Sexual violence in women's lives. Findings from the Women's Safety Project,a community-based survey

This paper presents a community-based study, which aims to determine the interconnections between women's experiences of sexual abuse in childhood, sexual assault in adulthood, and physical assault in intimate relationships in Toronto, Canada. An in-depth face-to-face interview was conducted with 420 women who comprised the random sample of the women living in Toronto, Canada. Findings on the prevalence and effects of various forms of sexual abuse and violence revealed that 97.6% of the woman interviewed reported that they personally experienced some form of sexual violation. Sexual abuse in childhood (including incest), sexual assault, sexual harassment, and physical assault in intimate relationships were documented. Among the findings were that one-fourth of the women in the sample were physically assaulted by a male intimate, one-half of the women reported being raped or almost raped, and nearly half of the respondents reported experiencing some kind of sexual abuse before reaching age 16.     

Exploring the intersection of partner stalking and sexual abuse

This study examined a range of sexually abusive acts women with protective orders against violent partners experienced using three groups: (a) women who never experience stalking or rape by the violent partner; (b) women who experienced stalking but who had never been raped by the violent partner; and (c) women who were stalked and raped by the violent partner. Findings suggest that women in violent relationships experienced a wide range of sexually abusive experiences and that there is a significant association of partner stalking and partner sexual abuse beyond rape. Implications for practice and future research are discussed.     

Experience of sexual coercion among adolescents in Ibadan,Nigeria

This study surveyed 1,025 adolescent students and apprentices in Ibadan, Nigeria, to document their sexual behaviour and experience of sexual coercion including verbal threats, unwanted touch, unwanted kiss, assault, deception, drugging, attempted rape, and rape. Sixty five per cent of male and 48% of female apprentices were sexually experienced, compared to 32% of male and 24% of female students. More males than females reported sex with multiple partners and contact with a sex worker while females had exchanged sex for money and gifts. Fifty five per cent of all the subjects had been victims of at least one type of sexual coercion, the commonest being unwanted kiss and touch of breasts (47%). Although both males and females were victims of coercion, females were disproportionately affected--68% of female students and 70% of apprentices had experienced one coercive behaviour, compared to 42% of male students and 40% of apprentices. Female apprentices fared worst, with 19% of them raped. The main perpetrators of the coercion were persons well known to the victims including neighbours, peers and boy/girlfriends. We recommend multiple intervention programs including skills training for young persons, sensitisation workshop for training health workers, and media advocacy for the public to challenge stereotypes that favour sexual coercion of adolescents.     

Sexual assault in postmenopausal women.

OBJECTIVE: To examine patient characteristics, patterns of injury, forensic evidence, and the frequency of sexual assault in postmenopausal rape victims from 1986-1991. METHODS: Medical and forensic records were reviewed from 129 postmenopausal women (50 years of age or older) and 129 women from a comparison group (14-49 years of age) who reported having been sexually assaulted. Statistical analysis was performed by Student t test, chi 2, multiple logistic regression, or Fisher exact test. RESULTS: Postmenopausal women represented 2.2% of women reporting sexual assault in Dallas County. The postmenopausal victim was more often white (64%), whereas the younger victim was more often black (53%). Drug or alcohol use within the previous 24 hours was more common in the younger group. Trauma, in general, was common, occurring in 67% of the postmenopausal women and 71% of the younger group (P = not significant). Genital trauma was more common in the postmenopausal group (43 versus 18%; P < .001). Nearly one in three postmenopausal women had genital abrasions or edema. Almost one in five older women had genital lacerations, with one in four severe enough to require surgical repair. In contrast, the frequency of extragenital trauma was more common in younger victims (66 versus 49%; P < .01). Forensic findings were similar in both groups; however, in postmenopausal women motile spermatozoa were seen only in those examined within 6 hours of the assault. CONCLUSION: Postmenopausal women who have been sexually assaulted are more likely to sustain genital trauma than younger victims.     

Prevalence and correlated factors of sexually transmitted diseases-chlamydia, Neisseria, cytomegalovirus--in female rape victims

IntroductionPrevalence of sexually transmitted infections (STIs) was not well known in female rape victims.AimTo assess the prevalence and correlated factors of STIs—especially Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), and cytomegalovirus (CMV) in female rape victims presenting to a dedicated regional referral center in South Korea after settle down of intergrated service center for sexual abuse in study hospital.Main Outcome MeasuresPositive polymerase chain reaction (PCR) result for CT, NG, and CMV.MethodsA retrospective observational analysis was conducted from December 2008 to February 2010. All females, regardless of age and previous sexual history, who were victims of rape, and self presented or referred to the regional center for medical care and couselling were included. Relevant diagnostic tests for STIs—including PCR by cervical swab—were performed. Analysis for virgin (VIR) and nonvirgin (non‐VIR) groups was done separately to compare certain clinical characteristics.ResultsA total of 316 females were included. Overall STI prevalence was 32.91%; CT in a majority (28.85%) followed by NG (6.27%), CMV(1.37%). In VIR group, prevalence of STI was 26.67%; 20.00% in CT, 4.55% in GN, 2.33% in CMV. A small and non‐significant difference in STI was noted in VIR and non‐VIR groups (26.67% vs. 34.26%, respectively). STI prevalence was higher in young women 20 to 24 years of age and girls 15 to 19 years of age compared with other age groups. Age (odds ratio [OR]: 0.909, confidence interval [CI]: 0.851–0.971) and pyuria (OR: 3.454, CI: 1.567–7.614) were determined as significant correlated factors after multivariate regression analysis.ConclusionsPrevalence of CT and GN in female rape victims was introduced and it was higher than that in the general population. Even in the VIR group, it was high. CMV prevalence in the female genital tract was reported firstly. Jo S, Shin J, Song KJ, Kim JJ, Hwang KR, and Bhally H. Prevalence and correlated factors of sexually transmitted diseases—chlamydia, Neisseria, cytomegalovirus—in raped female victims. J Sex Med 2011;8:2317–2326.     

Providing quality care to the sexual assault survivor: education and training for medical professionals

One in every six women in the United States will be the victim of an attempted or completed rape over the course of their lifetime.³ Health care providers trained in sexual assault examination procedures are not available in all clinical settings. CNMs/CMs have most of the requisite training to provide this service, and they are ideally poised to help women who report sexual abuse. We can assist persons who have been sexually assaulted by becoming educated in sexual assault care, attending specialty training as sexual assault examiners, joining SARTs, and serving as sexual assault response coordinators in our communities. Education about sexual assault care in midwifery programs can facilitate the ability of CNMs/CMs to provide physical assessments and forensic examinations to sexual assault victims.Once training has been obtained, it is essential to stay current about topics such as emergency contraception, STI treatments, and new methods of forensic evidence collection. Sexual assault examiners must have a knowledge of available referral sources and local resources where the person reporting these crimes may receive assistance as needed. Providing medical and forensic care for women who are victims of sexual violence should be considered a core practice within the midwifery scope of practice. CNMs/CMs need to be well prepared to care for sexual assault patients by receiving proper education and training. Specific instruction concerning care for victims of sexual and domestic violence, along with an introduction to serving as an expert witness, should be an integrated into midwifery education programs as part of the core curriculum.     

Female victims of rape and their genital injuries

Objective A minority (some report < 10%) of women report sexual assault. Of those that negotiate the police process, only a minority will come to a court hearing. It is thought that the courts still rely upon medical evidence, in particular evidence of genital injury to 'prove' the rape. This study aimed to ascertain the incidence of genital injury in victims of alleged rape
Design Retrospective review of case records of women who reported they had had been raped, provided by women doctors on the Northumbrian Police Doctors scheme.
Sample Case records from Newcastle, North and South Tyneside, Sunderland and Northumbria.
Methods Analysis of records in the standardised booklet used by police surgeons to examine women reporting rape.
Main outcome measures Presence of genital injury, presence of other physical injuries.
Results A minority of women had genital injuries (22/83); the majority had some form of physical injury (68/83), although most of these were minor.
Conclusion The study shows that only a minority of women examined by specifically trained police doctors show evidence of genital injury. The absence of genital injury does not exclude rape.     

Sexual victimization: incidence, knowledge and resource use among a population of college women

STUDY OBJECTIVE: To assess the incidence of sexual victimization among a convenience sample of college women and evaluate both victims and non-victims' knowledge and use of available on and off campus resources. DESIGN: Written questionnaire distributed to students in lobbies of two campus libraries and large computing center SETTING: A private northeastern university PARTICIPANTS: Upper-class undergraduate women (sophomores, juniors and seniors) MAIN OUTCOME MEASURES: Respondents (n=234) were asked to complete demographic information, report instances of sexual victimization (including rape, sexual coercion and unwanted sexual contact) that occurred during the 1999-2000 academic year and indicate whether they would or did use either university and/or outside resources available to sexual assault victims. RESULTS: Of the women who participated, 38% (90/234) affirmed one or more episodes of sexual victimization, with 6% (14/234) reporting a completed rape and 4% (9/234) an attempted rape. Drug or alcohol-related impairment leading to unwanted sexual activity was reported by 15% (35/234) of women. Utilization of available on- and off-campus resources was uncommon among victims (22% and 6%, respectively); 12% contacted health services, while only 4% reported an event to university security. Victims cited fear, embarrassment and guilt, as well as lack of confidentiality, as the most common reasons for failure to use resources. CONCLUSIONS: Increasing campus awareness of sexual victimization and removing barriers to access for victims should remain university goals.     

Suicidal ideation and the prevalence of intimate partner violence against women in rural western China

This study examined the extent of the association between intimate partner violence (IPV) and suicidal ideation in a rural county in Western China. A sample of 1,771 women participated in the study. The lifetime prevalence of physical assault, psychological aggression, and sexual coercion was 34%, 68%, and 4%, respectively. The preceding-year prevalence of physical assault and psychological aggression was 8% and 32%, respectively. The prevalence of lifetime suicidal ideation was 15.9%, and 3.3% of the women had suicidal ideation during the preceding week. Physical abuse victims were at more than four times greater risk of having suicidal ideation than those who had not suffered physical assault.     

Rape rates and military personnel in the United States: an exploratory study

This study involves a test of the cultural spillover hypothesis through a state-level analysis of the relationship between rape rates and the proportion of military personnel in the population. A statistically significant correlation not predicted by this hypothesis was found between rape rates and the proportion of Air Force personnel in the population. Further exploration revealed that this was largely because of the high correlation between the Air Force and the Indian population. Multivariate analyses revealed that the proportion of Indian women in the population was the main predictor of rape rates. Per capita alcohol consumption was also found to be positively correlated with both rape rates and Air Force personnel but was not significantly related to rape in the multivariate analysis.     

Experience of sexual violence among sexually experienced Japanese teenage girls and influencing factors

Aim  The aim of the present study was to identify influencing facors for sexual violence in sexually experienced teenage girls. Methods  Eighty sexually experienced teenage girls aged between 14 and 19 attending obstetrics and gynecology clinics in suburban Tokyo were selected as subjects. After completing a simple questionnaire on sexual behavior and lifestyle the subjects were interviewed using a semistructured interview technique. Logistic regression analysis was used to identify factors associated with sexual violence. Results  Police and government statistics for rape, sexual and domestic violence in Japan are extremely low. However, the present study showed that 52.5% of subjects had been victims of sexual violence. Furthermore, of these, 69.0% had been forced to have sex with a partner and 64.3% had been raped by someone other than a partner. Factors influencing the risk of sexual violence were sexual behavior and attitudes towards sexuality and lifestyle. Having a sexually transmitted infection was not an influencing factor. Conclusions  It is important to identify teenage girls attending obstetrics and gynecology clinics at risk of sexual violence and to teach them about the risks of sexual behavior associated with imbalances of power. Furthermore, it is essential to support victims of sexual violence to protect them from the recurrence of such abuse.     

Factors that correlate with injury sustained by survivors of sexual assault

A retrospective study of 440 cases of reported sexual assault was undertaken in order to identify factors that correlated with which victims sustained physical injury. Overall, 40% sustained nongenital and 16% genital injury, but most injuries were not severe. Which victim was injured strongly correlated with her age and race, the race of her assailant, and whether he had a weapon. White victims sustained both genital and nongenital injury almost twice as often as black victims. Whether she knew her assailant was less important, unless the victim was a child. Survivors attacked by a single assailant were injured as often as survivors of a "gang rape." Conclusions drawn from these data must take into account that these victims choose to report the event to the authorities, and self-reporting bias might explain some of the findings. Approximately half the victims seen sustained no injury. Apparently, physical injury is not a inevitable consequence of being raped.     

Comparing sexual assault prevalence estimates obtained with direct and indirect questioning techniques

Concerns have been expressed about the validity of self-reported data on sexual assault, as victims might be reluctant to disclose what happened to them. In this study, using an anonymous, web-based survey, a sample of 5,446 undergraduate women were asked about their experiences with physically forced sexual assault using both direct and indirect questioning methods. The prevalence of physically forced sexual assault obtained via indirect questioning was slightly higher than, though not substantially or statistically different from, the estimate obtained via direct questioning. The results suggest that either direct questioning yields reasonably valid estimates of the prevalence of sexual assault or that the item count technique does not produce estimates that are any more valid.     

Beyond the campus: unacknowledged rape among low-income women

Studies of college rape victims have found that many are unacknowledged; that is, they do not label their experience rape. The current study investigated factors associated with unacknowledged rape among low-income women. Out of a sample of 1,033 women, 167 reported having experienced rape. Unacknowledged victims, relative to acknowledged victims, reported less violent assaults and more alcohol use before the assault and were more likely to have been assaulted by a romantic partner. Unacknowledged victims also disclosed less often and reported fewer feelings of stigma. Implications of the work for future studies of unacknowledged rape are discussed.     

Rape against women: the magnitude, perpetrators and patterns of disclosure of events in Dar es Salaam, Tanzania

This cross-sectional household survey was conducted in Dar es Salaam between July and August 2000. The objectives were to establish the magnitude of rape against women, the perpetrators, disclosure of events and other related factors. Among the 1004 women who completed their interviews, 20% said they were ever raped. The known perpetrators were responsible for 92% of the most recent events. Whereas 34% of events were disclosed for non-legal purposes, only 10% were disclosed to the police. Repeated rape and patterns of disclosure were significantly associated with existing social relationships with the perpetrator. The results indicate that rape against women is a serious public health problem in Dar es Salaam commonly involving people who are close to the victims.     

Analysis and implications of the omission of offenders in the DoD Care for Victims of Sexual Assault Task Force report

This note addresses the weaknesses in the Department of Defense (DoD) Care for Victims of Sexual Assault Task Force (CVSATF) Report, released in May 2004. Sound policy and protocol cannot be developed to prevent and to respond to sexual assault in the military if the role of sex offenders is not understood, yet the report excludes information relevant to understanding sex offender behavior and to responsibility. Shortcomings in the CVSATF recommendations to improve military definitions of sexually violent behavior and data collection are summarized, as are limitations in the recommendations for sexual assault prevention strategies. This analysis highlights problems with the DoD CVSATF recommendations to improve offender accountability and secure safety for communities and discusses how the military social climate is prohibitive to facilitating these goals. This note suggests that policy and procedures guided by recommendations that omit information about sex offenders may actually leave communities at continued risk of sexual assault.     

Reported sexual assault in Nashville-Davidson County, Tennessee, 1980 to 1982

A review of the experience of 440 women reporting they had been raped was made from their initial contact with the police, through their medical-forensic examination at the county hospital emergency room, by any judicial proceedings, and by their longer term psychological counseling. The data were then compared with those from other municipalities. The assailant's use of a weapon seemed the strongest variable correlated with the victim's decision to press for prosecution. Being raped by a stranger or being physically injured did not correlate with this decision. Women most likely to have been victims of a previous rape were over 40 years old, were black, were assaulted by someone well known to them, or had some sort of mental health problem, and these variables were independent of each other. This implies these victims somehow suffer from an increased vulnerability to repeated rape. The data suggest that use of a county hospital emergency room for the medical management of rape victims discourages their reporting the event to the authorities and their seeking medical treatment.     

Adolescent sexual assault: an update of the literature

PURPOSE OF REVIEW: In this review, we examine the most recent literature on adolescent sexual assault, and summarize new findings regarding prevalence, risk factors, sequelae, cultural factors, genital injury, legal issues and practice implications. RECENT FINDINGS: Child and adolescent sexual-assault victims are at risk for a range of negative outcomes, including comorbid post-traumatic stress disorder and major depressive episode, comorbid post-traumatic stress disorder and substance abuse, eating disorders, delinquency, and revictimization. Cultural factors and severity levels of trauma may serve as risk factors to such outcomes in adolescent sexual-assault victims. Compared with adults, adolescent sexual-assault victims have a greater frequency of rape-related anogenital injuries, but data on healing of injuries in this population are lacking. Factors related to a child sexual-assault victim's demeanor and intelligence can influence the perceived credibility of the child as a witness to the abuse. SUMMARY: Recent studies investigating prevalence, risk factors, and sequelae of child and adolescent sexual assault highlight the need for educational programs and primary prevention interventions to educate pre-pubescent children and adolescents about sexuality, including sexual assault. In addition, further research is warranted in the area of statutory rape reporting to determine its effects on adolescent health-service-seeking behaviors and outcomes. Although most adolescent sexual assault victims do not seek acute post-rape medical care, forensic nurse examiners are often the first clinicians to encounter the adolescent sexual assault victim. Nursing protocols that standardize evidence collection as well as psychological support are important in the comprehensive care of these traumatized teens.