced nonfatal strangulation and 12.4% experienced nonfatal strangulation in the year after the PO by their abusive (ex)partner. Those with nonfatal strangulation experiences in the year before the PO were 3.5 times more likely to experience nonfatal strangulation after the PO. Additionally, death threats in the year before the PO as well as having spent any time in the relationship with the abuser after the PO were uniquely associated with post-PO nonfatal strangulation. Furthermore, abuser control tactics and severe violence after the PO were significantly associated with mental health status at follow-up after controlling for baseline mental health status. Study results also suggest that those with nonfatal strangulation experiences may have an especially difficult time initiating and maintaining separation from abusive partners. Results suggest that there are specific risk factors to consider in tailoring PO protections, safety supports, and resources for those with prior nonfatal strangulation experiences.

Migrant Women's Help-Seeking Decisions and Use of Support Resources for Intimate Partner Violence in China

In China, women who domestically relocate from rural or less developed regions to major cities are at a higher risk for intimate partner violence (IPV) than their non-migrant counterparts. Few studies have focused on Chinese domestic migrant women's help-seeking for IPV and their use of different sources of support. The present study aimed to identify factors that influence migrant women's help-seeking decisions. In addition, we also examined factors that contribute to migrant women's use of diverse sources of support for IPV. A sample of 280 migrant women victimized by IPV in the past year at the time of the survey was drawn from a larger cross-sectional study conducted in four major urban cities in China, including Beijing, Shanghai, Guangzhou, and Shenzhen. Using a multinomial logistic regression model and a zero-inflated Poisson model, we found that factors influencing migrant women's help-seeking decisions and their use of diverse sources of support included socioeconomic factors, IPV type, relationship-related factors, knowledge of China's first anti-Domestic Violence Law, and perception of the effectiveness of current policies. We discuss implications for future research and interventions.

Symptoms within somatization after sexual abuse among women: A scoping review

INTRODUCTION

Somatization, defined as a number of medically unexplained physical symptoms for many years, is a resource-intensive condition with much suffering. Adult somatization has been linked to childhood trauma in both men and women. Among women, sexual trauma affects somatization level to a greater extent than nonsexual trauma. Early diagnosis of a somatization disorder would be of great help for both patients and society. The purpose of this scoping review is to map and summarize the literature on symptoms within somatization in women who have been sexually abused, and investigate if any specific symptom can be linked to previous sexual abuse.

MATERIAL AND METHODS

A scoping review methodology was used. The databases PubMed, PsycINFO, and the Cochrane Library were searched for original qualitative and quantitative research published between 2008 and 2019 that matched the objectives of the review.

RESULTS

The database search identified 195 articles, of which 43 were retrieved in full text. Seven articles were included, involving 2076 women. All studies were quantitative. The included studies were heterogeneous. Four studies showed inconsistent findings regarding a link between sexual abuse and chronic or acute pain. Two studies showed an association between sexual abuse and increased incidence of somatic symptoms. One study showed an association between sexual abuse and symptoms of irritable bowel syndrome. No specific somatic symptoms in somatization were identifiable within the scope of this study.

CONCLUSIONS

This is to our knowledge the first scoping review on sexual abuse and symptoms of somatization. The findings suggest a link between sexual abuse and somatic symptoms, but the identified association with pain and irritable bowel syndrome is inconsistent. No studies have clearly identified specific symptoms within somatization associated with sexual abuse. Qualitative research on the topic was identified as a knowledge gap.