The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: a systematic review

Negative Sexual Experiences Among Gay, Bisexual, and Other Men Who Have Sex with Men Using GPS-Enabled Hook-Up Apps and Websites

Gay, bisexual, and other men who have sex with men (GBMSM) often use GPS-enabled dating apps and websites to facilitate in-person sexual encounters. Many of these encounters are positive and enjoyable. However, there is limited research on GBMSM's negative experiences with partners from hookup and dating apps/websites, especially those characterized by threats to GBMSM's sexual, physical, and/or psychological safety. In this report, we investigated this matter. We analyzed data from interviews with GBMSM (N = 60) and identified four categories of negative sexual experiences, each of which were comprised by sub-categories: 1) sexual violence (physical sexual assault, verbal sexual coercion, intoxicated assault/coercion), 2) sexual health risk behaviors (condom use resistance and coercion, deception related to HIV/STI status), 3) non-negotiated behaviors (undiscussed/unexpected sex acts, rough sex, sexualized racism, undesired substance use by the partner), and 4) threats to physical safety beyond sexual violence (being blocked from leaving, stalked, robbed, drugged). These results can inform future research and interventions that aim to promote safety on dating apps/websites within the GBMSM community.

Sexual Abuse, Commercial Sexual Exploitation, and Cumulative Adversity Among Sexually Diverse and Non-Sexually Diverse Girls in the Juvenile Justice System

Despite awareness about high rates of sexual abuse among girls in the juvenile justice system, little is known about the additional risk conferred upon sexually diverse (SD) youths, as well as the combined vulnerability of sexual abuse and commercial sexual exploitation of children (CSEC) - frequently a survival behavior amplifying disproportionate juvenile justice contact among SD and non-SD juvenile justice-involved (JJI) girls. In a sample of JJI-girls, we compared SD (n = 52) with non-SD (n = 46) JJI-girls on sexual victimization (e.g. sexual abuse occurring within different relationship-types, CSEC), and broader developmental adversity burden disadvantage (cumulative trauma/loss exposure-types) and distress (posttraumatic stress disorder [PTSD]; cumulative stressor-reactivity, grief-specific, and adversity-related symptoms), health distress/impairment, and sexual and physical health-risk indicators. While comparable on childhood sexual abuse frequency, SD JJI-girls reported greater cumulative sexual abuse severity across relationship-types, higher sexual abuse within non-familial contexts, and more CSEC involvement. They also reported more social determinants of health (e.g. trauma/loss exposure-types) and showed elevations on all health-risk indicators, and most cumulative adversity burden indicators, despite comparable PTSD severity. Our findings emphasize the need to consider multiple sexual victimization facets, including the combined vulnerability of sexual abuse and CSEC, and utilize cumulative developmental assessment approaches among youths vulnerable to maltreatment and exploitation.

Drug-facilitated sexual assault in youth nightlife contexts in Spain

OBJECTIVES

This study aimed to provide epidemiological information on drug-facilitated sexual assault in Spanish youth partying, with a focus on prevalence rates and associated sociodemographic factors.

STUDY DESIGN

Cross-sectional study.

METHODS

Quota sampling was used to recruit 1601 young people aged 18-35 years in Spain from a digital panel. A validated questionnaire on drug-facilitated sexual assault was used to assess five types of lifetime victimisation experiences while partying. Chi-square and the exact Fisher tests were used to describe the prevalence of victimisation, drug use patterns, and perpetrator profiles. Generalised ordered logistic regression was used to explore factors associated with victimisation, analysed by gender.

RESULTS

Half of young women and one-quarter of young men had experienced drug-facilitated sexual assault in their lifetime. Female victimisation due to touching and kissing was notably high, whereas men comprised almost half of the victims of more invasive DFSA experiences involving masturbation, penetration, and oral sex. Opportunism prevailed as the assault tactic, consisting of taking advantage of the victims' incapacity derived from voluntary alcohol use. Among women, risk of victimisation was associated with a lower education level, foreign-born status, and being non-heterosexual. Male victimisation risk was highest among non-heterosexual men.

CONCLUSIONS

Drug-facilitated sexual violence in youth nightlife contexts is a serious public health issue in Spain, which requires urgent action. Most assaults involve taking advantage of victims who are incapacitated by the effects of voluntary alcohol consumption. This sexual violence primarily affects women with lower educational levels or those who are foreign-born and non-heterosexual men and women.

Addressing the Health Needs of LGBTQ Persons in Medical Curricula: A Review of Educational Programs

OBJECTIVE

Given the vulnerability of and the importance of caring for the specific health care needs of the growing lesbian, gay, bisexual, transgender, and queer (LGBTQ) population, the authors attempted to identify all educational interventions in psychiatric settings with quantitative outcomes targeting medical students, residents, and physicians in postgraduate settings. To gain insight from other disciplines that have published research in this area, a second objective was to review studies in teaching in those other disciplines. The authors sought to describe the methods of selected studies.

METHODS

The authors searched the published English-language literature indexed in PubMed, EMBASE, and PsycINFO using key terms for health care education concerning LGBTQ populations. The authors described and critically appraised studies with quantitative outcomes designed to enhance knowledge, skills, and attitudes in treating the LGBTQ community.

RESULTS

Of the 15 trials identified, 10 included medical students, 4 included internal medicine residents or medical school faculty, and 1 included oncologists. We did not find any randomized controlled trials or controlled nonrandomized trials of curricula dedicated to teaching learners in psychiatry. All of the studies included a presurvey, followed by an educational intervention and then a postsurvey assessment. The educational interventions, outcome measures, and quality of studies varied widely. Four studies enrolled self-identified members of the LGBTQ community as trainers and facilitators of the educational interventions.

CONCLUSIONS

The lack of high-quality controlled studies indicates the need to develop evidence-based curricula to support the education of the psychiatric workforce to provide for the special needs of LGBTQ persons.

Revisiting the Harm of Hate: A Quasi-Experimental Approach Using the National Crime Victimization Survey

Early legal challenges to the 1990 Hate Crime Statistics Act were originally excused on the argument that hate crimes "hurt more," but there remain some empirical gaps on this topic. Although many works have concluded that biased offenders cause greater harms to their victims relative to unbiased perpetrators, this effect tends to be sensitive to individual and situational factors like victim and offender characteristics, bias motivation, weapon use, or crime location. This type of confounding has the potential to introduce selection bias in the estimation of victimization harms among biased criminal incidents. With data from the National Crime Victimization Survey (2010-2020), I use propensity scores and inverse-probability weighting to show that, on average, victims of bias motivated offenses are more likely to report later physical and emotional harms despite not suffering greater initial injury in incidence. Findings also demonstrate that the harm of hate varies across different bias motivations, with such crimes directed toward those on the basis of disability, gender, and sexual orientation causing greater short- and long-term individual trauma and damage.

Experiences of interpersonal victimization and abuse among autistic people

LAY ABSTRACT

What do we already know?Autistic people are more likely to have negative life experiences than non-autistic people, from bullying and ostracization, to being victims of crime, to unemployment and homelessness. This includes being victims of intimate partner violence, sexual assault and domestic abuse. Quantitative work has suggested that as many as 90% of autistic people experience these forms of abuse in some form during their lives, but there is little work asking them to talk about harmful relationships in their own words.What does this article add?This article reports on interviews with 24 autistic adults about their experiences of being victims of intimate partner violence, sexual assault and/or domestic abuse. Some of the themes which came from these interviews are shared with non-autistic victims, but others appeared unique to autistic people. One of these was evidence for unique autism-related vulnerabilities, as well as the impact the abuse had on their relationships long term. Participants also talked about how the sex and relationship education they had received had inadequately prepared them for adult relationships, and how this had contributed to their struggle to recognize and react to abusive behaviour.Implications for practice, research and policyPolicies around intimate partner violence and sexual assault need to be updated to account for the different ways in which neurodivergent people (people whose brains process information differently from the majority) may discuss their experiences, rather than looking for 'standard narratives' as an indicator of a need for support. Relationship and sex education should be tailored for autistic young people to help them recognize abusive behaviours, and include how to respond to these safely. We recommend that future research tries to focus specifically on the abuse experiences of autistic men, non-binary and trans people, who have been under-represented in studies to date. In addition, much less is known about the abuse experiences of autistic people of colour or autistic people with intellectual disabilities, who also need to be actively included in these discussions.

Trauma- and Violence-Informed Empowering Care for Sexual Assault Survivors

BACKGROUND

Forensic nurse examiners, including sexual assault nurse examiners, provide care for survivors holistically through healthcare, emotional support, connection to follow-up care, safety planning, and, if desired, evidence collection to aid in the prosecution of sexual assault. There is increasing recognition that trauma-informed care must also include an understanding of the impacts of structural violence on minoritized patients to ensure health equity.

AIM

To help address this guidance gap, we expanded Campbell and colleagues' empowering care model using a trauma- and violence-informed care (TVIC) lens.

METHODS

We used an iterative discussion-based process that included five joint meetings between a seven-member transdisciplinary research team and a five-member nurse advisory board.

RESULTS

In a TVIC-informed empowering care model, we propose behavioral examples for forensic nurses for each of Campbell et al.'s five key domains of empowering care for forensic nurse examinations (i.e., build rapport and establish trust, show compassion, provide patient-directed care, convey professionalism, and provide resource referral and follow-up).

CONCLUSIONS

These behavioral examples for nurses can help guide forensic nurse training and practice to reduce disparities in treatment and follow-up support. Structures and systems are needed that enable forensic nurses to provide trauma- and violence-informed empowering care to survivors of sexual assault and, over time, increase the accessibility of forensic nurse examinations and improve patient outcomes.

Experiences with health care services and HIV testing after sexual assault in cisgender gay, bisexual and other men who have sex with men and transgender people

OBJECTIVES

This qualitative sub-study aimed to explore how cisgender gay, bisexual, and other men who have sex with men (cis-GBMSM) and transgender people who reported non-consensual sex (NCS) accessed health care services, what barriers they faced, and how this experience influenced subsequent HIV testing.

METHODS

SELPHI is an online randomized controlled trial evaluating both acceptability and efficiency of HIV-self testing among cis-GBMSM and transgender people. Semi-structured interviews were conducted, audio-recorded, transcribed, and analysed through a framework analysis, as a qualitative sub-study. We identified narratives of NCS from interviews and investigated experiences of cis-GBMSM and transgender people accessing health care services following sexual assault.

RESULTS

Of 95 participants, 15 (16%) spontaneously reported NCS. Participants reported a broad range of NCS, including partner's coercive behaviours, non-consensual removal of condoms, and rapes. All feared HIV transmission, leading them to test for HIV, underlining a marked lack of awareness of post-exposure prophylaxis (PEP). Most had negative experiences in communicating with reception staff in sexual health clinics following these incidents. A lack of confidentiality and empathy was described in these situations of psychological distress. Clinic visits were primarily focused on testing for HIV and sexually transmitted infection, and generally no specific psychological support was offered. Getting a negative HIV result was a key step in regaining control for people who experienced NCS.

CONCLUSIONS

Sexual health care providers should take care to more fully address the issue of NCS with cis-GBMSM and transgender people when it arises. Recognizing and managing the emotional impact of NCS on affected patients would prevent negative experiences and increase confidence in care.

Alcohol's Effects on the Bystander Decision-Making Model: A Systematic Literature Review

To decrease rates of sexual assault victimization, young people are encouraged to become involved when they see questionable sexual situations (i.e., be a prosocial bystander). Several factors can facilitate or inhibit intervention, including alcohol use. To inform bystander prevention programs that aim to address alcohol's impact on bystanders, the current study reviewed research focused on alcohol use and bystander decision making. In December 2022, the authors searched published studies from six major electronic databases. Empirical articles were deemed eligible if they examined alcohol and the bystander decision-making model within the context of sexual assault, were based in the United States or Canada, and not an intervention study; 32 studies were included in the final review. Across 32 studies published between 2015-2022, 12 assessed the proximal effects of alcohol on bystander constructs and the additional studies examined the distal effects of alcohol on bystander constructs. Alcohol use appeared to impede earlier steps of the bystander decision-making model; however, alcohol use was associated with impeding and facilitating bystander decision making at the latter half of the model. Overall, alcohol use appears to be negatively rather than positively associated with bystander constructs. Bystander intervention programs may want to move beyond the narrative of alcohol as a risk factor for sexual assault and discuss how alcohol impairs a bystanders' ability to recognize risk. More work is needed to ensure researchers assess alcohol consistently and with similar methods (number of drinks, subjective intoxication) to increase generalizability of findings to prevention programs.

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.

Receipt of Coercive Condom Use Resistance: A Scoping Review

Condom use resistance (CUR) refers to practices used to obtain unprotected sex with a partner who wishes to use a condom. Coercive CUR is a manipulative and aggressive form of CUR, which is associated with detrimental mental, physical, and sexual health consequences. This review synthesizes quantitative evidence on the prevalence and correlates of experiencing coercive CUR. A systematic approach, including title, abstract, and full-text review, was used to identify relevant empirical studies. Thirty-seven articles met the inclusion criteria. Prevalence of experiencing coercive CUR ranged from 0.1% to 59.5%. Significant correlates of receiving coercive CUR included interpersonal violence, sexually transmitted infection (STI) diagnosis, emotional stress, and drug use. Importantly, vulnerable populations (e.g., racial/ethnic minorities, men who have sex with men, sex workers) and people with low perceived control and resistive efficacy (i.e., the ability to say "no") had an increased likelihood of experiencing coercive CUR. Methodological weaknesses in the current literature include a lack of longitudinal studies and studies that examine the effectiveness of interventions, as well as failure to use consistent measures and include samples of men and sexual minorities. Future research should address these limitations. Intervention and prevention strategies should prioritize populations that are at greater risk for experiencing coercive CUR to achieve better health equity outcomes.

A Qualitative Account of Coping Following Non-Consensual Sexual Experiences among Gay, Bisexual, and Other Men Who Have Sex with Men

Sexual consent among gay, bisexual, and other men who have sex with men (GBMSM) has not been thoroughly documented in the academic literature. Research has suggested that GBMSM incur a greater risk for experiencing non-consensual sexual experiences (NSEs) compared to heterosexual, cis-gendered men. Despite the high prevalence of NSEs impacting this population, little research has been conducted on how GBMSM cope after NSEs. The purpose of this study was to examine how GBMSM cope following NSEs. Responses were analyzed from 206 GBMSM, aged 18-77 (M = 31.84), recruited across Canada. Participants completed an online survey, answering open-ended questions on experiences of NSEs and how they coped afterward. Guidelines for thematic analysis were followed to analyze the responses, indicating that GBMSM cope both maladaptively (e.g., avoidance, withdrawal from social networks and sexual relationships) and adaptively (e.g., seeking therapy, social support) following NSEs. Some participants were affected by and needed to cope with their NSEs over a longer term (e.g., ongoing rumination, enjoying sexual and intimate relationships less). Participants used a range of coping skills and showed openness to reach out for help from formal and informal sources, but also noted that resources were not always accessible or culturally sensitive to GBMSM's needs. Responses are discussed in the context of barriers to effective coping, such as perceptions of masculinity and maladaptive sexual scripts.

Improving School Environments for Preventing Sexual Violence Among LGBTQ+ Youth

BACKGROUND

Sexual violence (SV) is a serious public health concern, and lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ+) youth report higher rates than their heterosexual and cisgender peers. This qualitative study aimed to understand LGBTQ+ students' perspectives on how middle and high school environments can better prevent and address SV.

METHODS

In partnership with a school-based LGBTQ+ support group in Washington State, we recruited 31 LGTBQ+ students ages 13-18 for virtual interviews (n = 24) and for providing text-based answers to interview questions (n = 7). We used inductive thematic analysis to analyze data and identify themes.

RESULTS

To prevent and respond to SV, students highlighted schools having: (1) access to gender-neutral spaces; (2) LGBTQ+ competency training for staff; (3) enforcement of school policies (eg, SV, anti-bullying) and accountability; (4) LGBTQ+-competent mental health support; and (5) comprehensive sexual health education that addresses LGBTQ+ relationships and SV.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Students expressed the need for changes in school physical and social environments to address SV among LGBTQ+ youth.

CONCLUSIONS

Incorporating youth perspectives, particularly LGBTQ+ youth at high risk of SV, can help schools implement strategies that are supported by youth and thus potentially more sustainable and effective.

Relationships Between Violent Sexual Victimization and Muscle-Building Exercise among Adolescents from the 2019 Youth Risk Behavior Survey

BACKGROUND

This study aimed to investigate the association between violent sexual victimization and muscle-building exercise among adolescents.

METHODS

Cross-sectional data from the 2019 National Youth Risk Behavior Survey (N = 8408) were analyzed. Two indicators of non-dating-related sexual violence (lifetime, past 12 months), along with one indicator of adolescent sexual violence (past 12 months), were assessed. Days of muscle-building in the past week were reported. Multinomial logistic regression analyses were conducted to determine the associations between the three violent sexual victimization variables and muscle-building exercise.

RESULTS

Among the sample (50.3% girls), lifetime violent sexual victimization (relative risk ratio [RRR] 1.87, 95% confidence interval [CI] 1.29 to 2.72), past 12-month violent sexual victimization (RRR 1.60, 95% CI 1.15 to 2.22), and past 12-month sexual dating violence (RRR 1.60, 95% CI 1.03 to 2.51) were associated greater relative risk of high engagement (ie, 6 to 7 days) in muscle-building exercise relative to no engagement.

CONCLUSIONS

A history of violent sexual victimization is associated with greater involvement in muscle-building exercise, particularly among adolescent girls. Engagement in muscle-building exercise in relation to violent sexual victimization may be a means of emotion regulation and occur due to body dissatisfaction resulting from experiencing violence.

Typologies of alcohol and other drug-related risk among lesbian, gay, bisexual, transgender (trans) and queer adults

INTRODUCTION

Prevalence and patterns of alcohol and other drug (AOD) use among specific lesbian, gay, bisexual, transgender (trans) and queer (LGBTQ+) subpopulations are well established. However, patterns of substance-related risk have been less thoroughly explored. This study aimed to determine typologies AOD risk among LGBTQ+ adults in Australia.

METHOD

Latent class analyses were performed to determine distinct patterns of AOD risk (n = 6835), as measured by the Alcohol Use Disorder Identification Test and Drug Abuse Screening Tool. Demographic characteristics, experience of harassment, assault and/or threats, mental wellbeing and LGBTQ+ connectedness were compared across emergent classes.

RESULTS

AOD risk was characterised as 'no risk' (13.3% of sample), 'low risk' (15.1%), 'moderate risk' (alcohol + other drugs; 30.1%), or 'moderate alcohol only risk' (41.5%). The 'moderate risk' class was the most likely class to report recent sexual assault, verbal abuse, harassment and physical threats compared to other classes, while those in the 'moderate alcohol only risk' group were least likely to report these experiences of all classes. However, both the 'moderate risk' and 'moderate alcohol risk only' classes reported greater mental wellbeing and LGBTQ+ connectedness compared to the 'no risk' and 'low risk' classes.

DISCUSSION AND CONCLUSIONS

Our findings indicate that level of AOD risk is not uniform among some LGBTQ+ adults, nor is the distribution of harms experienced by them. Tailored harm-reduction interventions may be fruitful in attenuating harms based on risk profile; most specifically, LGBTQ+ individuals engaging in moderately risky concurrent AOD use.

Associations of past-year overall trauma, sexual assault and PTSD with social support for young adult sexual minority women

Background: Young adult sexual minority women (SMW) are at elevated risk for sexual assault (SA), posttraumatic stress disorder (PTSD), and inadequate social support. While SA and PTSD can lead to reductions in social support from close significant others, the impact of SA and PTSD on SMWs' social support has not previously been assessed.Objective: This study examined the associations of past year SA and PTSD with SMW's social support from intimate partners, family, and friends. It was hypothesized that SA and PTSD would be negatively associated with support from partners, family and friends, and that PTSD would moderate the effect of SA on support in early adulthood.Method: Young adult SMW in the United States (N = 235) who were M = 23.93 (SD = 2.15) years old, primarily lesbian or bisexual (n = 186, 79.1%) and White (n = 176, 74.9%) completed measures on past year exposure to SA and non-SA trauma, PTSD, and social support from intimate partners, family and friends.Results: PTSD was associated with less social support from partners, (b  = -0.06, SE = 0.02, p = .010, R2change = .02), family, (b  = -0.06, SE = 0.03, p = .025, R2change = .02), and friends, (b  = -0.07, SE = 0.02, p = .008, R2change = .02). There was a significant interaction between PTSD and SA on social support from partners (b  = -0.01, SE = 0.01, p = .047, R2change = .01). Neither non-SA nor SA trauma was associated with support from family or friends.Conclusions: Results underscore the potential impact of recent SA on intimate partnerships for young adult SMW with more severe PTSD. Future work should explore how addressing PTSD and improving social support quality may help SMW recover from traumatic experiences and ameliorate the effects of SA on intimate partnerships.

Examination of the Sexual and Negative Dating Inventory (SANDI) Among Sexual and Gender Minorities: An Analysis of Psychometrics and Outcomes

ObjectiveAdverse sexual experiences (ASE), including sexual violence, sexual risk behaviors, and regretted sex, are highly prevalent among sexual and gender minorities (SGM) compared to cisgender and heterosexual individuals. Research indicates ASEs are associated with increased mental health symptomatology and decreased subsequent protective behavior use. The Sexual and Negative Dating Inventory (SANDI) measures dating and sexual protective strategies and includes five factors: Location Sharing, Assertiveness, Self-Protection, Risk Reduction and Privacy. SANDI total scores are linked to lower ASEs in heteronormative samples. Method: SANDI was previously validated in a sample of n = 1,289 college students. Data were examined from n = 313 (24.28%) SGM individuals at baseline, and n = 95 at one-month follow-up. Individuals were 19.70 (2.98 SD) years old, and 25% were non-white. Model fit was adequate for SGM: χ2(484) = 1729.621, p < .001, CFI = .947, RMSEA = .063 (90% CI = .060, .066), SRMR = .048. Results: Non-cisgender men and non-heterosexual individuals endorse using more of the SANDI at the factor level. Using logistic regression, SANDI was not associated with history of sexual violence or sexual violence over the next month. SANDI is inversely associated with history of sexual risk and prospectively associated with less sexual risk over the next month. Negative binomial regression analyses showed SANDI was not associated with a history of regretted sex; however, SANDI was moderately associated with decreased regretted sex over the next month. Conclusion: Findings highlight the importance of dating and sexual protective behaviors across dimensions of gender and sexual orientation.

Preventing sexual violence in sexual orientation and gender diverse communities: A call to action

Background: Members of the lesbian, gay, bisexual, transgender, queer, and other sexual orientation and gender diverse (SOGD) communities are at disproportionately higher risk for sexual violence compared to cisgender heterosexual people. Despite this elevated risk, relatively few sexual violence prevention efforts effectively reduce these victimization disparities based on sexual orientation or gender identity.Objective: This narrative review provides an overview of the prevalence of sexual violence in the SOGD communities, delineates risk factors for sexual victimization among SOGD community members, and reviews and evaluates existing prevention efforts for the SOGD communities. We outline specific recommendations for ensuring that prevention efforts meet the needs of the SOGD communities.Method: Drawing on ecological systems theory and public health approaches to sexual violence prevention, we outline current approaches and opportunities for preventionists and scholars to push the field forward.Results: There have been promising prevention programmes designed to be implemented within SOGD communities specifically; however, it is important that general primary prevention programmes endeavour to specifically address sexual violence perpetrated against SOGD people. While many packaged programmes that endeavour to prevent sexual violence across all gender identities and sexual orientations are inclusive of SOGD participants, more programming is needed that integrates anti-oppression training to target social norms that perpetuate SOGD-specific rape myths and normalize sexual violence against SOGD community members.Conclusion: Ecological prevention strategies in line with a public health approach for primary prevention may be particularly valuable for reducing victimization disparities based on SOGD status and identity. Comprehensive sexual education and anti-discrimination policies should be considered front-line prevention programming. To assess if these strategies are effective, the implementation of large-scale surveillance surveys that use comprehensive assessments of sexual orientation, gender identity, and sexual violence are needed. Using theoretically grounded implementation strategies for prevention programmes can ensure effective programme delivery.

"You kind of blame it on the alcohol, but. . .": A discourse analysis of alcohol use and sexual consent among young men in Vancouver, Canada

There is growing awareness about issues of sexual consent, especially in autonomy-compromising or "non-ideal" contexts, including sex involving alcohol. Understanding the conditions needed for consensual sex to occur in this emergent milieu is critically important, especially for young men (ages 18-30 years) who normatively combine drinking alcohol with sex and are most often perpetrators of sexual violence. This study offers a discourse analysis of young men's alcohol use and sexual consent. Data are drawn from qualitative interviews with 76 young men (including gay, bisexual, queer, and straight men) in Vancouver, Canada, from 2018 to 2021. Informed by Kukla's non-ideal theory of sexual consent and critical and inclusive masculinities, this analysis identified three discursive frames: careful connections, watering it down, and blurred lines. In careful connections young men discussed their efforts to actively promote sexual and decisional autonomy for themselves and their sexual partners when drinking. Yet, in watering it down young men invoked discourses of disinhibition, deflection, and denial to normalize alcohol use as being somewhat excusatory for sexual violence, downplaying the role and responsibility of men. Lastly, men operationalized blurred lines through a continuum of consent and of "meeting (masculine) expectations" when discussing sexual violence and victimization while intoxicated. Together, these discursive frames provide insights into the gendered nature of sexual violence and the extent to which idealized notions of sexual consent play out in the everyday lives of young men who use alcohol with sex. Findings hold philosophical and pragmatic implications for contemporary efforts to scaffold sexual consent.

Cumulative violence exposures among men who have sex with men living with HIV in India: Psychosocial correlates of HIV care continuum outcomes

Lifetime exposures to violence among men who have sex with men (MSM) are associated with multiple psychosocial health risks and can affect engagement and outcomes of HIV treatment. This study a) explored relationships between levels of exposures to violence and HIV care continuum outcomes among MSM living with HIV in India, and b) identified psychosocial correlates of HIV care continuum outcomes among MSM living with HIV and those with lifetime cumulative exposures to violence (CVE). CVE referred to exposures to violence in both childhood and adulthood. This cross-sectional analysis used survey data collected between August 2016 and May 2017 from 1763 men who have sex with men living with HIV across 10 cities in India, using respondent-driven sampling. We found that higher levels of violence exposure were significantly associated with lower awareness of HIV positive status, and lower likelihood of initiating antiretroviral therapy. Compared with MSM living with HIV that had no CVE, those with CVE were more likely to report perpetration of interpersonal violence, alcohol misuse, depressive symptoms, and HIV transmission risk behaviors and to have two to four co-occurring psychosocial problems. In multivariable analysis with the subset of MSM with CVE, psychosocial correlates significantly associated with at least one HIV care continuum outcome were HIV transmission risk behaviors, perpetration of interpersonal violence, depression, and alcohol misuse. The findings highlight the need for integrating care for lifetime violence exposures and associated behavioral problems in HIV care settings for men who have sex with men living with HIV in India.

Associations among sexual assault, posttraumatic stress, drinking to cope with anxiety, and alcohol use based on gender identity and sexual orientation

BACKGROUND

Sexual assault (SA) is experienced by a substantial proportion of emerging adult college students and is associated with elevated rates of posttraumatic stress disorder (PTSD) and alcohol use. This study examines the mediating role of posttraumatic stress symptoms (PTSS) in the associations among SA severity, drinking to cope with anxiety, and average weekly drinks while considering the moderating roles of gender identity and sexual orientation.

METHODS

A total of 2160 college students who were diverse in gender (cisgender women, 64.4%; cisgender men, 30.6%, and transgender and gender diverse [TGD] individuals = 4.9%) and sexual orientation (heterosexual = 68.0%, LGBQ+ = 32.0%) completed measures of SA severity, PTSS, drinking to cope with anxiety motives, and average weekly drinks.

RESULTS

The mediation model for the full sample indicated significant indirect effects of SA severity on drinking to cope with anxiety through PTSS, but not on average weekly drinks. Moderation analyses revealed differential relationships between the variables based on both gender identity and sexual orientation. For instance, the association between SA severity and PTSS was stronger for cisgender women and TGD individuals than cisgender men, and for LGBQ+ individuals than heterosexual individuals. While the association between PTSS and average weekly drinks was only significant for cisgender men, the association between PTSS and drinking to cope with anxiety was significant for both cisgender men and women but not TGD individuals. Furthermore, the association between SA severity and drinking to cope with anxiety was stronger for cisgender women than cisgender men.

CONCLUSIONS

Findings from this study demonstrate sexual orientation and gender identity differences and similarities in the associations of SA severity, PTSS, drinking to cope with anxiety, and alcohol use. Results are discussed in relation to the self-medication hypothesis and tailoring interventions for diverse groups.

Reproductive Coercion Among College Students: An Extension and Test of Routine Activity Theory

The current study is guided by routine activity theory to explore the risk of experiencing reproductive coercion among a sample of sexually active college students (N = 1,515). Findings indicate that being in an exclusive relationship was associated with lower odds of reproductive coercion, yet prior victimization, including emotional abuse and sexual violence, was associated with higher odds of reproductive coercion. This study supports other research that finds reproductive coercion does not occur in isolation from other victimization experiences, and multifaceted prevention strategies are needed. Implications relating to autonomous reproductive decision-making are discussed.

Experiences of stigma, mental health, and coping strategies in Lebanon among Lebanese and displaced Syrian men who have sex with men: A qualitative study

BACKGROUND

In Lebanon, men who have sex with men (MSM) face high rates of stigma, discrimination, and violence. Minority stress, or the unique stressors related to anti-MSM stigma and discrimination, negatively impacts the mental health of MSM. These stressors are heightened for those with intersectional minority identities such as displaced Syrian MSM in Lebanon.

METHODS

In this qualitative study conducted in 2020-21, part of a larger study focused on the mental and sexual health risks among MSM, we collected qualitative data from Lebanese and displaced Syrian MSM living in Lebanon and analyzed reports of their experiences with stigma, mental health, and coping strategies. We conducted semi-structured, in-depth interviews with 12 displaced Syrian MSM and 13 Lebanese MSM.

RESULTS

Our findings highlight how MSM in Lebanon navigate stigma and the mental health risks that result. Common stressors among Lebanese and displaced Syrian MSM were related to finances, sexual orientation discrimination, and social isolation. Comparing the two groups, we found that stressors specific to displaced Syrian MSM were related to adverse childhood experiences, recent exposure to the Syrian war, displacement, and discrimination in Lebanon based on their intersectional identities as MSM and Syrians. For Lebanese participants, the most common stigma coping strategies were avoidance, drinking alcohol, using drugs, or having sex. As for displaced Syrian MSM, the most common stigma coping strategy was seeking the freely available mental health services offered to them through non-governmental organizations.

CONCLUSION

Our findings suggest that increased targeted mental health and social support interventions, informed by the unique experiences of Lebanese and displaced Syrian MSM, are highly needed to improve the coping and mental health resources of all MSM in Lebanon.

Sexual and Relationship Violence Among LGBTQ+ College Students: A Scoping Review

Although there has been increased attention to campus sexual and relationship violence (SRV) because of Title IX and the #MeToo movement, much of that attention has focused on victimization of cisgender heterosexual women. This scoping review uncovers information from empirical studies on what is known about LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, queer, and nonbinary) students' experiences of campus SRV. Using rigorous scoping review methods (i.e., searches of 15 databases, searches of expert websites, hand searching, reference harvesting, and forward citation chaining), we identified 60 documents published since 2000 that contained findings from empirical studies related to LGBTQ+ students and SRV on U.S. college and university campuses. Through content analysis, we summarized findings around five key themes: (1) extent and types of victimization, (2) negative outcomes, (3) knowledge of and attitudes about SRV, (4) perspectives on SRV services and prevention education programs, and (5) recommendations from study authors based on their findings. Implications for research, practice, and policy based on these findings are discussed.

Comparisons Between Young, Middle-Aged, and Older Adult Sexual and Gender Minority Male Sexual Assault Survivors

OBJECTIVE

This study compared sexual abuse histories and depressive symptoms between younger, middle-aged, and older sexual and gender minority (SGM) male survivors.

DESIGN

Participants completed a brief, online screener as part of a large comparative effectiveness psychotherapy trial.

SETTING

SGM males 18 years or older, residing in the U.S. or Canada, were recruited online.

PARTICIPANTS

This study included younger (aged 18-39; n = 1,435), middle-aged (aged 40-59; n = 546), and older (aged 60+; n = 40) SGM men who reported a history of sexual abuse/assault.

MEASUREMENTS

Participants were asked about their sexual abuse history, experience of other traumas, symptoms of depression, and past 60-day mental health treatment engagement.

RESULTS

Older SGM men reported a lower rate of occurrence of adult sexual assault, exposure to other traumas, and depression. However, older and younger groups did not differ on any childhood sexual assault variable, the frequency of or number of attackers for adult sexual assault, the frequency of accidents and other injury traumas, or the occurrence or frequency of mental health treatment. Trauma load, including childhood and adult sexual assault, were more strongly related to current depressive symptoms than age group.

CONCLUSION

While there were some age-based or cohort differences in the rates of sexual trauma, the clinical response of both groups was similar. Implications for working clinically with middle-aged and older SGM men with untreated sexual assault-related mental health difficulties are discussed, including outreach and availability of gender- and older-inclusive survivor treatment and resources.

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.

A Need for More Research: How to Understand Elevated Rates of Sexual Assault Among Bisexual College Women

Bisexual college women exhibit some of the highest rates of sexual assault among all college students. Existing research relies on sexual orientation-related stigma as an explanation for these disparities. In this study, we use data from the Online College Social Life Survey (OCSLS) to explore factors that elevate the risk of sexual assault for bisexual college women compared to heterosexual women. Results show that bisexual women exhibit higher rates of sexual assault since the beginning of college for all types of sexual assault, compared to heterosexual women. We find that perceived sexual disrespect, sexual interactions with men, alcohol use, earlier sexual debut, and multiple ongoing partnerships are associated with a higher risk of sexual assault for both bisexual and heterosexual women. Compared to heterosexual women, bisexual women exhibited higher odds of experiencing sexual assault across the majority of risk factors. We envision this study as a preliminary exploration that can inform ongoing work examining which bisexual women are at the highest risk for sexual assault. Implications for future research and intervention are discussed.

A Structural Analysis of Gender-Based Violence and Depression in the Lives of Sexual Minority Women and Trans People

This article explores structural mechanisms that are the context for violence and depression in the lives of sexual minority women and trans people in Ontario, Canada. The article draws on interviews with 14 people who reported experiences of depression in the previous year, foregrounding three representative narratives. Narrative and case study analysis reveal that violence is a repeated and cumulative experience over lifetimes, occurring across different interpersonal contexts and institutional encounters. A common theme across the narratives is that experiences of violence are connected to a broader context in which structural arrangements, cultural norms, and institutional processes create conditions where marginalized people are put in harm's way, perpetrators are empowered, and justice and access to help are elusive. As the violence experienced by these sexual minority women and trans people is rooted in structural and cultural oppression represented in poverty, racism, misogyny, homophobia, and transphobia, the prevention of violence and its consequences for these and other marginalized populations requires systemic transformation of the structures and systems that currently allow and perpetuate harm.

Risk factors for perpetrating sexual aggression among adolescents: Differences by gender and sexual orientation

Although anyone-regardless of gender or sexual orientation-can perpetrate sexual aggression, most studies examining risk factors for engaging in sexual aggression include samples of boys and men, and do not consider the sexual orientation of the respondent. The current study addresses this gap in the literature by examining how risk factors for sexual aggression vary as a function of gender and sexual orientation in a sample of 1782 high school youth. Participants completed surveys evaluating engagement in consent behaviors, rape myth acceptance, perception of peer rape myth acceptance, perceived peer engagement in violence, and perceived peer support for violence. A one-way MANOVA found that constructs varied as a function of gender and sexual orientation. Specifically, heterosexual boys reported lower engagement in consent behaviors, higher rape myth acceptance, and higher perceived peer support for violence compared to heterosexual girls and sexual minority girls. The results highlight the importance of considering gender and sexual orientation when designing sexual aggression prevention programs.

Network analysis of adverse childhood experiences and cardiovascular diseases

Significance

The findings to date indicate that adverse childhood experiences (ACEs) increase the risk of cardiovascular disease (CVD) in later life. We demonstrate how network analysis, a statistical method that estimates complex patterns of associations between variables, can be used to model ACEs and CVD. The main goal is to explore the differential impacts of ACE components on CVD outcomes, conditioned on other ACEs and important covariates using network analysis. We also sought to determine which ACEs are most synergistically correlated and subsequently cluster together to affect CVD risk.

Methods

Our analysis was based on cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System, which included 31,242 adults aged 55 or older (54.6% women, 79.8% whites, mean age of 68.7 ± 7.85 years). CVD outcomes included angina/coronary heart disease (CHD) and stroke prevalence. Mixed graphical models were estimated using the R-package mgm, including all variables simultaneously to elucidate their one-to-one inter-relationships. Next, we conducted Walktrap cluster detection on the estimated networks using the R-package igraph. All analyses were stratified by gender to examine group differences.

Results

In the network for men, the variable "household incarceration" was most strongly associated with stroke. For women, the strongest connection was between "physical abuse" and stroke, followed by "sexual abuse" and angina/CHD. For men, angina/CHD and stroke were clustered with several CVD risk factors, including depressive disorder, diabetes, obesity, physical activity, and smoking, and further clustered with components of household dysfunction (household substance abuse, household incarceration, and parental separation/divorce). No clusters emerged for women.

Conclusions

Specific ACEs associated with CVDs across gender may be focal points for targeted interventions. Additionally, findings from the clustering method (especially for men) may provide researchers with valuable information on potential mechanisms linking ACEs with cardiovascular health, in which household dysfunction plays a critical role.

Sexual Victimization Among Sexual and Gender Minoritized Groups: Recent Research and Future Directions

PURPOSE OF THE REVIEW

Sexual victimization is a significant public health concern. Compared to heterosexual and cisgender peers, sexual and gender minoritized (SGM) individuals are at elevated risk for sexual victimization. Prominent theories suggest that this risk is due in part to the stigma SGM individuals face when navigating heteronormative cultures. The goal of this article is to review the prevalence, risk factors, and consequences of sexual victimization in SGM individuals.

RECENT FINDINGS

Studies continue to show that SGM individuals-bisexual and/or gender minoritized in particular-are at higher risk for sexual victimization. Little work has focused on risk factors, though recent research continues to highlight post-victimization disparities among SGM individuals. Emerging studies also point to theoretically informed factors that may influence victimization risk and recovery, including sexual and gender-related stigma. To inform prevention and intervention efforts, future research would benefit from streamlining assessment, methodology, and dissemination practices.

Trajectories of Emerging Adults' Binge Drinking and Depressive Symptoms and Associations With Sexual Violence Victimization: Examining Differences by Sexual and Gender Minority Status

We examined longitudinal associations between binge drinking (BD), depressive symptoms, and sexual violence (sexual harassment and sexual assault) among sexual and gender minority (SGM) and non-SGM emerging adults. Data were drawn from four annual web-based surveys of a diverse cohort of 2,553 emerging adults, spanning from approximately age 19 (2016) to age 22 (2020). About 18% were SGM individuals. We tested a multigroup parallel process latent growth curve model (recent depression symptoms; past-year BD) with time-varying covariates (past-year sexual harassment; sexual assault) to determine associations of sexual violence with BD and depression outcomes over time, and whether growth curves and associations differed by SGM status. For both SGM and non-SGM emerging adults, past-year sexual harassment was associated with depressive symptoms at each time point, but harassment was not associated with BD. For both groups, sexual assault was associated with both depressive symptoms and BD. To our knowledge, this is the first study to examine longitudinal, contemporaneous associations of sexual violence (including both harassment and assault as distinct constructs), with BD and depressive symptoms among racially and ethnically diverse emerging adults, comparing SGM and non-SGM groups. Although our models do not disentangle directionality or causality, the findings suggest the need to address sexual violence victimization (assault and harassment) in the context of depression screening and treatment, and vice versa. We discuss a number of intervention strategies currently in use for an implicitly non-SGM general population that could be adapted for greater inclusion of and relevance to SGM populations.

Group Therapy for Survivors of Adult Sexual Assault: A Scoping Review

Across the world, women experience significant rates of sexual assault and there is a need to strengthen support services offered to survivors. Group therapy could provide an important addition to services that support healing and growth; however, the effectiveness of group therapy interventions with survivors of adult sexual assault is not well understood and clearer insights into designing and running group therapy interventions require further exploration. This review synthesizes literature exploring group therapy for survivors of adult sexual assault to inform future interventions and research implementing group therapy. A systematic approach was used to gather literature describing and evaluating group therapy interventions with survivors of adult sexual assault. Of the initial 466 articles identified through a comprehensive search strategy including database and hand searches, 32 met the inclusion criteria by describing a group therapy intervention conducted with survivors of adult sexual assault. A thematic approach to analysis was conducted to synthesize and collate the literature. Findings explore potentially useful strategies and characteristics of group therapy with survivors of adult sexual assault and make recommendations for the design and evaluation of future interventions. Group therapy has potential as a valuable support service provided to survivors but further rigorous research and evaluations are required to better capture outcomes and understand how to design and implement effective interventions.

A Comparison of Sexual Minority and Heterosexual College Students on Gendered Sexual Scripts and Sexual Coercion Perpetration

Prior work has identified endorsement of gendered sexual script beliefs as predictive of sexual coercion perpetration among heterosexual individuals, primarily men. This research is lacking among sexual minority individuals and may be important in informing inclusive and effective sexual coercion prevention efforts. The current study sought to (1) assess the level of adherence to gendered sexual script beliefs, (2) report relative rates of general sexual coercion and sexual intimate partner violence (IPV), and (3) examine the relationship between gendered sexual script beliefs and self-reported sexually coercive behavior among sexual minority and heterosexual college men and women. Undergraduate students (n = 1,199; 182 sexual minorities) completed self-report measures assessing gendered sexual script beliefs, sexual coercion perpetration, and sexual IPV. Results from Gender × Sexual Minority group ANOVAs and logistic regression analyses indicated similar rates of perpetration across sexual orientation groups, with men overall reporting the most perpetration. Furthermore, men and heterosexual individuals adhered more strongly to gendered sexual scripts than women and sexual minority individuals, respectively. Results of path models revealed no moderation by sexual orientation, and that adherence to gendered sexual scripts was positively related to sexual IPV perpetration among the full sample of heterosexual and nonheterosexual individuals, though this effect was small. Gendered sexual scripts did not significantly relate to general sexual coercion perpetration among the full sample, suggesting that traditional sexual script beliefs may not be as relevant to perpetration in a contemporary college sample. This study adds to limited literature on sexual coercion perpetration among sexual minority individuals and is an important step in understanding relationships between endorsement of gendered sexual script beliefs and sexual coercion perpetration among sexual minority and heterosexual college students.

Women Receive More Positive Reactions to Childhood Sexual Abuse Disclosure and Negative Reactions are Associated With Mental Health Symptoms in Adulthood for Men and Women

Although disclosure of sexual abuse has become more socially acceptable for both men and women in recent years, there is much yet to be understood about differences in the disclosure process and associated pathology between men and women. The current study aimed to (a) investigate differences in aspects of the childhood sexual abuse (CSA) disclosure process between adult men and women and (b) explore how timing of disclosure, perceived parental style, and negative social reactions to disclosure relate to various mental health symptoms. Using a cross-sectional, quasi-experimental design, adult men and women in the United States recruited through Amazon's Mechanical Turk (N = 299) completed self-report surveys. Women reported disclosing to a significantly greater number of people than men, and were more likely to disclose to parents, while men were more likely to tell friends. Results revealed that women reported receiving significantly more positive responses and emotionally supportive responses to their CSA disclosures than men. Negative reactions to disclosure were positively associated with internalizing symptoms and externalizing symptoms, while both negative reactions to disclosure and perceived parental dysfunction were positively associated with substance use symptoms. Results signify a need for resources to aid individuals in supporting survivors of CSA, as reactions have the potential to impact recovery trajectory and for clinicians to consider how disclosure experiences impact survivor cognitions and symptom exacerbation.

Predictors of sexual aggression among gay men and lesbian women: An application of Malamuth's confluence model

The present study investigated whether the core constructs of Malamuth's confluence model (i.e., hostility against individuals of the same sex and sexual orientation [HASSO], impersonal sexuality [IS], and high dominance/low nurturance [HDLN]) could predict sexual aggressive behavior (SA) of gay men against other gay men and of lesbian women against other lesbian women. For both gay men (N = 226) and lesbian women (N = 190) regression analysis showed that IS, HDLN, and especially HASSO proved to be important predictors for sexual aggression. The confluence of all three risk factors in terms of a three-way interaction added to the prediction of SA in lesbian women but not in gay men. Overall, the three predictors explained 30% of the variance in SA among men and 62% of the variance in SA among women.

LGBTQ+-Affirming Campus Sexual and Relationship Violence Prevention: A Qualitative Study

LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, nonbinary, queer) people are often left out of campus sexual and relationship violence (SRV) prevention efforts despite experiencing higher rates of SRV. To inform LGBTQ+-affirming prevention efforts, we use a practice-to-research approach to aggregate wisdom from 32 LGBTQ+ professionals working to address campus SRV among LGBTQ+ college students garnered through semi-structured interviews. Participants shared four approaches to including or excluding LGBTQ+ students in campus SRV prevention programs as well as recommendations to cultivate more LGBTQ+-affirming campus SRV prevention efforts. We summarize recommendations for possible action steps at individual, relationship, community, and policy levels of the social ecological model for LGBTQ+-affirming campus SRV prevention.

Analysis of aborted fetal material using autosomal STR markers in forensic cases of sexual assault

Sexual violence represents a widespread social problem associated with serious lifelong consequences. In many cases, an outcome of sexual violence is the victim's unwanted pregnancy, usually ended in an abortion. The objective of this paper is to report five rape cases, including rapes of a minor and young woman, two incest cases and a case of human trafficking for sexual exploitation, where every case resulted in the victim's pregnancy. In each case, pregnancy was terminated in the first trimester or at the beginning of the second trimester in the relevant medical center or clinic. Fresh fetal blood or aborted tissue samples were delivered to our laboratory in order to perform paternity testing for the purpose of proving the crime. DNA extraction using Qiagen Dneasy™ Tissue Kit was optimized according to the sample type. Amplification of autosomal STR (Short Tandem Repeat) markers was performed using the PowerPlex®16 System. In two cases, mixtures of maternal and fetal DNA in the aborted fetal material were found. Using the LRmix Studio v.2.1.5 Software for interpreting DNA mixtures based on a probabilistic model, the likelihoods of maternal contribution and presence of fetal allelic variants inherited from the alleged father/suspect were calculated. Based on these results, we confirmed the presence of assumed fetal fractions (determined before software analysis) in the mixtures. In all cases, positive paternity proved the crime (probabilities of paternity >99.9999%). This cases report once again pointed out the importance of DNA analysis in the process of clarifying and solving forensic cases and demonstrated that the LRmix Studio v.2.1.5 Software can deal with complex cases such as sexual assaults.

Does Gender Inclusive Language Affect Psychometric Properties of the Illinois Rape Myth Acceptance Scale-Short Form? A Two-Sample Validation Study

The Illinois-Rape Myth Acceptance-Short Form (IRMA-SF) is a widely used scale measuring people's endorsement of rape myths. However, it uses heavily gendered wording and makes gender-based assumptions that may affect its generalizability to various subgroups of people, including sexual and gender minorities who may view gender constructs outside of the heteronormative gender binary. This study validates the psychometric properties of a modified form of the IRMA-SF that is gender inclusive. Participants were adults with a range of sexual orientations and gender identities. Two sets of data were merged and then the sample was randomly split with a 20/80 weight. Data in the 20% split were used for exploratory factor analyses. Data in the 80% split were used for confirmatory factor analyses. According to the exploratory factor analysis, we found a theoretically predicted one-factor model was best (41% variance explained). Further, we found acceptable absolute model fit according to the confirmatory factor analysis (RMSEA = .07, p < .001; SRMR = .06) but unsatisfactory incremental fit (CFI = .82). These model issues were likely due to a floor-effect of low item variability which may call into question the utility of this scale in determining differences in rape myth acceptance overall. Overwhelmingly, participants in this study rejected rape myths. Researchers should explore the use of gender inclusive wording with an updated rape myth scale for use with sexual and gender minorities and, perhaps the general population, as some of these statements may be lacking in cultural relevance.

Society of Family Planning Clinical Recommendation: Emergency contraception

Emergency contraception (EC) refers to several contraceptive options that can be used within a few days after unprotected or under protected intercourse or sexual assault to reduce the risk of pregnancy. Current EC options available in the United States include the copper intrauterine device (IUD), levonorgestrel (LNG) 52 mg IUD, oral LNG (such as Plan B One-Step, My Way, Take Action), and oral ulipristal acetate (UPA) (ella). These clinical recommendations review the indications, effectiveness, safety, and side effects of emergency contraceptive methods; considerations for the use of EC by specific patient populations and in specific clinical circumstances and current barriers to emergency contraceptive access. Further research is needed to evaluate the effectiveness of LNG IUDs for emergency contraceptive use; address the effects of repeated use of UPA at different times in the same menstrual cycle; assess the impact on ovulation of initiating or reinitiating different regimens of regular hormonal contraception following UPA use; and elucidate effective emergency contraceptive pill options by body mass indices or weight.

Validation of the Alcohol-Related Sexual Consequences Scale in Swedish University Students

BACKGROUND

Alcohol-related sexual consequences are common in college students. A newly developed 41-item Alcohol-Related Sexual Consequences Scale has recently been evaluated in at-risk young adults in the U.S. The current study aims to validate the Scale in Swedish college students.

METHODS

The occurrence of alcohol-related sexual consequences was assessed by birth gender, relationship status, gender identity/sexual orientation, and age. Negative binomial regression was used to assess convergent and divergent validity.

RESULTS

On average, 5.4 (SD 5.1) alcohol-related sexual consequences were experienced past three months. Greater scores were reported in singles, LGBTQ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning), and younger students. All sex-related covariates showed robust associations with alcohol-related sexual consequences while most alcohol-related covariates were not associated (e.g., convergent validity). All alcohol-related covariates showed robust associations with alcohol consequences while most sex-related covariates were not associated (e.g., divergent validity). In the full model predicting alcohol-related sexual consequences, being a woman, single, and younger were identified as independent predictors.

CONCLUSIONS

This newly developed scale assessing alcohol-related sexual consequences could be used in both epidemiological studies and intervention studies targeting at-risk students.

Enhancing Inclusivity for LGBTQIA+ Student Survivors of Color Commentary: Creating a University Strategic Plan to Address Relationship Violence and Sexual Misconduct (RVSM): An Application of Principles-Focused Evaluation at Michigan State University

Campbell and colleagues propose a robust and rigorous strategic model to address and reduce Relationship Violence and Sexual Misconduct (RVSM) at Michigan State University, which significantly advances the field of RVSM prevention and education, particularly for survivors belonging to marginalized populations. While prior efforts have addressed RVSM on college and university campuses, Campbell and colleagues' model is groundbreaking in its ability to reduce RVSM against lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual/agender (LGBTQIA+) students of color, by its principles of intersectional and trauma-informed action. This commentary highlights the contributions of Campbell et al.'s model and provides recommendations for enhancing programming and postassault services by addressing the totality of LGBTQIA+ survivors of color's identities.

Prevalence and Formal Reporting of Sexual Violence among Undergraduate Student-Athletes: A Multi-State Study

Sexual violence (SV) is a serious problem on college campuses, and student-athletes are one group of college students at risk for experiencing SV. The administrative context and close-knit bonds of college teams introduce opportunities and structures for responding to SV and delivering uniquely tailored prevention programming, but there is limited research about formal reporting of SV among student-athletes. The current study examines the prevalence of SV and SV reporting history and perceptions among a multi-state sample of undergraduate student-athletes. Student-athletes at 10 National Collegiate Athletic Association (NCAA) Division I institutions across the US participated in an online survey about their experiences of SV victimization, formal reporting of SV, knowledge of resources, and perceptions of responses to SV at their institutions. Among 1004 student-athletes who completed the survey, 29% experienced some type of SV since enrolling at their university, with higher prevalence of SV among student-athletes on women's teams (36%) compared to men's teams (13%). About one fifth of student-athletes felt very or extremely knowledgeable about where to make a report of SV, and only about 10% felt very or extremely knowledgeable about what happens when a student reports SV. Only 9% of participants who experienced SV filed a formal report at their institution. Perceptions about whether campus officials would take the report seriously or would conduct a fair investigation were most positive for students who experienced and formally reported SV. Further research with student-athletes about their decision to formally report and barriers to reporting is needed to build a more comprehensive understanding of the unique experiences of SV among student-athletes. Our results highlight the importance of including and targeting student-athletes in campus SV prevention efforts to build knowledge and trust in hopes of ultimately decreasing the prevalence and adverse consequences of SV.

Does Alcohol Consumption Influence People's Perceptions of Their Own and a Drinking Partner's Ability to Consent to Sexual Behavior in a Non-sexualized Drinking Context?

The purpose of this study was to examine the extent that alcohol consumption affected participants' perceptions of their own and their friend's ability to consent to sex in a non-bar drinking environment. We interviewed 176 people at tailgates in dyads about their own and their friends' alcohol consumption, intoxication symptoms, and ability to consent. Participants reported consuming a mean of 4.6 drinks and had a breath alcohol concentration (BrAC) of .075 on average, but few thought they or their friend had diminished cognitive function. Accordingly, 92.6% indicated they could consent to sex and 81.8% indicated their friend could consent to sex. Number of drinks people reported consuming, self-reported intoxication levels and symptoms, and BrACs were not significantly related to participants' perceptions of their own or their friends' ability to consent to sex. However, gender pairing of the dyad was significant; those in man-man pairs were more likely than those in woman-woman pairs to indicate their friend could consent and they would allow their friend to have sex if approached by an interested party. Participants also indicated that they did not perceive themselves or their friends to be "too intoxicated" as common reasons why they believed they and their friend could consent. Because alcohol-facilitated sexual assault is common among college students, we recommend sexual assault prevention educators focus on raising awareness regarding alcohol's negative cognitive effects, particularly related to consent communication.

Hate crimes against LGBT people: National Crime Victimization Survey, 2017-2019

We estimate the prevalence and characteristics of violent hate crime victimization of lesbian, gay, bisexual, and transgender (LGBT) people in the United States, and we compare them to non-LGBT hate crime victims and to LGBT victims of violent non-hate crime. We analyze pooled 2017-2019 data from the National Crime Victimization Survey (n persons = 553, 925;n incidents = 32, 470), the first nationally representative and comprehensive survey on crime that allows identification of LGBT persons aged 16 or older. Descriptive and bivariate analysis show that LGBT people experienced 6.6 violent hate crime victimizations per 1,000 persons compared with non-LGBT people's 0.6 per 1,000 persons (odds ratio = 8.30, 95% confidence interval = 1.94, 14.65). LGBT people were more likely to be hate crime victims of sexual orientation or gender bias crime and less likely to be victims of race or ethnicity bias crimes compared to non-LGBT hate crime victims. Compared to non-LGBT victims, LGBT victims of hate crime were more likely to be younger, have a relationship with their assailant, and have an assailant who is white. Compared to LGBT victims of non-hate violence, more LGBT hate crime victims reported experiencing problems in their social lives, negative emotional responses, and physical symptoms of distress. Our findings affirm claims that hate crimes have adverse physical and psychological effects on victims and highlight the need to ensure that LGBT persons who experience hate crime get necessary support and services in the aftermath of the crime.

Sexual Violence and Nonconsensual Experiences Among Alt-Sex Communities' Members

BACKGROUND

As behaviors, alternative sexual (alt-sex) (i.e., kink, bondage, discipline, dominance, submission, sadism, and masochism , consensual non-monogamy, swinging, leather, and fetish practices) practitioners often emphasize that consent and boundaries are key elements of alt-sex activities. Despite these emphases, individuals experience consent violations and sexual assault both prior to engaging and during their involvement in alt-sex activities.

PURPOSE

This study examines alt-sex practitioners' sexual assault and nonconsensual experiences in order to highlight potential means of intervention and prevention, as well as inform clinical and legal professionals.

METHODS

In collaboration with the National Coalition for Sexual Freedom, this study uses an international survey of adults in alt-sex communities (N = 2996) to examine sexual assault and nonconsensual experiences both within and outside of alt-sex contexts.

RESULTS

We found a lower rate of consent violations in the alt-sex community (26%) compared to sexual assault as an adult outside of alt-sex contexts (34%) and sexual assault as a minor (40%). We found significant differences by groups in sexual assault as a minor (gender, sexual orientation, age, and live in the US or not), sexual assault outside of alt-sex contexts (gender, sexual orientation, and age), nonconsensual experiences in alt-sex contexts (gender, sexual orientation, age, and race), receiving nonconsensual touch in alt-sex contexts (gender, sexual orientation, and age), giving nonconsensual touch in alt-sex contexts (sexual orientation, age, living in the US or not, and race), and being falsely accused of nonconsensual touching in alt-sex contexts (gender, age, and living in the US or not). Within the most recent consent violation, the most common behaviors were non-kink related, except for lack of aftercare. Nearly 40% of participants reported the reasons for their most recent consent violation in alt-sex contexts were being selfish or caught up in the moment.

IMPLICATIONS

Focused interventions are needed to address how different populations are experiencing assault and violations in alt-sex contexts.

Sexual and gender minority health in the Middle East and North Africa Region: A scoping review

Background

Researchers in studies from multiple countries suggest that sexual and gender minority people experience high rates of violence, stigma, and discrimination, as well as mistrust of health care providers and systems. Despite growing evidence related to sexual and gender minority health in North America and Europe, we know little about the health of this population in the Middle East and North Africa.

Objectives

We aimed to comprehensively examine the literature related to the health of sexual and gender minority people in the Middle East and North Africa and to identify research gaps and priorities.

Design

We conducted a scoping review informed by the framework recommended by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) tool.

Data sources

We searched the following databases: PubMed (using Medline All on the Ovid platform), PsycINFO (Ovid), CINAHL (Ebsco), and Embase (Ovid). The search strategy combined terms for the geographic region of interest (Middle East and North Africa) and the population of interest (sexual and gender minority). Each was operationalized using multiple search terms and, where available, controlled vocabulary terms.

Review Methods

Research articles were identified and assessed for inclusion using an explicit strategy. Relevant information was extracted and synthesized to present a descriptive summary of existing evidence.

Results

Research designs of the 98 articles we reviewed included quantitative (n = 73), qualitative (n = 20), and mixed methods (n = 5). Most studies were conducted in Lebanon (n = 33), Pakistan (n = 32), and Iran (n = 23) and focused mainly on gender minority individuals (n = 46) and men who have sex with men (n = 32). Five themes emerged from the review: sexual health (52; 53%); mental health (20; 20%); gender identity (17; 17%); violence and discrimination (7; 7%); and experiences with the healthcare system (2; 2%). Although researchers focused on multiple health outcomes in some studies, we included them under the theme most closely aligned with the main objective of the study.

Conclusion

Although our study is limited to few countries in the Middle East and North Africa region, we found that sexual and gender minority individuals face multiple adverse sexual and mental health outcomes and experience high rates of stigma, discrimination, and violence. More research is needed from countries outside of Lebanon, Pakistan, and Iran, including community-based participatory approaches and multi-level intervention development. Nurses and other healthcare providers in the region need training in providing inclusive care for this population.

Comparing Rates of Sexual Assault Between Panel Quota and Social Media Samples: Findings Across Sexual Orientation Categories

Sexual assault is prevalent and may be even more prevalent among sexual minorities. However, prevalence rates vary, in part, due to discrepancies in sampling methods. Given this, we assessed whether two popular non-probability sampling types (panel quota vs. social media recruitment) produced different sexual assault prevalence rates when holding all other methodological choices (definitions, measures, scoring) constant in a sample of lesbian, bisexual, queer, and heterosexual adults, excluding cisgender men. Two phases of data collection occurred-a panel quota sample (n = 1366), recruited from an online sample aggregator, and social media sample (n = 1102), recruited through lesbian, gay, bisexual, transgender, and queer (LGBTQ) social media sites. Participants were asked about sexual assault and rape experiences in both childhood and adulthood using a modified form of the Sexual Experiences Scale-Short Form Victimization. Both phases used the same definitions of sexual assault, prevalence measures, and prevalence scoring. Overall, the sample recruited via LGBTQ social media yielded statistically higher sexual assault prevalence rates for all four types of victimization experiences measured: lifetime sexual assault (LSA), rape-specific LSA, childhood sexual assault (CSA), and adulthood sexual assault. However, when parsing out subgroups, this finding only held for heterosexual participants who had rates > 30% higher in the social media sample compared with the panel quota sample. These findings suggest that researchers studying sexual assault in lesbian, bisexual, or queer adults may be able to use social media sampling techniques, which require less resources, without concern that the sampling technique is inflating prevalence when compared to panels.

The Prevalence of Sexual Violence Perpetration in Sexual Minority Men: A Secondary Analysis of Systematic Review Data

Prior literature illustrates that sexual minority people (e.g., bisexual, gay, queer) are at increased vulnerability for sexual violence victimization compared to heterosexual peers, including while in college. However, the study of sexual violence perpetration in sexual minority populations, much less specifically sexual minority college men, has been neglected. This article reviews the literature and presents a secondary data analysis of a systematic review on college men's sexual perpetration rates and associated methodology. We also conducted analyses to summarize available literature regarding publishing dates, authors, and data inclusivity.

METHODS

We downloaded the dataset and associated materials from Mendeley.com's data archive.

RESULTS

To our surprise, we could not analyze sexual perpetration prevalence rates in sexual minority men using the systematic review data due to absence of reported data across all 77 independent samples including over 5,500 male participants. We found no significant relationship between inclusion of sexual minority men and the use of measurement strategies specialized to assess sexual minority needs. We did find a positive relationship between recency of publication and the inclusion of sexual minority men, r(76) = .24, p = .03, and that most authors/co-authors were women (72%).

CONCLUSIONS

Preventing perpetration is central to ending sexual violence; therefore, future research should include sexual minority people and use appropriate methodology in the investigation of sexual perpetration characteristics and patterns.