Silenced suffering: the need for a better understanding of partner sexual violence

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

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

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

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

"Counteract the gaslighting" - a thematic analysis of open-ended responses about what women survivors of intimate partner sexual violence need from service providers

BACKGROUND

Intimate partner sexual violence (IPSV) is a prevalent but misunderstood form of gender-based violence with significant impacts women's health and well-being. Research suggests that IPSV has a specific context and unique impacts, but little is known about how to tailor service responses. To address this gap, we explored help-seeking experiences and needs among IPSV survivors after disclosure.

METHODS

This study draws on qualitative data from a subsample of women who participated in a cross-sectional survey about the service needs of intimate partner violence survivors. Women who reported IPSV and provided information about IPSV-specific help-seeking needs after disclosure were included in the analysis. Open-ended text responses of 37 IPSV survivors were analysed using thematic analysis.

RESULTS

IPSV was invisible and silenced in service responses. Three themes suggest potential ways forward. In the first theme, 'Don't dismiss it', women needed providers to take their disclosures seriously and listen to the significant impacts of IPSV on their well-being and safety. In the second theme, 'See the bigger picture', women needed service providers to understand that IPSV fits into broader patterns of abuse, and that psychological abuse and coercive control impacts women's ability to consent. In the third theme, 'counteract the gaslighting', women needed providers to educate them about the continuum of IPSV and help them label IPSV as a form of violence.

CONCLUSIONS

Our exploratory findings extend the limited evidence base on IPSV and highlight a need for further in-depth research to explore a tailored approach to supporting IPSV survivors. To avoid contributing to the silencing of IPSV survivors, service responses should recognise the harmful and sexualised nature of IPSV, challenge cultural stereotypes that minimise IPSV, and understand that co-occurring psychological abuse may exacerbate shame and prevent women from articulating the source of their distress.

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

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

My Parents, My Grandparents Went Through Residential School, and All this Abuse has Come From it: Examining Intimate Partner Violence Against Canadian Indigenous Women in the Context of Colonialism

While the global rates of intimate partner violence (IPV) for Indigenous women have been acknowledged as substantial, few studies have incorporated an analysis of the impacts of colonization in the context of IPV. This secondary mixed-methods analysis explored the experiences of 40 Indigenous women from the Canadian prairie provinces who were abused by their intimate partners. The women discussed the impact of colonization, including the use of residential schools, to break down family life, spiritual beliefs, and languages, at times linking this to IPV. Of the 40 women, 38 described male partners as the abusers and two identified female abusive partners. Consistent with the literature, many of the male partners physically assaulted the respondents so severely that the women were injured and were at risk of death. Almost half of the men (47.4%) used sexually coercive strategies and/or sexually assaulted the women. Implications include the importance of professionals considering the broader historical experiences and possible trauma of Indigenous women who seek assistance for IPV from abusive partners.

"Your Skin Crawled Every Time He Touched You": A Secondary Qualitative Analysis Exploring Bagwell-Gray's Taxonomy of Intimate Partner Sexual Violence

Bagwell-Gray et al. developed a taxonomy of intimate partner sexual violence (IPSV) focusing on type of force (physical or nonphysical) and type of sexual activity (penetration or no penetration). The current secondary descriptive qualitative analysis of interviews with 89 Canadian women IPV victims assessed IPSV that fit Bagwell-Gray's taxonomy. About half (46 or 51.7%) described sexual violence, most commonly sexual abuse (26 or 29.2%), sexual assaults (17 or 19%), and sexual coercion (16 or 17.9%), with overlap across categories. Forced sexual activity was seldom mentioned (3 or 3.4%). Implications for service providers and researchers are provided.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

In Their Own Words: Sexual Assault Resistance Strategies Among Kenyan Adolescent Girls Following Participation in an Empowerment Self-Defense Program

The purpose of this study was to examine, via testimonial data, resistance strategies used to thwart a sexual assault among slum-dwelling Kenyan adolescent girls (N  =  678) following their participation in an empowerment self-defense program (IMpower). The majority (58.2%) of perpetrators were strangers; there were no differences in resistance strategies used between strangers versus known perpetrators (83.8% used verbal strategies, 33.2% used resistance strategies, 16.7% ran away, and 7.9% used distraction). Associations between resistance strategies and perpetrator tactics, number of assailants, location of the assault, and the presence of a bystander were also examined.

"He'd Tell Me I was Frigid and Ugly and Force me to Have Sex with Him Anyway": Women's Experiences of Co-Occurring Sexual Violence and Psychological Abuse in Heterosexual Relationships

Intimate partner sexual violence (IPSV) is a common yet hidden form of violence. It is primarily perpetrated against women by their male partners and is associated with a range of serious mental and physical health outcomes. Despite these harms, it is chronically under-researched. In particular, the overlaps between IPSV and psychological abuse in relationships are poorly understood. Extant literature has focused primarily on the relationship between IPSV and physical violence, neglecting the fact that IPSV often involves verbal or emotional coercion, threats or blackmail rather than the use of 'force'. In this paper, we draw on reflexive thematic analysis of qualitative interviews with n = 38 victim/survivors of IPSV to explore how they understood the relationship between sexual and psychological abuse in their heterosexual relationships. Four themes were developed from this analysis: 1. I felt like I couldn't say Nno'; 2. I felt degraded and worthless; 3. Letting me know who's boss; and 4. Making me feel crazy. These themes broadly correspond to four distinct patterns or interactions between IPSV and psychological abuse. Our findings strongly suggest that the relationship between sexual and psychological abuse in relationships is far more complex than previous research would indicate. Psychological abuse is not simply a tool to obtain sex and sexual violence is not only used as a mechanism of psychological control. Instead, the two forms of abuse interact in ways that can be unidirectional, bi-directional or simultaneous to develop and maintain an environment of fear and control and erode women's self-worth.

Work Harassment and Resource Loss Among (Ex)partner Stalking Victims

Prior research suggests that economic abuse and work sabotage are common tactics for abusers and (ex)partner stalkers. This study examines the context and timing (i.e., during the relationship or during separation) of work harassment among women stalked by abusive (ex)partners among victims who did (n=271) and who did not (n=302) experience work losses (significant problems at work or loss of work due to the abuse/stalking) and whether work losses and non-work related resource losses were associated with current mental health symptoms. Results showed that almost half of the women in the study reported they experienced work losses because of their abusive (ex)partner. Women with work losses experienced more work harassment particularly during periods of separation. Women who experienced work losses also experienced more work harassment, separation attempts, economic control, coercive control, physical and sexual abuse, higher fear levels, and a higher number of non-work related resource losses compared to women who did not report experiencing work losses. Women with work losses experienced more symptoms of current depression, anxiety, and Post-Traumatic Stress Disorder. Further, in the multivariate analysis, non-work related resource losses were significantly and uniquely associated with current mental health symptoms. In conclusion, women being stalked by abusive (ex)partners are at significant risk of resource losses, and those losses have long term impacts on mental health suggesting that safety planning for stalking victims should include plans to protect resources as well as physical safety.

Nonconsensual Distribution of Sexually Explicit Images Within a Context of Coercive Control: Frequency, Characteristics, and Associations with Other Forms of Victimization

The present study examined the frequency and characteristics of nonconsensual distribution of sexually explicit images (NCD) among undergraduates (n = 496) and its co-occurrence with other forms of interpersonal violence (e.g., physical, sexual, and psychological abuse). Overall, 17.34% of participants reported NCD victimization; most were women (90.70%). Women who reported NCD from current/former partners (71.79%), compared to non-romantic acquaintances, reported more additional interpersonal violence from the same perpetrator and marginally higher threats of NCD, but were no more likely to receive NCD demands. NCD appears to occur within a pattern of elevated violence; prevention and intervention efforts are needed.

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

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

The prevalence of sexual violence against female children: A systematic review and meta-analysis

BACKGROUND

Sexual violence against female children is considered an important public health problem. However, there are currently no clear prevalence rates across the globe on which to base measures to protect these children. The objective of this study is to systematically summarize the prevalence of sexual violence against female children.

METHODS

We conducted a comprehensive search of the PubMed, Embase and Web of Science databases from their inception through April 2021 for pertinent studies reporting the prevalence of sexual violence against female children. The prevalence rate was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I² statistic. Differences by study-level characteristics were estimated through subgroup analysis and meta-regression.

RESULTS

A total of 28 cross-sectional studies were included (a total of 30,524 participants). The pooled sexual violence rate against female children was 0.24 (95 % CI = 0.20-0.27). Groups comparisons revealed that sexual violence rates obtained from 1981 to 2000 (0.28, 95 % CI = 0.21-0.36) were higher than those obtained from 2001 to 2020 (0.21, 95 % CI = 0.16-0.25), that rates were higher for female children from developed countries (0.25, 95 % CI = 0.20-0.29) than for those from developing countries (0.21, 95 % CI = 0.14-0.27), the rates for surveyed adults (0.22, 95 % CI = 0.17-0.28) than for surveyed female children (0.18, 95 % CI = 0.10-0.26), and that rates for those ≤15 years of age (0.10, 95 % CI = 0.01-0.20) were much lower than those for older children.

CONCLUSIONS

Nearly a quarter (24 %) of female children have been victims of sexual violence. Prevention strategies should be developed urgently to protect female children from aggression.

The Role of Perpetrator Tactics on Physical and Mental Health Outcomes Associated With Intimate Partner Sexual Violence: A Sex-Specific Analysis

Intimate partner sexual violence (IPSV) is a concerning, yet understudied form of intimate partner violence. Using data from the National Intimate Partner and Sexual Violence Survey (NISVS), the current study builds on prior research to explore variation in tactics used to facilitate IPSV and their relationship with physical and mental health outcomes. Further, this study examines sex differences in both tactics and their associated health outcomes. Results show that all forms of IPSV are related to adverse health outcomes, with physical force being associated with the greatest number physical and mental health consequences. Women are more likely to report a greater number of negative physical health outcomes and posttraumatic stress disorder symptoms, while male IPSV victims are more likely to report overall worse mental health.

Unfounding the Ideal Victim: Does Christie's Ideal Victim Explain Police Response to Intimate Partner Sexual Assault?

Nils Christie's (1986) ideal victim is said to receive "complete and legitimate status as a victim." Many victims of intimate partner sexual assault (IPSA), are not given this status, resulting in their cases being unfounded. The current study evaluates 16 years of reported IPSA cases (n = 1,558) in a large municipal police department in the midwestern United States. Through multivariate logistic regression this study evaluates which factors lead a reported IPSA case to be unfounded. Further, it examines how the IPSA victim fits into the concept of the ideal victim. The results indicate that several variables representing the ideal victim criteria are influence in unfounding IPSA cases; however, many are the opposite of what might be expected based on Christie's work. Results further indicate that race (victim race, detective race, racial composition of district) has a substantial impact on IPSA cases being unfounded.

Toward an Ecological Understanding of Intimate Partner Sexual Violence

Intimate partner sexual violence (IPSV) is a common yet hidden form of violence against women. It encompasses a range of behaviors, including rape and sexual assault, and also more subtle behaviors such as the use of coercion and blackmail to obtain sex. It is typically described as an aspect of intimate partner violence, yet, although it often co-occurs with physical or psychological abuse, the contextual factors and nuances of sexual violence perpetrated by an intimate partner are likely to be very different. IPSV also differs greatly from sexual assault perpetrated by a stranger or other known person. Despite this, ecological theories and models developed to help understand and prevent violence against women have neglected or excluded IPSV. This is problematic given the serious mental and physical health problems consistently associated with it. In response, this article aims to explore the ecological factors that may be associated with IPSV at the individual, relationship, community, and societal levels. It draws on both inductive and deductive thematic analysis of N = 38 in-depth, unstructured interviews with women victim/survivors. Individual-level factors included sexual inexperience and past trauma (for victims), and fragile masculinity and a sense of entitlement to sex (for perpetrators). Relationship-level factors included a large age gap in the relationship and co-occurring psychological abuse. Community-level factors were identified as failure to talk about sex, isolation, and lack of support, while societal-level factors included the idea that sex is a woman's duty in a relationship, and that "real rape" is perpetrated by strangers. These factors are incorporated into a proposed ecological model that is unique to IPSV, furthering our understanding of this complex problem and its areas of overlap and difference with intimate partner violence and sexual violence. With refinement and testing through large-scale quantitative studies, this model may be critical in guiding future prevention efforts.

"When You're in a Relationship, You Say No, but Your Partner Insists": Sexual Dating Violence and Ambiguity Among Girls and Young Women

Sexual dating violence (DV) is highly prevalent and associated with deleterious outcomes. Unfortunately, this form of violence remains poorly understood. Furthermore, the measures used to assess sexual DV may not account for the various manifestations of sexual DV, which limits our understanding of this problem. This study aimed to (a) explore how girls and young women describe their experiences of sexual DV and (b) explore whether the taxonomy on intimate partner sexual violence developed by Bagwell-Gray and colleagues could be applicable to girls and young women's experiences of sexual DV. A total of 71 adolescent girls and young women who identified themselves as heterosexual were recruited. Sexual DV was assessed using an adapted version of the Sexual Experiences Survey, followed by a semistructured interview. Findings revealed that 29.6% of participants reported sexual DV victimization in the past 12 months. A direct content analysis was performed based on the taxonomy of Bagwell-Gray and colleagues. Four manifestations of sexual DV were illustrated from the youth's narratives: (a) sexual coercion, (b) sexual assault, (c) sexual abuse, and (d) forced sexual activities. Our results underscore the ambiguity of sexual consent and definition of sexual DV among adolescent girls and young women. This research further supports the necessity to develop and implement prevention programs that specifically target sexual DV in this population.

#MeToo on the Canadian Prairies: Raising Awareness of Sexual Assaults and Mental Health in Women Abused by Intimate Partners

Studies of intimate partner sexual assault (IPSA) and its effects on mental health are limited. This secondary data analysis examines IPSA, a history of child sexual abuse, depression, trauma, mental distress and quality of life in 665 Canadian women, 41% of whom had been sexually assaulted by intimate partners; 53% were sexually abused as children. Women who had experienced any IPSA had significantly higher scores on all Composite Abuse subscales (IPV), mental distress (SCL-10), and depression (CES-D-10). PTSD (PCL) was higher for women with both IPSA and CSA histories. Implications for advocates, clinicians, and researchers are presented.

Intimate Partner Sexual Violence Among Canadian University Students: Incidence, Context, and Perpetrators' Perceptions

Men's sexual violence against women is pervasive and is commonly committed against young women by intimate partners. Limited research has examined occurrence rates of intimate partner sexual violence among university students separated by various tactics and sexual acts. Using surveys with convenience samples of 142 Canadian university women and 441 Canadian university men, we examined women's self-reported intimate partner sexual violence victimization and men's self-reported perpetration rates in their most recent heterosexual intimate relationship in the past year. We examined a detailed breakdown across different tactics (i.e., verbal coercion, intoxication, and threats of harm/physical force) and sexual acts (i.e., nonpenetrative sexual contact; oral, vaginal, and anal penetration). Thirty-three percent of women reported at least one victimization experience, and 16% of men reported at least one perpetration experience. The most common tactic reported was verbal coercion for both women's victimization and men's perpetration, and the most common sexual act reported was vaginal penetration for women's victimization and oral sex for men's perpetration. We also examined contextual features and perceptions of the effects of perpetrators' most memorable incidents. These most memorable incidents often occurred either in their own or their partner's home and involved alcohol consumption. Most men reported no significant effects of their sexual violence on their relationships and sometimes normalized their behavior. We briefly discuss the implications of our results for future research and interventions.

Predictors of Sexual Violence Across Young Women's Relationship Histories

The goal of the current study was to identify risk factors that predict sexual intimate partner violence (IPV) victimization across young women's relationship histories, within a socioeconomically diverse sample recruited from a university, a 2-year college, and community organizations serving low-income young women. We interviewed 148 young women aged 18 to 24 years about partner victimization (physical IPV, coercive control, and sexual IPV) within each of their relationships (up to four relationships, beginning with their first; 388 in total). We used the life history calendar to structure the interviews and obtain detailed information about each relationship, including age difference between participants and their partners, and relationship length. We used multilevel modeling to examine primary caregiver highest grade completed (an indicator of socioeconomic status [SES]), participant age, age difference, relationship length, setting, and physical IPV/coercive control as predictors of sexual IPV during their first relationship and across Relationships 1 to 4. Sexual IPV during participants' first relationship was inversely associated with SES and age, and positively associated with physical IPV/coercive control; 2-year college and community participants reported lower rates of sexual IPV during the first relationship, compared with university participants. The trajectory of sexual IPV across Relationships 1 to 4 declined among university participants and increased among 2-year college participants; age difference and physical IPV/coercive control positively covaried with sexual IPV across Relationships 1 to 4. Low SES, young age, large age difference, and the presence of physical IPV and coercive control may be risk factors for sexual IPV victimization within adolescent relationships. Sexual violence prevention and intervention approaches should incorporate these risk factors, and be designed to reach an increasingly socioeconomically diverse population across a variety of settings, to be effective.

Bystander Prevention for Sexual Violence: #HowIWillChange and Gaps in Twitter Discourse

Twitter has rapidly gained popularity as a space for the public to discuss sexual violence (SV) prevention due to a number of high-profile SV cases. This study aimed to examine Twitter discourse on SV prevention through the hashtag #HowIWillChange, which encouraged Twitter users to come forward and report plans to engage in bystander prevention. We analyzed 1,493 #HowIWillChange tweets from October 2017 through a directed content analysis approach rooted in an evidence-based framework for the continuum of bystander intervention. We assessed emergent themes around how Twitter users discuss SV to identify gaps and misinformation in public Twitter discourse. Although Twitter users discussed a range of prevention strategies, misinformation was also spread, including perpetuation of the myth that only strangers commit rape, that only male children need lessons on consent, and that SV prevention vilifies men. These results can inform health promotion programs aiming to educate the public on bystander prevention.

The Lived Experience of Older Women Who Are Sexually Abused in the Context of Lifelong IPV

The present study explores the lived experience of older women who are sexually abused in the context of lifelong intimate partner violence (IPV). An interpretive phenomenological analysis was used, and semi-structured interviews were performed with 19 older women survivors of lifelong IPV and sexual violence. Three themes emerged: sexual violence shaping lifelong IPV, the occurrence of sexual violence in old age in the context of lifelong IPV, and cumulative insights and reflections on being a survivor of lifelong IPV and sexual violence. The transition to aging has a profound impact on the violent relationship dynamics and this should be considered in practical interventions.

Characterizing Sexual Violence in Intimate Relationships: An Examination of Blame Attributions and Rape Acknowledgment

Rape by an intimate partner frequently involves a precedence of sexual consent between victim and perpetrator, often does not include the use of physical force, and may not fit societal definitions of rape. Given these unique characteristics, women who are assaulted by an intimate partner may be less likely to acknowledge the experience as a rape. In turn, they might make fewer blame attributions toward themselves and their perpetrators than victims of rape by a nonpartner. Consistent with these expectations, results from 208 community women reporting rape in adulthood revealed the presence of indirect effects of perpetrator type (nonpartner vs. intimate partner) on both behavioral self-blame and perpetrator blame through rape acknowledgment, even when controlling for both victim substance use at the time of the assault and coercion severity. Compared with women who experienced a rape by a nonpartner, women who experienced rape in the context of a marital or dating relationship were less likely to blame themselves or the perpetrator for the assault, in part because they were less likely to label their experience as a rape. Overall, these findings highlight the unique nature of intimate partner rape and provide further information about the relatively underresearched area of sexual violence in intimate relationships.

Exploring the gray areas between "stealthing" and reproductive coercion and abuse

The aim of this qualitative study was to understand and differentiate between women's experiences of "stealthing" (non-consensual condom removal) and reproductive coercion and abuse (RCA) which is defined as any deliberate attempt to control a woman's reproductive choices or interfere with her reproductive autonomy. These two experiences are often conflated within the literature, yet little is known about whether this understanding reflects women's lived reality. We recruited female participants from a large Australian metropolitan hospital who self-identified as having experienced a partner interfering with contraception or trying to force them to get pregnant or end a pregnancy against their wishes. Fourteen women (predominantly white, educated and employed) participated in an in-depth interview. Interviews were transcribed verbatim and a process of thematic narrative analysis was undertaken, focusing on the meanings women assigned to their experiences and the differences and similarities across the stories. Analysis revealed that stories about stealthing were characterized by disrespect and selfishness, whereas RCA stories highlighted control with intent. The concepts of intent and control can therefore be understood as central to defining RCA and differentiating it from stealthing. It seems likely that stealthing is primarily a form of sexual violence, as it lacks the specific reproductive intent that characterizes RCA. These findings have important implications for how RCA and stealthing are addressed and measured in research and responded to in practice.

Sexual Aggression Analogues Used in Alcohol Administration Research: Critical Review of Their Correspondence to Alcohol-Involved Sexual Assaults

BACKGROUND

Alcohol administration studies are crucial because causal questions about alcohol's role in human behavior can only be answered through experimental research that randomly assigns participants to drink conditions. The primary goal of this review was to catalogue the characteristics of experimental analogues used in alcohol administration research to assess men's sexual aggression proclivity and evaluate the extent to which they represent the scope of alcohol-involved sexual aggression. Although this review focuses on sexual aggression analogues, the identified methodological issues are relevant to a wide range of alcohol administration studies.

METHODS

Online databases were searched for published studies that randomly assigned participants to drink conditions and assessed participants' sexual aggression proclivity with an experimental analogue. Characteristics of the analogues were coded by both authors.

RESULTS

Seventeen studies were identified that used 12 unique experimental analogues. All of the analogues depicted a completed or potential sexual assault in an apartment between a male perpetrator and female victim who did not know each other well. This information was presented in written (n = 7), audio (n = 1), video (n = 3), or virtual simulation (n = 1) format. Sexual aggression proclivity was measured through participants' self-reports (n = 10) and behavioral responses (n = 2). Perpetrators primarily used physical force which the woman verbally and physically resisted. Only one analogue depicted behavioral signs of the woman's alcohol impairment; none included signs of the man's alcohol impairment.

CONCLUSIONS

These analogues were designed to address important theoretical questions; however, they do not represent the full range of alcohol-involved sexual assaults. This hampers the development of evidence-based prevention and treatment programs because we do not know whether these findings generalize to other types of sexual assaults (e.g., with incapacitated victims, within serious relationships, with sexual and other gender minorities). Funding agencies need to support more alcohol administration research in order to provide a strong foundation for the development of effective interventions.

Supporting survivors of sexual violence: protocol for a mixed-methods, co-research study of the role, funding and commissioning of specialist services provided by the voluntary sector in England

INTRODUCTION

The voluntary sector provides a range of specialist services to survivors of sexual violence, many of which have evolved from grass roots organisations responding to unmet local needs. However, the evidence base is poor in terms of what services are provided to which groups of survivors, how voluntary sector specialist (VSS) services are organised and delivered and how they are commissioned. This will be the first national study on the role of the voluntary sector in supporting survivors in England.

METHODS AND ANALYSIS

This study uses an explanatory sequential naturalistic mixed-methods design with two stages. For stage 1, two national surveys of providers' and commissioners' views on designing and delivering VSS services will facilitate detailed mapping of service provision and commissioning in order to create a taxonomy of VSS services. Variations in the national picture will then be explored in stage 2 through four in-depth, qualitative case studies using the critical incident technique to explain the observed variations and understand the key contextual factors which influence service provision. Drawing on theory about the distinctive service contribution of the voluntary sector, survivors will be involved as co-researchers and will play a central role in data collection and interpretation.

ETHICS AND DISSEMINATION

Ethical approval has been granted by the University of Birmingham research ethics committee for stage 1 of the project. In line with the sequential and co-produced study design, further applications for ethical review will be made in due course. Dissemination activities will include case study and end-of-project workshops; good practice guides; a policy briefing; project report; bitesize findings; webinars; academic articles and conference presentations. The project will generate evidence about what survivors want from and value about services and new understanding about how VSS services should be commissioned and provided to support survivors to thrive in the long term.

Misperceptions and stereotypes in nursing care for sexually transmitted infections and domestic violence: a qualitative exploratory study

Background: Sexually transmitted infections (STI) and domestic violence (DV) are common healthcare issues experienced worldwide with DV increasing the risk of acquiring STI/s. Although nurses are well-placed to provide care for both issues, little is known about how and whether nurses perceive STI risk within the context of DV and whether this informs nursing care.Aim: To explore nurses' perceptions of STI acquisition within the context of DV and whether this informs nursing care.Design: Qualitative exploratory descriptive design.Methods: Eight participant narratives were collected from Australian Registered Nurses (RNs), with 1-17 years of clinical practice in varied settings. Participants were required to be registered with the Australian Health Practitioner Regulation Agency (AHPRA) and converse in English. Semi-structured interviews were undertaken via face-to-face, telephone and computer-mediated communication (CMC). Thematic analysis was guided by Braun and Clarke (2006).Results: Three themes emerged from the data: 'Perceptions: They don't talk about it, 'Stereotypes: Just that stigma and 'Provision of Care for STIs/DV: Physical and emotional. Participants held various perceptions associated with STIs and DV including the covert nature of both issues, the care of STIs within the context of DV, and how the nature of nursing care differed between STIs and DV.Conclusions: Nurses need to recognise the impact that nurse perceptions and stereotyping have on disclosures and provision of care for STIs, particularly in the context of DV. Consideration is also needed in relation to sexual and reproductive autonomy, the impact on disclosure and provision of care.

Sexual coercion, consent and negotiation: processes of change amongst couples participating in the Indashyikirwa programme in Rwanda

Sexual coercion among married or cohabitating couples is a complex phenomenon with few effective strategies for prevention. This paper explores sexual coercion among couples from rural Rwanda who participated in Indashyikirwa, a 4-year intimate partner violence prevention programme that included a 5-month couples curriculum to promote equalitarian, non-violent relationships. Drawing on three rounds of longitudinal qualitative interviews with partners from 14 couples (28 individuals), this paper explores processes of change in experiences and conceptualisations of coerced sex over the course of the intervention and 1 year after. The data were analysed using thematic and dyadic analysis. Both partners of couples reported significant changes in their sexual relationship, including reduced experiences of coerced sex, greater communication about sex and increased acceptability for women to initiate sex. Men and women became more willing to disclose sexual coercion over the course of the interviews, both current and past experiences, and couples' accounts generally became more concordant. Findings yield insights to inform programming to prevent coerced sex among spouses. These include grounding discussion of sexual coercion in an analysis of gendered power and norms, reflecting on the consequences of broader forms of sexual coercion and employing a benefits-driven, skills-based approach.

Addressing the measurement challenge in elder abuse interventions: need for a severity framework

The field of elder abuse is evolving toward an emphasis on intervention research. However, researchers currently rely on binary approaches to measure elder abuse phenomena, which fail to capture changes in problem status over the course of intervention. This commentary develops a case for severity as a framework to operationalize and measure elder abuse in intervention research and practice. A severity framework provides enhanced elder abuse measurement responsiveness and aligns with the dominant client-centered, harm-reduction clinical approach to intervening with elder abuse cases.

Elder Abuse Severity: A Critical but Understudied Dimension of Victimization for Clinicians and Researchers

Purpose of the Study

To describe the variation in severity of elder emotional abuse, physical abuse, and neglect and identify factors associated with more severe forms of elder mistreatment (EM).

Design and Methods

Population-based study using random digit-dial sampling and telephone interviews with a representative sample (n = 4,156) of community-dwelling, cognitively intact older adults in New York State. The Conflict Tactics Scale and DUKE Older Americans Resources and Services scales were adapted to assess EM subtypes. For each EM subtype, severity was operationalized by summing the number of different mistreatment behaviors and the frequency of each behavior. Among older adults reporting some degree of mistreatment, ordinal or multinomial regression predicted severity of elder emotional abuse, physical abuse, and neglect.

Results

Distribution of EM severity was characterized by a negative/right skew. More severe emotional abuse was predicted by younger age, living with the perpetrator only, Hispanic background, and higher education. Increasing physical abuse severity was associated with younger age and living only with the perpetrator. Higher neglect severity was associated with functional impairment, younger age, living only with the perpetrator, lower income, and lower education. The presence of nonperpetrator others living in the home served a protective function against escalating mistreatment severity.

Implications

Extends existing EM risk factor research by operationalizing mistreatment phenomena along a continuum of severity. Findings enhance capacity to screen and report particularly vulnerable EM victims and inform targeted interventions to ameliorate the problem. Incorporation of severity into EM research/measurement reflects the clinical and phenomenological reality of the problem.

Stalking: A Multidimensional Framework for Assessment and Safety Planning

Despite the high prevalence of stalking and the risk of harm it poses to victims, arrest rates, prosecutions, and convictions for stalking continue to be low in the United States. The overall goal of this article is to introduce a multidimensional framework of stalking that adds to the current literature by (1) providing a conceptual framework consistent with legal elements of many stalking statutes to facilitate assessment, communication, documentation, and safety planning for stalking several victims; (2) introducing a more systematic way of assessing course of conduct and the context of fear in stalking situations in order to increase the understanding of cumulative fear for stalking victims; (3) emphasizing the aspects of stalking harm that go beyond violence and that show how harm from stalking accumulates over time including life sabotage; and (4) discussing 12 risk factors derived from the overall multidimensional framework that can be used to describe the big picture of stalking and to facilitate safety planning for victims. Implications for future research are discussed.

Associations Between Sexual Behavior Norm Beliefs in Relationships and Intimate Partner Rape Judgments

Using a community sample ( n = 296), we investigated the associations between sexual behavior norm beliefs, acceptance of partner rape, judgments that non-consensual partner sex is "wrong not rape," and decisions if non-consensual partner sex should be charged as rape. Sexual behavior norm beliefs were associated both directly and indirectly with latter components in the model related to acceptance of non-consensual partner sex judgments and charging rape judgments. In addition, participant gender moderated the model, such that many of the associations between the variables were stronger for males than for females. The results have implications for understanding how individuals label rape between intimate partners.

Gang membership and marijuana use among African American female adolescents in North Carolina

The southeastern US sustains the highest high school dropout rates, and gangs persist in underserved communities. African American female adolescents who drop out of school and are gang members are at substantial risk of exposure to severe violence, physical abuse, and sexual exploitation. In this study of 237 female African American adolescents 16-19 years of age from North Carolina who dropped out or considered dropping out, 11% were current or past gang members. Adolescents who reported gang membership began smoking marijuana at a mean age of 13, whereas those who reported no gang membership began at a mean age of 15 years (P<0.001). The mean ages of first alcohol use were 14 years and 15 years for gang members and non-gang members, respectively (P=0.04). Problem alcohol use was high in both groups: 40% and 65% for non-gang and gang members, respectively (P=0.02). Controlling for frequent marijuana use and problem alcohol use, adolescents who reported gang membership were more likely than non-gang members to experience sexual abuse (odds ratio [OR] =2.60, 95% confidence interval [CI] [1.06, 6.40]), experience physical abuse (OR =7.33, 95% CI [2.90, 18.5]), report emotional abuse from their main partner (OR =3.55, 95% CI [1.44, 8.72]), run away from home (OR =4.65, 95% CI [1.90, 11.4]), get arrested (OR =2.61, 95% CI [1.05, 6.47]), and report violence in their neighborhood including murder (OR =3.27, 95% CI [1.35, 7.96]) and fights with weapons (OR =3.06, 95% CI [1.15, 8.11]). Gang members were less likely to receive emotional support (OR =0.89, 95% CI [0.81, 0.97]). These findings reinforce the urgent need to reach young African American women in disadvantaged communities affiliated with gangs to address the complexity of context and interconnected risk behaviors.

The Use of Drinking and Sexual Assault Protective Behavioral Strategies: Associations With Sexual Victimization and Revictimization Among College Women

Despite consistent high rates of campus sexual assault, little research has examined effective strategies to decrease sexual assault victimization. Sexual assault and drinking protective behavioral strategies (PBS) may be important means of reducing sexual assault victimization risk on college campuses but need further examination. The current study examined the relationship among sexual assault in childhood, before college, and since college to evaluate the mitigating roles of both sexual assault PBS and drinking PBS on sexual assault victimization. Participants (n = 620) were undergraduate women, 18 to 20 years old. The current study was a cross-sectional online survey assessing participants' sexual assault PBS and sexual assault history. Sexual assault history was positively associated with future sexual assault experiences. Pre-college sexual assault was associated with increased since-college sexual assault and increased drinks per week. Since-college adolescent/adult sexual assault was associated with less use of sexual assault PBS. These findings suggest that PBS may have an important role in sexual assault victimization and future research should examine their usefulness in risk reduction programs for college women.