Management of people who have been raped

PTSD of rape after IS ("Islamic State") captivity

Research into the psychological consequences of rape on women in war and warlike situations is limited. The aims of this study were (a) to describe the prevalence and the nature of PTSD symptoms among Yazidi women reporting rape during IS captivity, (b) to describe comorbidity of other psychological disorders, and (c) to examine the risk factors associated with posttraumatic stress disorder.The study included 296 Yazidi women survivors of rape and has been conducted in Germany since January 2016 as part of a special-quota project in the German region of Baden-Wuerttemberg, designed to support the women and children who have escaped after being held hostage by IS.The survivors were recruited into a retrospective, cross-sectional study. Interviews in Germany were done through trained personnel to evaluate the mental health status of raped women.All the investigated women had been raped many times during IS captivity. About 82% of the women were also physically tortured. Of the sample, 67% suffered from somatoform disorder, 53% suffered from depression, 39% from anxiety, and 28% from dissociation. The prevalence of PTSD in those with rape events of more than 20 times was 57% (95% CI = 35.1-65.9%), less than 20 times was 41% (95%, CI = 28.7-4.8% and less than 10 times 39% [95% CI = 28.2-41.8%], respectively.The IS captivity and wartime rapes had deep immediate and long-term consequences on the mental health of women survivors. The high prevalence of PTSD emphasizes the need for culturally sensitive diagnostic and therapeutic services to address the intermediate and long-term consequences of wartime rape.

Visual Representations of Sexual Violence in Online News Outlets

To study visual representations of sexual violence, photographs accompanying German Internet news articles that appeared between January 2013 and March 2015 (N = 42) were subjected to thematic analysis. Two main themes, consisting of several sub-themes, emerged from the data. The first theme was "rape myths," illustrating a stereotypical view of sexual violence. It consisted of three sub-themes: "beauty standards," referring to the fact that all women in our sample fit western beauty standards, "physical violence," as most images implied some form of physical violence, and finally "location," suggesting that rape only happens in secluded outdoor areas. These findings suggest that the images from our sample perpetuate certain rape myths. The second theme was "portrayal of victimhood," referring to the way victims of sexual violence were portrayed in photographs. The analysis of the sub-theme "passivity" showed that these portrayals fit a certain stereotype: the women were shown to be weak and helpless rather than individuals with agency and able to leave their status as a victim. Further sub-themes were "background," "organization of space," "camera perspective," and "lighting." We discuss these findings in relation to possibly reinforcing rape myths in society and as an issue in creating a biased perception of women who have experienced sexual violence.

Crack, AIDS, and women in São Paulo, Brazil

Brazil is currently experiencing a growing number of newly recorded cases of HIV infection among women, with transmission mainly occurring by sex. This increase may be associated with the development of sexually risky behavior among female crack users who, according to informal reports, prostitute themselves for drugs or for money to be used for buying drugs. Since epidemiologic studies have not yet addressed this phenomenon, the aim of this study was to investigate this in depth using a qualitative ethnographic approach. An intentional sample was utilized, composed of 75 female crack users in S?o Paulo, who were selected by specific criteria using the snowball strategy and key informants. Fourteen different chains of users were investigated, allowing us to include the largest possible number and variety of users. Each participant was submitted to a semi-structured in-depth interview that was guided by a questionnaire. Verbal information was corroborated and extended using participative observation. These 14?45-year-old women, who had little schooling and no job connections, opted to sell their bodies as a strategy to obtain drugs and to satisfy their compulsive use of crack. The subjects engaged in up to nine acts of sexual intercourse per day, in unsafe locations and with multiple partners who were approached in a besieging way and selected using subjective criteria. These crack users generally exchanged sex under craving for ridiculously low prices and left the use of protection up to the client. Because the users used inadequate pipes to smoke crack, it was common for them to have lesions on their lips and mouths. Since they often provided oral sex, they exposed themselves to considerable risk for infection with STDs including HIV, because of the contact of their partners? semen with their open wounds. These women make up an important risk group with respect to the transmission of STDs including AIDS.

Examination for sexual assault: evaluating the literature for indicators of women-centered care

This study aimed to assess the extent to which recent peer-reviewed published literature on the acute management of sexual assault was women-centered. We developed indicators and a framework that operationalized women-centered care provision in the context of sexual assault. We then reviewed and evaluated the literature in relation to these indicators. A systematic search identified a total of 20 relevant articles for inclusion in the analysis. These were published in medical journals (65%, 13/20), nursing journals (20%, 4/20), and journals targeted toward other health care practitioners (15%, 3/20), and originated from the United States (65%, 13/20), the United Kingdom (15%, 3/20), Australia (10%, 2/20), Spain (5%, 1/20), and Canada (5%, 1/20) between January 2000 and August 2005. We found little acknowledgment of the inherent tensions faced by sexual assault examiners in providing women-centered care. Moreover, absent from most articles were discussions of the complexities of consent in sexual assault examinations, social justice issues, the need for gender-sensitive training for health care providers, and a critical appraisal of colposcopic and DNA technologies. Indicators of respect, safety and restoring control, and connections to community were present in the majority of articles.

Psychological consequences of rape on women in 1991-1995 war in Croatia and Bosnia and Herzegovina

AIM

To explore the short- and long-term psychological consequences of rape on women victims of rape during the 1992-1995 war against Croatia and Bosnia and Herzegovina.

METHODS

The study included 68 women victims of rape and was conducted at the Medical Center for Human Rights, Zagreb, Croatia, from 1992 to 1995. Testimony method and a questionnaire were used to retrospectively obtain the description of rapes and symptoms women suffered immediately after rape and at the time of the study, ie, 11.9-/+2.4 after the trauma. Structured clinical interviews were conducted to diagnose psychiatric disorders that were present at the time of study, according to the third edition of Diagnostic and Statistical Manual of Mental Disorders.

RESULTS

The raped women were Croatian and Muslim (Bosniak) women, residents of Croatia and Bosnia and Herzegovina. Forty-four of them were raped more than once, 21 were raped every day during their captivity, and 18 were forced to witness rapes. Most of the rapes (n=65) were accompanied by physical torture. The most frequent psychological symptoms felt immediately after the rape were depressiveness (n=58), avoidance of thoughts or conversations associated with the trauma (n=40), and suicidal ideas (n=25). Although none of the women had a psychiatric history before the rape, at the time of study 52 suffered from depression, 51 from social phobia, 21 from posttraumatic stress disorder (PTSD), and 17 had sexual dysfunctions. These disorders were often comorbid. Out of 29 women who got pregnant after rape, 17 had artificial abortion. The decision to have an abortion was strongly predicted by suicidal thoughts and impulses (odds ratio, 25.8; 95% confidence interval, 2.53-263.2).

CONCLUSION

War-time rapes had deep immediate and long-term consequences on the mental health of women victims of rapes and their social and interpersonal functioning.