Risk Of Sexual Violence Research Articles

Syndemic Psychosocial Health Conditions Associated with Recent Client-Perpetrated Violence Against Female Entertainment and Sex Workers in Cambodia.

Female entertainment and sex workers (FESW) are vulnerable to violence, which impedes safer sex behaviors and increases risk of HIV. FESW are also disproportionately affected by co-occurring psychosocial health conditions, including substance use, depression, and economic insecurity, which increased risk of exposure to violence. We used a syndemic framework to examine the effects of co-occurring psychosocial conditions on the risk of client-perpetrated physical and sexual violence against FESW. Data were collected among 1198 Cambodian FESW on recent client-perpetrated physical and sexual violence, and psychosocial conditions (psychological distress, alcohol consumption, amphetamine-type stimulant (ATS) use, debts, housing, and food insecurity). Bivariate and multivariate logistic regressions were conducted. Prevalence of physical and sexual violence from clients was 4.8% and 6.9%, respectively. Client-perpetrated physical violence was associated with housing insecurity, ATS use, and psychological distress. All psychosocial conditions, except ATS, were associated with exposure to sexual violence. In multivariable models, odds of client-perpetrated physical violence were twice higher among women with ≥ 4 compared to ≤ 3 psychosocial conditions. Risk of sexual violence increased with the number of psychosocial conditions. Compared to those with ≤ 1 condition, FESW with two psychosocial conditions had twice the odds (AOR = 2.08; 95% CI 1.00-4.31) and women with 5-6 psychosocial conditions had eightfold higher odds (AOR = 8.10; 95% CI 3.4-19.31) of sexual violence from clients. Our findings support a syndemic model of co-occurring psychosocial conditions among FESW that are associated with increased risk of violence. Violence prevention interventions targeting FESW should adopt comprehensive approaches that address co-occurring psychosocial conditions.

Gang membership and sexual violence: associations with childhood maltreatment and psychiatric morbidity.

Gang members engage in many high-risk sexual activities that may be associated with psychiatric morbidity. Victim-focused research finds high prevalence of sexual violence towards women affiliated with gangs. To investigate associations between childhood maltreatment and psychiatric morbidity on coercive and high-risk sexual behaviour among gang members. Cross-sectional survey of 4665 men 18-34 years in Great Britain using random location sampling. The survey oversampled men from areas with high levels of violence and gang membership. Participants completed questionnaires covering violent and sexual behaviours, experiences of childhood disadvantage and trauma, and psychiatric diagnoses using standardised instruments. Antisocial men and gang members had high levels of sexual violence and multiple risk behaviours for sexually transmitted infections, childhood maltreatment and mental disorders, including addictions. Physical, sexual and emotional trauma were strongly associated with adult sexual behaviour and more prevalent among gang members. Other violent behaviour, psychiatric morbidity and addictions accounted for high-risk and compulsive sexual behaviours among gang members but not antisocial men. Gang members showed precursors before age 15 years of adult preference for coercive rather than consenting sexual behaviour. Gang members show inordinately high levels of childhood trauma and disadvantage, sexual and non-sexual violence, and psychiatric disorders, which are interrelated. The public health problem of sexual victimisation of affiliated women is explained by these findings. Healthcare professionals may have difficulties promoting desistance from adverse health-related behaviours among gang members whose multiple high-risk and violent sexual behaviours are associated with psychiatric morbidity, particularly addictions.

Evaluating Change in Men Who Have Sexually Offended: Linkages to Risk Assessment and Management

We provide a review and synthesis of the sexual offense treatment change literature with implications for dynamic sexual violence risk assessment and management. An argument is presented for the need for a dynamic approach in research and practice, and that for change to be prognostic, such changes need to be risk relevant and to come from credible change agents. Extant research demonstrates that changes on psychologically meaningful dimensions of risk and need (e.g., sexual deviance; attitudes and cognitions; anger, aggression, and hostility) tend to be associated with reductions in sexual and other forms of recidivism; however, changes in domains less germane to risk and need tend not to be (e.g., empathy, mental health and well-being). Formalized dynamic sexual offense risk measures can be administered at multiple time points to reliably measure changes in sexual violence risk. Change information can then be used systematically to adjust risk appraisals. The extant literature supports the dynamic nature of sexual violence risk. Working toward the routine assessment of change with psychometrically sound measures, and integrating this information into risk management interventions, can not only improve lives and reduce sexual violence but is an ethical and human responsibility.

Married very young adolescent girls in Niger at greatest risk of lifetime male partner reproductive coercion and sexual violence.

ObjectiveThe purpose of this analysis was to compare and contrast reproductive health (RH), gender equity attitudes, and intimate partner violence (IPV) among married very young adolescent (VYA) girls with married older adolescent girls and young women (AGYW) in rural Niger given limited literature on the topic.MethodsWe conducted an exploratory analysis of baseline data from the Reaching Married Adolescents Trial in Dosso region, Niger. We report counts and percents, by age group (13–14 years (VYA), 15–16 years, 17–19 years), of AGYW’s self-efficacy to use family planning (FP), accurate knowledge of FP, current use of modern FP, and unintended last pregnancy (UIP); lifetime reproductive coercion (RC), physical IPV, and sexual IPV; and gender equity attitudes. We also assess whether percents differ between VYA and older groups using Pearson’s Chi-Square and Fisher’s exact p-values. Results are stratified by parity. Finally, we use logistic regression to consider associations.ResultsThere were 49 VYA, 248 girls aged 15–16, and 775 AGYW aged 17–19 in our sample (n = 1072). Accurate knowledge of FP, self-efficacy to use FP, current use of modern FP, and UIP increased with age; all percents between VYA and AGYW 17–19 were marginally or statistically significantly different. We also saw VYA report higher lifetime RC and sexual IPV versus older groups, with sexual IPV statistically different between VYA and girls 17–19. Parous VYA reported a significantly higher percent of lifetime RC versus older AGYW. Among 17–19 year-olds, odds of current use of FP were higher among AGYW who reported physical IPV, and odds of UIP were higher among those reporting more gender equitable attitudes, both adjusted for parity.ConclusionsWe observed differences in RH, RC, and sexual IPV among married VYA and older AGYW in rural Niger. VYA should be prioritized in research to confirm and further understand their RH needs.

Review: Captive Genders: Trans Embodiment and the Prison Industrial Complex, edited by Eric A. Stanley and Nat Smith

Review: Captive Genders: Trans Embodiment and the Prison Industrial Complex, edited by Eric A. Stanley and Nat Smith

Displacement-related factors influencing marital practices and associated intimate partner violence risk among Somali refugees in Dollo Ado, Ethiopia: a qualitative study

BackgroundChild and forced marriage have negative health consequences including increased risk of intimate partner violence (IPV) for women and girls. War and humanitarian crises may impact decision-making around marriage and risks of IPV for displaced populations. A qualitative study was conducted among Somali refugees in Dollo Ado, Ethiopia to understand the interplay of factors that contribute to IPV and to inform an intervention. This secondary analysis aims to explore the influence of displacement on marital practices and associated IPV risk.MethodsInterviews and focus group discussions were conducted in 2016 in Dollo Ado, Ethiopia, among Somali women and men living in Bokolmayo refugee camp, host community members, non-governmental staff and service providers, stakeholders, and community and religious leaders (N = 110). Data were transcribed, translated to English, and coded and analyzed thematically using Dedoose software and a codebook developed a priori.ResultsFindings reveal numerous displacement-related factors that led to perceived shifts in marital practices among refugees, including reductions in child and forced marriages. NGO awareness-raising programs and Ethiopian laws prohibiting child marriage as well as increased access to education for girls were reported to have contributed to these changes, despite continued economic hardship and high perceived risk of non-partner sexual violence within the camp and host community. Polygamy was also perceived to have decreased, primarily due to worsening economic conditions. Forced marriage, polygamy and dowry were reported to contribute to physical IPV, and sexual IPV was reported as common in all types of marital unions. However, there was no evidence that changes in these marital practices contributed to any perceived declines in IPV within this context.ConclusionSafe access to education for girls should be prioritized in humanitarian settings. Interventions to address child and forced marriage should address gender and social norms. Intimate partner violence prevention programming should include specialized content taking into account marital practices including child and forced marriage and polygamy. Laws recognizing sexual IPV within marital relationships are needed to reduce sexual IPV.

A prospective multisite examination of dynamic sexual violence risk: Extension and update to Olver, Nicholaichuk, Kingston, and Wong (2014).

The present study is an extension and update of Olver, Nicholaichuk, Kingston, and Wong's (2014) prospective multisite examination of sexual violence risk and treatment change on a large federal Canadian sample of 570 treated sexual offenders rated pretreatment and posttreatment on the Violence Risk Scale-Sexual Offense version (VRS-SO). The present study featured the clinical application of a risk assessment and treatment planning tool, the VRS-SO, with recidivism outcome data updated by 4 years to a total of 10.2 years. VRS-SO change scores, representing reductions in sexual violence risk from treatment or other change agents (e.g., aging), were reanalyzed in terms of their associations with community sexual, violent, and general recidivism postrelease. Recidivism base rates increased with the concordant increase in follow-up time. VRS-SO risk scores significantly predicted all recidivism outcomes, whereas change scores were consistently associated with decreases in sexual and violent recidivism after controlling for baseline risk through bivariate (d = -.24 to -.61) and Cox regression survival analyses (eB = .878 to .938). The results affirm the dynamic nature of sexual violence risk and demonstrate that structured assessments of change, linked to participation in sexual offense specific treatment, to be associated with decreases in future sexual offending as well as other recidivism outcomes. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Understanding female veterans' experiences and perspectives of firearms.

Although firearms are the leading suicide means among female veterans, firearm research in this population remains limited. This study explored female veterans' firearm-related experiences and perspectives. Sixteen cisgender female veterans (ages 27-69) participated in qualitative interviews. Participants gained initial firearm knowledge and exposure in childhood and adolescence through older male family members. Military service led to broader exposure to firearms, which were perceived as important for survival and protection in a male-dominated environment, predominantly due to the risk for sexual violence. Following military service, the desire for self-protection motivated firearm ownership and storage practices. Participants perceived trust as essential to firearm discussions, preferring for family members to initiate such conversations. This study provides insight into the context in which female veterans' firearm-related beliefs and practices develop. Interpersonal factors and various lifespan experiences appear to play a vital role in female veterans' firearm access, ownership, and storage practices.

‘Empowering our people’ to address depression, violence, and sexual risk among Native Americans with recent binge alcohol use

ABSTRACT Background: This study was launched in response to an American Indian (AI) community’s concern regarding the comorbid occurrence of substance use, poor mental health, and other risk factors on sexual health. The purpose of this manuscript was to assess the relationship between alcohol use, violence, depression and STI/HIV risk behaviors on the frequency of unprotected sex acts and number of sexual partners among AI adults. Methods: Specifically, this analysis examines sociodemographic characteristics, experience of sexual and physical violence, binge drinking, depression, and sexual risk taking among n = 281 AI adults ages 18–55. Regression models examine associations between the aforementioned risk factors, number of sex partners and number of unprotected sex acts, by depression status and sex, among participants. Results: Frequent binge drinking predicted frequency of unprotected sex for both males and females; ever experiencing physical violence was a powerful predictor of unprotected sex for females, but not males. Ever experiencing physical violence strongly predicted having multiple sexual partners for females but was related to decreased number of sexual partners for males. Females ever experiencing sexual violence had more sexual partners; this was not observed for males. Binge drinking predicted frequency of unprotected sex acts, regardless of depression status. Discussion: Interventions for AI adults seeking to reduce sexual health risk should reflect past violence victimization in sexual decision making, primarily among women. The significant role of binge alcohol use for modifying sexual decisions should be of prime focus and interventions should be personalized to address individuals’ own alcohol use patterns. Additional research should explore how binge alcohol use moderates the relationship between depression and sexual risk.

Physical and Sexual Violence Among Gay, Lesbian, Bisexual, and Questioning Adolescents

This cross-sectional study uses data from the National Youth Risk Behavior Surveys to quantify the risks of physical and sexual violence faced by sexual minority adolescents in the United States from 2014 to 2017.

Episodes of violence suffered by migrants transiting through Libya: a cross-sectional study in \u201cM\xe9decins du Monde\u2019s\u201d reception and healthcare centre in Seine-Saint-Denis, France

IntroductionThe Central Mediterranean Route, passing through Libya, is one of the most dangerous for migrants. Episodes of violence have been documented but have not been accurately quantified. The objective of the study was to estimate the prevalence of episodes of violence suffered in Libya by migrants consulting the Médecins du Monde reception and healthcare centre in Seine-Saint-Denis (Ile-de-France).MethodologyA monocentric cross-sectional study was conducted from February to May 2019 including migrants over the age of 18 years who had passed through Libya and arrived in Europe from 2017. The presence of emotional distress was considered as exclusion criterion. The proportion, frequency and factors associated to physical, deprivation and sexual violence in Libya were estimated through a bespoke questionnaire, as well as healthcare access in Libya and psychosocial support needs.ResultsNinety eight people were recruited and 72 were interviewed (17 refused to participate and 9 were excluded). 76.4% were men, with a mean age of 31.9 years, 76.4% had low educational level, 66.7% came from Ivory Coast and 59.7% had left their country for security reasons. The median length of stay in Libya was 180 days. The overall proportion of participants having suffered from violence was 96.4% among men and 88.2% among women. The prevalence of physical, deprivation and sexual violence for men and women were 94.2, 81.7 and 18% and 80.0, 86.7 and 53.3%, respectively. Access to healthcare in Libya was 2.8 and 63.9% of participants were oriented to psychosocial support after the interview.ConclusionsThe vast majority of migrants reported having been victims of violence during their transit through Libya. Women were at particular risk of sexual violence. Access to health care in Libya was almost non-existent. Psychosocial support for this population is urgent.

Sexual violence and suicide risk in the transgender population: the mediating role of proximal stressors

ABSTRACT The transgender population is at increased risk for mental and physical health disorders. Previous research indicates these disparities exist as a result of exposure to disproportionately more adverse life events, including multiple forms of violence, and hostile and unaccepting social environments. Minority stress theory posits that exposure to unique types of stressors (i.e. distal stressors and proximal stressors), in addition to the stress experienced by the general population, result in poor health outcomes. A consequence of exposure to these stressors is a high rate of suicide. The current study sought to examine the mediating role of proximal stressors (e.g. internalised stress related to gender identity) on the relationship between sexual violence and suicide risk in a transgender sample. Participants included 155 transgender individuals who completed measures related to experiences of traumatic events, gender minority stress, and suicide risk. The association between experiences of sexual violence and suicide risk was significant (F[1,153] = 33.86, p < .001, R2 = 0.18). Proximal stressors were found to partially mediate the relationship between sexual violence and suicide risk (t[2, 152] = 3.49, p = .006). These findings demonstrate a need for increased resources in sexual violence prevention and competent care for survivors of sexual assault in the transgender community.

Interrater reliability, concurrent validity, and predictive validity of the risk for sexual violence protocol.

This study empirically evaluated risk judgments made using the Risk for Sexual Violence Protocol (RSVP; Hart et al., 2003), a widely used set of structured professional guidelines for assessing and managing sexual violence risk. Based on evaluations of other structured professional judgment guidelines, we hypothesized that judgments made using the RSVP would demonstrate good interrater reliability, concurrent validity, and predictive validity. Based on file review, research assistants made ratings using the RSVP and two commonly used actuarial tools for sexual violence risk assessment in a sample of 100 adult male sexual offenders who successfully completed a community-based sex offender treatment program. Recidivism information was obtained from official records 10 years after treatment completion. With respect to interrater reliability, judgments of the presence and relevance of individual risk factors ranged from moderate to almost perfect, and those for composite scores reflecting the sum of these ratings were almost perfect. Interrater reliability for integrative summary risk ratings was substantial to almost perfect. Regarding concurrent validity, the findings indicated that judgments made using the RSVP had moderate to large and statistically significant correlations with scores on the actuarial tools. Finally, with respect to predictive validity, RSVP presence total scores and summary risk ratings were predictive of new sexual violence over the follow-up, and the magnitude of their predictive validity effect sizes was similar to that of scores on the actuarial tools. The findings supported the potential utility of the RSVP in practice. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Bystander Program Effectiveness to Reduce Violence and Violence Acceptance Within Sexual Minority Male and Female High School Students Using a Cluster RCT.

Bystander interventions have been highlighted as promising strategies to reduce sexual violence and sexual harassment, yet their effectiveness for sexual minority youth remains largely unexamined in high schools' populations. This rigorous cluster randomized control trial addresses this gap by evaluating intervention effectiveness among sexual majority and minority students known be to at increased risk of sexual violence. Kentucky high schools were randomized to intervention or control conditions. In intervention schools, educators provided school-wide Green Dot presentations (phase 1) and intensive bystander training to student popular opinion leaders (phase 2). Each spring from 2010 to 2014, students attending 26 high schools completed anonymous surveys about violence acceptance and violent events. An analytic sample of 74,836 surveys with no missing data over the 5years was available. Sexual violence acceptance scores declined significantly over time in intervention versus control schools among all but sexual minority males. This intervention was also associated with reductions in both perpetration and victimization of sexual violence, sexual harassment, and physical dating violence among sexual majority yet not sexual minority youth. Both sexual minority and majority youth experienced reductions in stalking victimization and perpetration associated with the intervention. In this large cluster randomized controlled trial, the bystander intervention appears to work best to reduce violence for sexual majority youth. Bystander programs may benefit from explicitly engaging sexual minority youth in intervention efforts or adapting intervention programs to include attitudes that shape the experience of sexual minority high school youth (e.g., homophobic teasing, homonegativity).

Transforming Teaching towards Empowered Learning: What #MeToo Taught Us about Anthropology

This article calls for revisiting how we teach anthropology in light of three mutually reinforcing “moments” – the #MeToo Movement, the development of the American Anthropological Association’s first Sexual Harassment and Sexual Assault Policy, and shifting student expectations regarding personal safety and wellbeing. By thinking anthropologically about anthropology, against a backdrop of larger questions for the discipline as a whole, we single out the consequences of the “lone anthropologist” trope as it reproduces idealized notions of fieldwork in ways that limit access to the discipline. We suggest ten practical strategies for changing normative pedagogies as a way to increase benefits and reduce harms as we work to minimize risk for sexual violence while preserving the benefits of immersive fieldwork. We conclude by exploring how the classroom itself is feeding back into transforming cultures and institutional structures.

Gaps in Sexual Assault Health Care Among Homeless Young Adults

Young adults experiencing homelessness are at increased risk for sexual assault. Receiving a post-sexual assault examination has important implications for HIV and unintended pregnancy prevention; yet, utilization is not well understood. In a population at elevated risk for HIV, unintended pregnancy, and sexual violence, identifying barriers and facilitators to post-sexual assault examination is imperative. As part of a large, multisite study to assess youth experiencing homelessness across 7 cities in the U.S, a cross-sectional survey was conducted between June 2016 and July 2017. Data were analyzed in 2019 to determine the prevalence and correlates of sexual violence and examine the correlates of post-sexual assault examination utilization. Respondents (n=1,405), aged 18-26 years, were mainly youth of color (38% black, 17% Latinx) and identified as cisgender male (59%) and lesbian, gay, bisexual, or queer (29%). HIV risks were high: 23% of participants had engaged in trade sex, 32% had experienced sexual assault as a minor, and 39% had experienced sexual exploitation. Young adults reported high rates of sexual assault (22%) and forced sex (24%). Yet, only 29% of participants who were forced to have sex received a post-sexual assault examination. Latinx young adults were more likely than other races/ethnicities to receive post-assault care. Participants frequently said they did not get a post-sexual assault exam because they did not want to involve the legal system and did not think it was important. Interventions are needed to increase use of preventive care after experiencing sexual assault among young adults experiencing homelessness.

Sexual violence and eclampsia: analysis of data from Demographic and Health Surveys from seven low- and middle-income countries.

BackgroundScientific literature has provided clear evidence of the profound impact of sexual violence on women’s health, such as somatic disorders and mental adverse outcomes. However, consequences related to obstetric complications are not yet completely clarified. This study aimed to assess the association of lifetime exposure to intimate partner sexual violence with eclampsia.MethodsWe considered all the seven Demographic and Health Surveys (DHS) that included data on sexual violence and on signs and symptoms suggestive of eclampsia for women of reproductive age (15-49 years). We computed unadjusted and adjusted odds ratios (OR) to evaluate the risk of suggestive eclampsia by ever subjected to sexual violence. A sensitivity analysis was conducted restricting the study population to women who had their last live birth over the 12 months before the interview.ResultsSelf-reported experience of sexual violence ranged from 3.7% in Mali to 9.2% in India while prevalence of women reporting signs and symptoms compatible with eclampsia ranged from 14.3% in Afghanistan to 0.7% in the Philippines. Reported sexual violence was associated with a 2-fold increased odd of signs and symptoms suggestive of eclampsia in the pooled analysis. The sensitivity analysis confirmed the strength of the association between sexual violence and eclampsia in Afghanistan and in India.ConclusionsWomen and girls in low-and-middle-income countries are at high risk of sexual violence, which may represent a risk factor for hypertensive obstetric complication. Accurate counseling by health care providers during antenatal care consultations may represent an important opportunity to prevent adverse outcomes during pregnancy.

Determinantes sociodemográficos y la violencia contra la mujer Tacna Perú: un análisis retrospectivo de los datos de los centros de emergencia mujer

Objetivo. Determinar la relación de los determinantes sociodemográficos y la violencia contra la mujer. Tacna 2015-2017. Material y métodos. Estudio transversal, con una muestra de 1945 casos que realizaron denuncia. El análisis estadístico utilizó el chi- cuadrado, O.R. (razón de prevalencia) para análisis de los determinantes asociados, considerándose un valor p significativo &lt;0.05. Resultados. La violencia psicológica es la más predominante. Los determinantes sociodemográficos de la agredida asociados a violencia psicológica y física fueron: edad, estado civil, nivel educativo y condición de trabajo remunerado. Los determinantes de la agredida asociados a violencia sexual son: edad (más vulnerables &lt;19 años). Los determinantes del agresor asociadas a violencia psicológica fueron: edad y sexo siendo las mujeres las que realizan mayormente este tipo de violencia; Los determinantes del agresor asociados a violencia física: edades intermedias y convivencia. Los determinantes asociados a violencia sexual son: edad, sexo y la convivencia con la víctima, con un valor p=&lt;0,001 para la mayoría de estas asociaciones. Conclusiones. Según los determinantes sociodemográficos de la agredida, a mayor edad mayor riesgo de violencia psicológica, edades entre 20 y 49 años mayor riesgo de violencia física, &lt;19 años mayor riesgo de violencia sexual. Tener trabajo remunerado aumenta el riesgo de violencia. Determinantes del agresor predominantes son: edad con características similares para la violencia psicológica, física y sexual que, en la mujer, con evidencia que la mujer agrede a otra mujer.

Understanding the Risk of Sexual Abuse for Adults With Intellectual and Developmental Disabilities from an Ecological Framework

AbstractCurrent research on sexual violence perpetrated against individuals with intellectual and developmental disabilities (IDD) focuses on rates of victimization and individual risk factors. This research suggests that individuals with IDD are at a greater risk for sexual violence compared with the general public. At this time, there is no comprehensive theoretical framework to explain sexual abuse risk factors for individuals with IDD. This article describes such a framework by examining how an ecological perspective can be used to understand why individuals with IDD are at increased risk as well as provide a roadmap for how to prevent sexual abuse. An ecological framework, first introduced by Bronfenbrenner in 1979, examines individuals at multiple contextual levels. Current research on sexual violence and adults with IDD is reviewed through an ecological lens. We argue that an ecological approach is necessary for examining the nature of sexual violence and IDD, understanding why individuals with IDD are at a greater risk for sexual violence, and providing insight into how to prevent sexual violence.

The Association Between Gender Inequality and Sexual Violence in the U.S.

Few societal-level factors are established as risk or protective factors for sexual violence. Traditional gender norms and gender inequality are linked to sexual violence, but much of this research was conducted internationally or is becoming outdated and may not reflect current norms in the U.S. This study expands on previously published research by examining gender inequality's association with state-level sexual violence. Using state-level prevalence estimates published in the National Intimate Partner and Sexual Violence Survey 2010-2012 State Report and the Gender Inequality Index, Pearson correlations were examined to investigate the relationship between state-level gender inequality and lifetime victimization for various types of sexual violence among U.S. female and male adults. The analysis was conducted in 2019. Findings indicate that states with a high degree of gender inequality also report higher prevalence estimates among women for rape using physical force. Gender inequality was also negatively correlated with noncontact unwanted sexual experiences among women and men. In addition, an exploratory analysis of the relationship between individual indicators of gender inequality and violence outcomes suggest that the adolescent birth rate, female government representation, and labor force participation demonstrate an association with certain state-level violence outcomes, although the patterns were inconsistent. Although this study relied on cross-sectional data, collectively, these findings suggest that gender inequality may represent an important societal-level factor associated with sexual violence among women and men. However, this relationship appears complex and requires further research. These findings have potential to inform population-level violence prevention approaches.