Sexual Assault Centre Research Articles

Early Intervention after Rape to prevent post-traumatic stress symptoms (the EIR-study): an internal pilot study of a randomized controlled trial

BackgroundRape is one of the trauma incidents with the highest risk of subsequent post-traumatic stress disorder. Early interventions, such as prolonged exposure therapy (PE), have shown promise in preventing PTSD following a sexual assault. The primary objective of this internal pilot trial was to examine the feasibility of the EIR study protocol, which used modified prolonged exposure therapy (mPE) as a preventive intervention after rape.MethodsThis parallel two-arm clinical pilot study involved three sexual assault centers (SACs) in Trondheim, Oslo, and Vestfold, with data collected between June 2022 and March 2023. Women seeking assistance at one of these three SACs within 72 h after rape or attempted rape received acute medical treatment and forensic examinations. Women who wanted further psychosocial treatment were, if eligible and consenting, recruited to complete baseline assessments and a clinical interview before being randomized to one of two study arms. The intervention group prescribed up to five sessions of modified PE (mPE) in addition to treatment as usual (TAU), starting within the first 14 days after the rape incident, followed by weekly sessions. The other group received TAU.The present pilot evaluation is based on 22 participants, i.e., nine mPE + TAU and 13 TAU alone. Primary outcomes were predefined progression criteria regarding recruitment, retention, intervention implementation, a harm reporting system, and applying biological measurements and actigraphy.ResultsDuring the 6-month recruitment period, 235 women visited the three SACs. After eligibility screening and consent, 22 (9.4%) women were randomized. Three months later, 14 (63.6%) participants completed the final assessments. Intervention implementation was successful using trained SAC personnel to deliver mPE. The harm reporting system was used according to the study’s plan, and adverse and serious adverse events were detected during the trial. The biological measurements and actigraphy had substantial missing data but were still considered usable for statistical analyses.ConclusionIt may be feasible to conduct a full-scale RCT of early intervention after rape by comparing mPE + TAU to TAU alone. Minor design refinements were made to the protocol to enhance the main study outcome.Trial registrationClinicalTrials.gov Identifier: NCT05489133. Registered on 15 July 2022, retrospectively.

Attention-Seeking Strategies: An Investigation of Sexual Assault Organizations’ Communication Tactics on Twitter

This study examines the attention-seeking strategies of sexual assault organizations on Twitter in Canada, exploring the factors influencing the level of attention received. Drawing on the foundation work of Guo and Saxon’s four-factor explanatory model, the research extends and refines the model by incorporating new factors, including Covid-related content, network size, intended audience, direct services, donations, and visual content. The study’s methodology involved sampling 124 sexual assault and rape crisis centers in Canada, collecting Twitter data ( n = 320,836 Tweets up to April 2023), and employing ordinary least squares and fixed effect regression analysis. Results showed significant relationships between these factors and attention received, providing insights for both theoretical understanding and practical guidance.

A Typology of Social Media Use by Human Service Nonprofits: Mixed Methods Study.

Nonprofit organizations are increasingly using social media to improve their communication strategies with the broader population. However, within the domain of human service nonprofits, there is hesitancy to fully use social media tools, and there is limited scope among organizational personnel in applying their potential beyond self-promotion and service advertisement. There is a pressing need for greater conceptual clarity to support education and training on the varied reasons for using social media to increase organizational outcomes. This study leverages the potential of Twitter (subsequently rebranded as X [X Corp]) to examine the online communication content within a sample (n=133) of nonprofit sexual assault (SA) centers in Canada. To achieve this, we developed a typology using a qualitative and supervised machine learning model for the automatic classification of tweets posted by these centers. Using a mixed methods approach that combines machine learning and qualitative analysis, we manually coded 10,809 tweets from 133 SA centers in Canada, spanning the period from March 2009 to March 2023. These manually labeled tweets were used as the training data set for the supervised machine learning process, which allowed us to classify 286,551 organizational tweets. The classification model based on supervised machine learning yielded satisfactory results, prompting the use of unsupervised machine learning to classify the topics within each thematic category and identify latent topics. The qualitative thematic analysis, in combination with topic modeling, provided a contextual understanding of each theme. Sentiment analysis was conducted to reveal the emotions conveyed in the tweets. We conducted validation of the model with 2 independent data sets. Manual annotation of 10,809 tweets identified seven thematic categories: (1) community engagement, (2) organization administration, (3) public awareness, (4) political advocacy, (5) support for others, (6) partnerships, and (7) appreciation. Organization administration was the most frequent segment, and political advocacy and partnerships were the smallest segments. The supervised machine learning model achieved an accuracy of 63.4% in classifying tweets. The sentiment analysis revealed a prevalence of neutral sentiment across all categories. The emotion analysis indicated that fear was predominant, whereas joy was associated with the partnership and appreciation tweets. Topic modeling identified distinct themes within each category, providing valuable insights into the prevalent discussions surrounding SA and related issues. This research contributes an original theoretical model that sheds light on how human service nonprofits use social media to achieve their online organizational communication objectives across 7 thematic categories. The study advances our comprehension of social media use by nonprofits, presenting a comprehensive typology that captures the diverse communication objectives and contents of these organizations, which provide content to expand training and education for nonprofit leaders to connect and engage with the public, policy experts, other organizations, and potential service users.

Bridging and Bonding Social Capital by Analyzing the Demographics, User Activities, and Social Network Dynamics of Sexual Assault Centers on Twitter: Mixed Methods Study.

Social media platforms have gained popularity as communication tools for organizations to engage with clients and the public, disseminate information, and raise awareness about social issues. From a social capital perspective, relationship building is seen as an investment, involving a complex interplay of tangible and intangible resources. Social media-based social capital signifies the diverse social networks that organizations can foster through their engagement on social media platforms. Literature underscores the great significance of further investigation into the scope and nature of social media use, particularly within sectors dedicated to service delivery, such as sexual assault organizations. This study aims to fill a research gap by investigating the use of Twitter by sexual assault support agencies in Canada. It seeks to understand the demographics, user activities, and social network structure within these organizations on Twitter, focusing on building social capital. The research questions explore the demographic profile, geographic distribution, and Twitter activity of these organizations as well as the social network dynamics of bridging and bonding social capital. This study used purposive sampling to investigate sexual assault centers in Canada with active Twitter accounts, resulting in the identification of 124 centers. The Twitter handles were collected, yielding 113 unique handles, and their corresponding Twitter IDs were obtained and validated. A total of 294,350 tweets were collected from these centers, covering >93.54% of their Twitter activity. Preprocessing was conducted to prepare the data, and descriptive analysis was used to determine the center demographics and age. Furthermore, geolocation mapping was performed to visualize the center locations. Social network analysis was used to explore the intricate relationships within the network of sexual assault center Twitter accounts, using various metrics to assess the network structure and connectivity dynamics. The results highlight the substantial presence of sexual assault organizations on Twitter, particularly in provinces such as Ontario, British Columbia, and Quebec, underscoring the importance of tailored engagement strategies considering regional disparities. The analysis of Twitter account creation years shows a peak in 2012, followed by a decline in new account creations in subsequent years. The monthly tweet activity shows November as the most active month, whereas July had the lowest activity. The study also reveals variations in Twitter activity, account creation patterns, and social network dynamics, identifying influential social queens and marginalized entities within the network. This study presents a comprehensive landscape of the demographics and activities of sexual assault centers in Canada on Twitter. This study suggests that future research should explore the long-term consequences of social media use and examine stakeholder perceptions, providing valuable insights to improve communication practices within the nonprofit human services sector and further the missions of these organizations.

Views on Interprofessional Collaboration in a Dutch Sexual Assault Center: A Qualitative Study Among Workers.

As the response to sexual assault victims proved to be shattered and substandard, sexual assault centers were set up to improve care by providing the victims with medical, psychosocial and legal care. The Dutch Centers for Sexual Assault were launched in 2012. We wished to examine the challenges in interprofessional collaboration experienced in a long-running Dutch Sexual Assault Center. In this qualitative study, data was collected via semi-structured explorative interviews which were analyzed using thematic analysis in an iterative process. The semi-structured interviews were held with fifteen professionals from medical, psychosocial and legal disciplines. An interview guide was developed based on expert opinion and the Bronstein Index of Interprofessional Collaboration. Qualitative analyses were done using the method of thematic analysis in ATLAS.ti and were reported according to the COREQ criteria. The themes of the experienced challenges in interprofessional collaboration were further clarified using quotations. Participants mentioned three themes that challenged interprofessional collaboration: 1. discrepancies in professional involvement, 2. conflicting goals and 3. a lack of connection. Discrepancies in motivation and affinity to work with victims of sexual violence between professionals proved to be the most pivotal challenge to collaboration, leading to disturbing differences in professional involvement. A low caseload and time restraints complicated gaining expertise, affinity and motivation. Conflicting goals and confidentiality issues arose between the medical and legal disciplines due to their contrasting aims of caring for victims versus facilitating prosecution. Some professionals felt a lack of connection, particularly due to missing face-to-face personal contact, which hindered the sharing of complex or burdensome cases and gaining insight into the other discipline's competences. Building collective ownership and equal professional involvement are crucial for interprofessional collaboration. Professional involvement should be increased by training courses to clarify conflicting goals and to improve reciprocal personal contact between professionals. Training courses should be facilitated with organizational financial support.

Resilient again: COVID‐19, feminist anti‐violence work, and the question of sustainability

AbstractGender‐based violence has increased during the COVID‐19 pandemic. As a result, feminist anti‐violence organizations have experienced greater demands for services and complexity of need. Sharing results from a qualitative study with two sexual assault centers, this paper discusses how organizations experienced the pandemic and adapted their work in response. It engages with critical discussions of resilience, arguing for a movement away from a focus on resiliency, which overlooks larger structural issues and the need for sustainability. Further, it calls for greater recognition of the important and varied roles feminist anti‐violence organizations undertake in their communities.

A Systematic Review of Sexual Assault Referral Centers (SARC)

Background: Sexual violence against women is a commonly prevalent human rights violation and a widespread public health problem. It is associated with substantial short and long-term ill consequences for women and their families. As the response of the community is increasing day by day to sexual assault, new interventions have evolved in the form of sexual assault centers. These centers are community-based organizations that work to counteract the potential negative impacts of sexual assaults on the physical, mental, and psychological health of the victims. Objective: The objective of the study is to find out the multi-disciplinary professional services provided by these centers globally to treat sexual assault victims. Methods: The information is collected from secondary sources. This systematic review was prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis. Online databases were searched including, Research Gate, Taylor & Francis, Wiley Online Library, Scopus, and Google Scholar, and the search included the term ‘sexual assault centers, rape crisis centers, integrated services at sexual assault centers’. Results: The important post-assault services provided by these centers include medical treatment, forensic examination, police services, and psychological counseling to the sufferers of the tragic event. In addition, these centers are also involved in carrying out significant research and educational work. Practical Implication: These rape crisis centers are providing multidisciplinary services to rape victims including services of specially trained nurses, treatment and care of medical injuries, forensic medical examination, police services, counseling by psychologists and a highly organized follow-up. Conclusion: These centers are providing valuable multidisciplinary services including medical treatment, forensic examination, police services, and psychological counseling to the sufferers of sexual abuse under one roof. The understanding of these multidisciplinary services could be used to endorse the development of sexual assault centers in different parts of the world Keywords: Sexual assault, sexual assault centers, multidisciplinary services

Modified prolonged exposure therapy as Early Intervention after Rape (The EIR-study): study protocol for a multicenter randomized add-on superiority trial

BackgroundSexual assault and rape are the traumatic life events with the highest probability for posttraumatic stress disorder (PTSD), which can have devastating consequences for those afflicted by the condition. Studies indicate that modified prolonged exposure (mPE) therapy may be effective in preventing the development of PTSD in recently traumatized individuals, and especially for people who have experienced sexual assault. If a brief, manualized early intervention can prevent or reduce post-traumatic symptoms in women who have recently experienced rape, healthcare services targeted for these populations (i.e., sexual assault centers, SACs) should consider implementing such interventions as part of routine care.Methods/designThis is a multicenter randomized controlled add-on superiority trial that enrolls patients attending sexual assault centers within 72 h after rape or attempted rape. The objective is to assess whether mPE shortly after rape can prevent the development of post-traumatic stress symptoms. Patients will be randomized to either mPE plus treatment as usual (TAU) or TAU alone. The primary outcome is the development of post-traumatic stress symptoms 3 months after trauma. Secondary outcomes will be symptoms of depression, sleep difficulties, pelvic floor hyperactivity, and sexual dysfunction. The first 22 subjects will constitute an internal pilot trial to test acceptance of the intervention and feasibility of the assessment battery.DiscussionThis study will guide further research and clinical initiatives for implementing strategies for preventing post-traumatic stress symptoms after rape and provide new knowledge about which women may benefit the most from such initiatives and for revising existing treatment guidelines within this area.Trial registrationClinicalTrials.gov NCT05489133. Registered on 3 August 2022

Sexually transmitted infections among patients attending a sexual assault centre: a cohort study from Oslo, Norway

ObjectivesWe estimate the prevalence of sexually transmitted infection (STI) among patients after sexual assault, assess the possible value of azithromycin prophylaxis, and identify risk factors for assault-related STI and for...

Discussion Guide for the May Article.

Discussion Guide for the May Article.

Risk factors for PTSD diagnosis in young victims of recent sexual assault

ABSTRACT Background Sexual assault is associated with a high risk of developing PTSD. Little is known about the PTSD onset in children who have recently been victimized by sexual assault. It is important to identify children at risk for PTSD after sexual assault to prevent chronic problems and revictimization. Objective The first aim of this study was to describe the development of post-traumatic stress symptoms in the four weeks after sexual assault. The second aim was to analyse whether pre-assault factors, assault-related factors, social support, and post-traumatic stress, measured at two weeks post-assault, were associated with an indication of PTSD. Method From January 2019 to March 2021, data were collected of victims aged 8–17 years (n = 51; mean age = 15.00; SD = 1.78) who had contacted a Sexual Assault Centre. Severity of post-traumatic stress symptoms was measured at two and four weeks post-assault. The study was designed to use a multivariate logistic regression analysis. The study included female victims only. Results Most of the victims (58.8%) showed a decline in the severity of post-traumatic stress symptoms in the four weeks after sexual assault. However, 27.4% showed an increase and 13.7% showed no change in symptoms. More than two-thirds of the children (70.6%) showed severe post-traumatic stress symptoms at four weeks post-assault, i.e. had an indication of PTSD. Since only one significant difference was found, the multivariate analysis was not executed. A significant difference was found between severity of symptoms at two weeks and an indication of PTSD at four weeks (t(49) = −5.79; p < .001). Conclusion Children with high levels of post-traumatic stress at two weeks post-assault are at risk for PTSD indication at four weeks post-assault. Further research is needed to determine whether early trauma-based treatment for children with high post-traumatic stress symptoms can prevent the development of PTSD. HIGHLIGHTS Young victims of recent sexual assault with high levels of post-traumatic stress symptoms at two weeks post-assault are at risk for PTSD indication at four weeks post-assault, although they received immediate psychological care

Comparison Between Male and Female Survivors of Sexual Abuse and Assault in Relation to Age at Admission to Therapy, Age of Onset, and Age at Last Sexual Assault: Retrospective Observational Study.

Sexual abuse and sexual assault are complex phenomena that involve many factors (or correlates) and have many health and financial implications for individuals, families, and society. Every correlate needs to be studied in detail, individually and in relation to other correlates. Only with a thorough understanding of these correlates can more efficient and targeted prevention and intervention programs be designed. The purpose of this study was to examine the differences between male and female survivors of sexual abuse and sexual assault regarding the correlates of the survivors' age of onset of assault, age at the last assault, and age at which they entered therapy. Therapists at eight sexual assault centers in the province of Alberta, Canada, completed a questionnaire on each of their clients over a period of 7 years. A total of 3302 participants, of whom 2901 (87.86%) were female and 401 (12.1%) were male survivors of sexual abuse and assault, were included in this study. Mostly descriptive analyses were carried out on the 4 variables of concern in this study. Regarding the number of survivors who sought therapy, female survivors outnumbered male survivors by a ratio of 7:1, with different ratios for different age groups. As children age, their risk of being sexually assaulted for the first time decreases. Male children are more likely to be sexually abused at a younger age, whereas female children are more vulnerable to being assaulted at all ages, particularly in adolescence. The mean age of onset of sexual abuse was found to be 6.71 (SD 2.86) years, and the odds of experiencing the first sexual assault during childhood, as opposed to adolescence, were 4:1 for females and 9:1 for males. Male survivors were two times more likely than female survivors to experience their first sexual assault in childhood. The vast majority of survivors sought help many years after being sexually assaulted, and male survivors waited an average of 3 years longer from the last sexual assault before seeking therapy. The majority of survivors of sexual abuse and sexual assault live with the consequences for many years before they seek help, and a large proportion of male survivors are not likely to seek help.

The Dynamics of Interpersonal Relationships: Understanding Power and Control Tactics Among College Students.

Intimate partner violence (IPV) is a significant public health problem among college students and many students have difficulty identifying unhealthy and abusive behaviors. The aims of this mixed methods study are to: (a) create an inclusive tool that illustrates the power and control experiences of a diverse group of young adult college students, (b) ensure a broad scope of tactics are illustrated (related to technology and different types of relationships), and (c) measure the experience of these tactics, including how IPV knowledge, attitudes, and self-efficacy are influenced by a more inclusive tool. In Phase I, semi-structured interviews were conducted with students (n = 33) and staff (n = 10) at campus sexual assault centers at the three University of Michigan (UM) campuses to explore power and control tactics utilized by perpetrators on college campuses. Content analysis revealed 13 categories of tactics in college relationships. A draft tool was created and assessed for accuracy using cognitive interviews with students (n = 20) from all three campuses in Phase II. Cognitive interviews resulted in the following changes to the final tool: (a) new presentation of the Socioecological Model, (b) identification of substance use as a facilitator for multiple forms of violence, and (c) edits to tactic descriptions. In Phase III, 250 students at UM-Ann Arbor participated in a quasi-experimental evaluation in which 133 interacted with the tool and 117 received access to usual care (campus sexual misconduct policy). Both groups answered survey questions about IPV knowledge, attitudes, self-efficacy, and experiences at baseline, and after one month and five months. Among all college participants in Phase III, 33.5% had experienced lifetime IPV and 25.2% had experienced IPV in the past year. There were no significant differences among IPV knowledge, attitudes, or self-efficacy by group. The Dynamics of Interpersonal Coercion Among College Students tool was created by incorporating current tactics utilized among a diverse college population.

Male Victims at a Dutch Sexual Assault Center: A Comparison to Female Victims inCharacteristics and Service Use.

Recently, there has been an increase in referrals of male victims of sexual assault to interdisciplinary sexual assault centers (SACs). Still, there is limited research on the characteristics of men who refer or are referred to SACs and the services they need. To facilitate the medical, forensic, and psychological treatment in SACs, a better understanding of male victims is indispensable.The first aim of the study was to analyze the victim and assault characteristics of male victims at a Dutch SAC, and to compare them to those of female victims. The second aim was to analyze and compare SAC service use between male and female victims.The victim characteristics, assault characteristics, and service use of 34 male victims and 633 female victims were collected in a Dutch SAC. T-tests and chi-square tests were used to analyze differences between male and female victims.No differences between males and females in victim or assault characteristics were found. Most victims received medical and psychological care, with no differences between male and female victims. Female victims were more likely to have contact with the police, but no differences in reporting or forensic medical examinations between males and females were found.These findings indicate that SACs can and do provide equal services to male and female victims, and that the current services are suitable for male victims as well. However, a focus on educating and advising male victims about police involvement is advisable.

Trends in victim, incident and care characteristics of a Dutch sexual assault center

Worldwide, one in three women have experienced sexual violence, causing various physical and mental health problems such as depression, posttraumatic stress disorder and medically unexplained symptoms. Much has changed in the last decade. The use of the Internet, smartphones and apps has increased enormously, sexual violence is discussed more and more openly in the media. These changes have provided a platform for victims of sexual violence which has profoundly influenced the disclosing process and the victims' help-seeking behavior. Nevertheless, the question remains whether the number of victims seeking help from a professional institution has gone up. Therefore, our study aims to investigate if there have been changes in victim, incident and care characteristics among victims of a Dutch Center for Sexual Violence. We used data of victims attending the center between 2013 and 2020, including registered police file registrations instead of victim's reporting statements. Victims were divided into a cohort of early years (2013–2016) and recent years (2017–2020). In 2017–2020, a total of 270 victims attended the center compared to 83 victims in 2013–2016. The percentage of self-referrers increased from 10% to 30% in recent years; the use of psychotropic drugs among victims decreased from 24% to 11%; and more victims were willing to receive psychosocial follow-up care (64% versus 79%). The percentage of male victims remains low at approximately 5% of all victims in both cohorts. Background characteristics such as age and mental disability have hardly changed between 2013 and 2020. The proportion of known perpetrators remains high with approximately 80% in both cohorts, and the proportion of perpetrators who met victims on the Internet remains unchanged with approximately 6% in both cohorts. To improve our understanding of the influence of societal changes on help-seeking behavior, the monitoring of victim, incident and care characteristics remains crucial in the future.

Reporting after sexual violence: The influence of victim, assault and perpetrator characteristics

Sexual violence is a worldwide public health concern. Care for victims has improved with the development of sexual assault centres, which have served to professionalise and tailor care and to get different services to improve collaboration. Nonetheless, reporting rates remain low, causing perpetrators to walk free without prosecution. We aimed to investigate, firstly, the influence of victim, perpetrator and assault characteristics on the reporting rate, and, secondly, the reasons why victims did not report to the police. Data of a Dutch sexual assault centre was used in this cross-sectional study. All victims who attended the centre between January 2016 and January 2019 were included. Logistic regression analysis was used to assess the relation of certain characteristics with reporting. Forty per cent of the victims reported to the police. Age and injuries were significantly related to reporting. Victims of 26 years or over were less likely to report than victims under 18 years old. Victims with objectified injuries reported to the police more often. Contrary to previous research, no relation between the perpetrator being well-known to the victim and a lower reporting rate was found. Victims mainly refrained from reporting as they experienced conflicting emotions, followed by their feeling discouraged by the police. Other reasons were fear of the perpetrator and defamation, wanting to move on with their life and wanting to spare the perpetrator. Our findings will serve to further optimise care for victims of sexual violence and increase reporting rates.

Trends in rape cases in a Nigerian state.

Rape remains a controversial issue with a few victims reporting experience because of the myriad of societal perception, prolonged steps in pursuing a case to logical conclusion of securing conviction, as well as psychological and physical residuals of the experience. Data in Nigeria is therefore hard to come by as it is diminished and often not available. To assess the pattern and trend of rape cases in a State in Nigeria. A descriptive and retrospective study where data records on socio-demographics and case specifics was collected on victims of sexual assault that reported to DFID/ PATHS 2 supported Tamar Sexual Assault Centre between 2014 and 2016 after which it was analysed and presented in bar charts. The yearly prevalence varied for the different age groups studied with the highest prevalence noted for 13 years and above (175,200,255) over the 3 years of 2014, 2015 and 2016 studied. The reported cases also improved over the studied years with rates of 0.47, 0.96 and 0.5 respectively. The yearly comparison and baseline data show that the centre's establishment caused an improvement in rape case reporting and follow-up.

Correlates and predictors of self-harm in a prospective sample of sexually assaulted adolescents.

Sexual assault of adolescents is associated with negative mental health outcomes, including self-harm. Little is known about correlates and predictors of self-harm after sexual assault. We hypothesized that pre-assault vulnerabilities and post-assault psychological distress would be associated with self-harm after experiencing a recent sexual assault. The sample was recruited from adolescents aged 13 to 17 years accessing sexual assault centers and it included 98 females. Longitudinal data were collected at T0 (3.9 weeks on average post-assault) and T1 (21.8 weeks on average post-assault). Bivariate analysis and hierarchical binary logistic regressions were performed. The rate of self-harm was 38.1% before the assault and 37.8% after the assault (T1). History of family dysfunction (OR 3.60 (1.30, 10.01)), depressive symptoms at T0 (OR 5.83 (2.35, 14.43)) or T1 (OR 2.79 (1.20, 6.50), and posttraumatic stress symptoms at T1 (OR 3.21 (1.36, 7.58)) predicted self-harm at T1. These effects were attenuated when adjusting for confounders, except for depressive symptoms at T0 (OR 4.21 (1.57, 11.28)). Clinical implications for the prevention of onset or continuation of self-harm following adolescent sexual assault are discussed. Future studies should replicate these findings in a larger sample and consider different trajectories of self-harm.

Prevalence and correlated factors of sexually transmitted infections among women attending a Korean sexual assault center

Long-term observation of the prevalence of sexually transmitted infections (STIs) is unclear in sexual assault victims (SAVs).We aimed to identify the trends in the prevalence of STIs in SAVs and factors correlated with STIs. Between January 2010 and May 2019, a retrospective observational study was conducted in a regional sexual assault center in Seoul. Data were collected from sexual assault questionnaires and laboratory results. PCR for STIs, including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), Trichomonas vaginalis (TV) and cytomegalovirus (CMV), was performed via vaginal swab. Associations between STIs and covariates were examined by logistic regression. A total of 1843 SAVs were included, and 60.2% were positive for at least one STI. UU was the dominant agent (32.6%), followed by MH (27.7%) and CT (17.4%). The annual positivity rate ofMH showed a significant decreasing trend (tau = -0.600, P value = 0.020). The highest positivity rate of STI by age group was 68.0% (282/415) in the 15-19 years of age group. Age (OR = 0.951, 95% confidence interval [CI] = 0.934-0.968) and pyuria (OR = 1.898, 95% CI = 1.543-2.329) were associated with clinically important STIs (NG, CT and TV). The prevalence of STIs in SAVs was consistently high over 10 years, and most STIs were more prevalent in SAVs than in the general population. Presumptive treatment is still needed, especially for young SAVs with pyuria.

"Call for Help Immediately": A Discourse Analysis of Resident Assistants' Responses to Sexual Assault Disclosures.

Formal support providers can play a critical role in sexual assault survivors' well-being (e.g., providing resource referrals). In a university setting, resident assistants (RAs) are key support providers with a unique relationship to survivors based on their dual roles as help-provider and peer. We examined 305 RAs' responses to student sexual assault disclosure scenarios. Employing a critical discourse analysis, we identified four discourses used by RAs in their discussion of resources: controlling, gatekeeping, minimizing, and empowering. Due to power dynamics between RAs and residents, we conclude that empowering discourses would facilitate survivors' access to other resources (e.g., sexual assault center).