Survivors Of Sexual Violence Research Articles

Measures Assessing Barriers and Facilitators to Post-Sexual Violence Services: A Critical Review.

Sexual violence (SV) is a significant public health problem associated with poor health, social, and economic outcomes. Although services exist to support survivors of SV, many do not access these services. This critical review examines measures used to assess barriers and facilitators to post-SV services and whether these measures address the full breadth of concerns among SV survivors, particularly those who hold marginalized identities. Eligible studies had to be original and peer-reviewed, include a measure of barriers or facilitators to service-seeking, and focus on SV survivors. We reviewed 10 measures that assessed barriers and/or facilitators to mental health, medical, advocacy, and legal services among SV survivors. These measures were designed for and/or applied to survivors of intimate partner violence, human trafficking, military sexual trauma, child sexual abuse, and adult sexual assault. Populations sampled included college students, military personnel, gender and sexual minority youth, women living with HIV, and crime victims seeking legal services. Using a social-ecological model approach, we assessed barriers at the individual, interpersonal/community/provider, and structural/organizational levels. Barriers at the community level were largely absent, and only three measures addressed facilitators. Five measures provided some psychometric data with survivors, and only three incorporated survivor feedback in their development. Four measures included some cultural and/or identity-specific factors. Future research should prioritize the development of trauma- and violence-informed measures that incorporate survivor feedback and address diverse cultural and identity contexts to improve service access and utilization.

Managing a survivor of conflict-related sexual violence.

Managing a survivor of conflict-related sexual violence.

Silent Suffering: The Unspoken Reality of Male Rape

Sexual violence is a pervasive issue that transcends gender, age, and sexual orientation. While extensive research has shed light on crimes against women, there remains a significant gap in awareness regarding similar crimes committed against men. The term "man" carries connotations of power, masculinity, and emotional control, perpetuating societal beliefs that men are less emotionally expressive than women. This perception often deters men from disclosing their experiences of sexual violence, as it may be viewed as contradictory to traditional masculine norms. In a male-dominated society, speaking out about such experiences can be stigmatized as "feminine behaviour," further complicating efforts to address and support male survivors of sexual violence. Closing this awareness gap and challenging gender stereotypes are crucial steps towards creating a society where all survivors feel empowered to seek help and support, regardless of their gender. Keywords: Sexual violence, Crimes, against men, Less emotionally expressive, Male survivors. .

Community perceptions about factors influencing access to care after sexual violence in North Kivu, Democratic Republic of the Congo: a qualitative study

BackgroundSexual violence is widespread in the eastern parts of the Democratic Republic of the Congo, including in the North Kivu province. Moreover, in this region survivors of sexual violence often have limited access to care and encounter a variety of barriers when seeking care and support. The aim of this study was to explore community perceptions about access to care, barriers, enablers and possible actions to improve access to care for survivors of sexual violence in North Kivu. A deeper understanding of community perceptions about access to care can guide ongoing efforts to overcome barriers and increase access to care for survivors of sexual violence.MethodsThe study utilised a qualitative design, based on focus group discussions with male and female adult community members in the study area. Previous experience of sexual violence was not a requirement. The transcripts from the discussions were analysed using manifest and latent qualitative content analysis.ResultsA total of 18 focus group discussions were carried out. The analysis resulted in three main themes; Knowledge and misconceptions around medical consequences crucial for care seeking, Community and family attitudes playing a dual role in care seeking behaviours and Care seeking dependent on optimised healthcare facilities and sensitive staff.ConclusionsLack of correct knowledge, harmful attitudes from community and healthcare staff, and poorly adapted healthcare services constitute barriers to accessing care. Improved awareness raising around sexual violence is needed to address both lack of knowledge and misconceptions. Efforts should be made to build upon the community support models and actively work to improve community attitudes towards survivors of sexual violence. In addition, there is a need for better adapted healthcare services with improved proximity, access for different groups of survivors and respectful and well-trained healthcare staff.

Exploring voluntary sector specialist services for victim-survivors of sexual violence in England: the PROSPER co-production study.

There is increasing recognition in England that voluntary sector specialist sexual violence services are essential in providing crisis and longer-term support to victim-survivors. However, there is limited empirical evidence about the scope, range and effectiveness of voluntary sector specialist provision and commissioning, or what victim-survivors want from services. Explore victim-survivors' experiences of accessing and using voluntary sector specialist services. Analyse the range, scope and funding of voluntary sector specialist services and how demand is managed. Explore the usefulness of different approaches to service delivery and different therapy models. Explore how different principles underlying service provision influence service delivery. Investigate referral patterns and pathways, and how voluntary sector specialist services fit with each other and link to the wider network of services for victim-survivors. Explore how arrangements for commissioning and funding services for victim-survivors across health, local authorities and criminal justice have evolved. Develop a taxonomy of the voluntary sector specialist services/service models being commissioned and provided. Make recommendations for the commissioning and provision of voluntary sector specialist services at practice and policy levels. Interviews with key stakeholders, focus groups with victim-survivors; a national survey of key stakeholders. This multimethod study comprised five sequential work packages: work package 1: exploratory interviews with commissioners and providers and focus groups with victim-survivors; work package 2: national survey of service providers and commissioners; work package 3: in-depth case studies in four areas of England; work package 4: co-research with victim-survivors; work package 5: data integration. Co-production was built into the study from its inception through robust patient and public involvement and engagement activities. These included a co-applicant who is a survivor of sexual violence, plus the appointment of five expert-by-experience co-researchers. We captured the combined findings conceptually and diagrammatically into a new model comprising six themes: the complex and precarious funding landscape; the challenge of competition for funding and contracts; the importance and success of partnership working with organisations; the pressured environments within which voluntary sector specialist services work; different roles, scope and eligibility of voluntary and statutory services within an area; and the ways services are organised and delivered, underpinned by services' values and philosophies. The COVID-19 pandemic meant that we were unable to use the proposed methods of data collection for the qualitative components. Mitigation was through developing online modes of data collection. Recruitment to the case study phase did not reach intended thresholds, but rich insights were drawn from earlier phases of the study. The PROSPER study has provided hitherto missing evidence regarding the funding and commissioning of sexual violence services in England. The findings are likely to be useful in informing future commissioning of such services. The PROSPER study has also presented some unexpected opportunities for learning, particularly regarding co-research in the field of sexual violence. We also claim a contribution to theory development through the expansion of a current theoretical framework that may be of use to others working in the specialistvoluntary sector. The model will require development and testing to assess its usefulness as a resource for training and education or as an aid to communications in any interactions that are concerned with the delivery, funding and commissioning of voluntary sector specialist services. This study is registered as Research Registry researchregistry5144. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 18/02/27) and is published in full in Health and Social Care Delivery Research; Vol. 13, No. 10. See the NIHR Funding and Awards website for further award information.

Book Review: On The Wrong Side: How Universities Protect Perpetrators and Betray Survivors of Sexual Violence , By Nicole Bedera and Hear Our Stories: Campus Sexual Violence, Intersectionality, and How We Build a Better University , By Jessica C. Harris On The Wrong Side: How Universities Protect Perpetrators and Betray Survivors of Sexual Violence. By BederaNicole. Berkeley, CA: University of

Book Review: <i>On The Wrong Side: How Universities Protect Perpetrators and Betray Survivors of Sexual Violence</i> , By Nicole Bedera and <i>Hear Our Stories: Campus Sexual Violence, Intersectionality, and How We Build a Better University</i> , By Jessica C. Harris On The Wrong Side: How Universities Protect Perpetrators and Betray Survivors of Sexual Violence. By BederaNicole. Berkeley, CA: University of

Exploring the Use of an Augmented Reality Device Learning Tool for Multidisciplinary Staff Training on Domestic Abuse and Sexual Violence: Postintervention Qualitative Evaluation.

Legislative policies published by National Health Service, England and the UK Government focus on prioritizing the creation of a stronger system. These frameworks emphasize on the improvement of health care staff's ability to identify and refer domestic abuse (DA) survivors as key areas for supporting workforce development. Health care staff are often the first professional contact of survivors of DA, and insufficient staff training is a key barrier to survivors being identified and directed to support. The Microsoft HoloLens2 is a mixed-reality headset that allows virtual objects (holograms) to be integrated into the real world. Mixed-reality headsets are being increasingly used within medical education and have the advantage of independent operation, reducing the staffing requirements for teaching. The HoloLens2 can be used to project HoloPatients (HPs), which resemble clinically unwell patients, into the classroom. Two of these HPs have been specifically designed to portray survivors of DA and sexual violence (SV). This study explored potential uses of the HP in DA and SV training as a potential survivor-centered educational initiative that could be used as an adjunct to existing training for health care professionals and community sector workers. Frontline staff and community stakeholders from the national health service, DA, and law enforcement sectors were invited on 3 separate occasions (n=14, 12, 22) to a HoloLens2 demonstration that displayed 9 HPs. The patient voice was to be outlined by personalized scripts, co-created alongside sector charities, ensuring survivor engagement and participation. Participants were given the opportunity to wear the headset and familiarize themselves with the technology during the sessions. A post-intervention evaluation research model was used to explore the feasibility and functionality of the HP as an educational tool. Thematic analysis described the HP as a "realistic," "adjustable" tool that "creates a safe learning environment." Participants suggested it could be useful in "pre-exposure preparation" by "improving communication" and allowing different approaches to be trialed in a safe environment. The use of survivor scripts was described as a useful tool to "bring the survivor into the learning space" in a safe way. Participants identified the HP as a suitable tool for workers inside and outside health care, including social sectors such as law enforcement (32%). The HP acts as a low-risk, adaptable tool for trainees to develop skills in a safe environment. This study demonstrates that professionals perceived the HoloLens as an innovative means to amplify the lived experience voice. Further research will evaluate this additional impact on trainees' confidence and responses to survivors disclosing DA and SV within different disciplines to drive improved outcomes.

Book Review: On the wrong side: How universities protect perpetrators and betray survivors of sexual violence by Bedera, N. BederaN. (2024). On the wrong side: How universities protect perpetrators and betray survivors of sexual violence. University of California Press. 320 pp. $26.95 (hardback). ISBN: 9780520395893.

Book Review: <i>On the wrong side: How universities protect perpetrators and betray survivors of sexual violence</i> by Bedera, N. BederaN. (2024). On the wrong side: How universities protect perpetrators and betray survivors of sexual violence. University of California Press. 320 pp. $26.95 (hardback). ISBN: 9780520395893.

Strength in Adversity: A Qualitative Study on Resilience Among Indian Survivors of Sexual Violence

ABSTRACT Purpose Although there has been substantial research that explores pathological consequences among sexual violence survivors. However, there is not enough knowledge about how these women survivors rise beyond being mere victims and develop resilience. This qualitative study explores resilience in Indian female survivors of sexual violence. Material and methods The study employed qualitative semi-structured interviews with seven (n = 7) female participants. The interviews were conducted both online and face-to-face. The interviews were transcribed and analyzed using reflexive thematic analysis. Results Four main themes emerged from data analysis: (1) Family as Both Perpetrator and Protector, illustrating the dual role of family in both harm and healing; (2) Religious and Spiritual Beliefs, providing strength and meaning; (3) Coping Mechanisms, revealing diverse recovery strategies; and (4) Establishing Boundaries, reflecting survivors’ empowerment in reclaiming autonomy. Discussion The findings highlight the complex interplay between family dynamics, religion, and personal resilience in the recovery process for survivors of sexual violence. Family plays a dual role as a source of harm and healing, while religious beliefs provide strength and meaning. Survivors also rely on diverse coping mechanisms and empowerment through establishing boundaries, all of which contribute to their recovery. Conclusion Our findings underscore the role of personal and cultural factors in resilience, informing the development of culturally sensitive support systems for trauma recovery.

Seroprevalence and Risk Factors for Hepatitis B, HIV, and Syphilis Among Survivors of Sexual Violence in the Eastern Cape Province, South Africa.

Understanding the prevalence of hepatitis B (HBV), human immunodeficiency virus (HIV), and syphilis among survivors of sexual violence in South Africa is crucial for guiding targeted healthcare interventions, despite the limited available data. This study aimed to investigate the prevalence of these infections and their associated risk factors in survivors from the Eastern Cape Province, South Africa. This retrospective cross-sectional study reviewed 1957 medical records of survivors of sexual violence who received care at two large healthcare facilities in the Eastern Cape Province of South Africa between January 2019 and December 2020. All survivors were screened for HBV, HIV, and syphilis infections. Logistic regression analysis was used to identify factors associated with HIV and syphilis infections. The overall seroprevalence rates for HBV, syphilis, and HIV were 0.7%, 4.9%, and 17.3%, respectively. Six individuals were co-infected with at least two of these infections. Predictors for HIV infection included age (age < 16: adjusted odds ratio [aOR] 0.05; 95% confidence interval [CI], 0.03-0.08 and ages 16-25: aOR 0.45; 95% CI, 0.34-0.59) and black race (aOR 4.78; 95% CI, 1.09-20.88). Predictors for syphilis infection were age (age < 16: aOR 0.05; 95% CI, 0.02-0.15 and ages 16-25: aOR 0.41; 95% CI, 0.25-0.66) and residing in an urban area (aOR 0.23; 95% CI, 0.10-0.50). Survivors of sexual violence are at increased risk of HBV, HIV, and syphilis. Urgent measures are needed to provide comprehensive screening, treatment, prevention, and education to address this critical public health issue.

Moral Injury:Religious and Spiritual Struggles Among Survivors of Intimate Partner Sexual Violence in the USA.

Intimate partner sexual violence (IPSV) has significant psychological consequences, yet no research has examined the relationship between IPSV and moral injury-a distinct form of bio-psycho-social-spiritual distress. This study explored IPSV, moral injury, religious and spiritual struggles (R/SS), purity culture beliefs (PCB), and psychological distress among Christian women in the USA (N = 210). Results revealed significant relationships between study variables. While the gender roles subscale of PCB moderated the link between IPSV and R/SS, the shame and guilt subscale did not. Further, R/SS significantly mediated the association between IPSV and moral injury, and moral injury (self- and other-directed) mediated the relationship between IPSV and psychological distress. These findings underscore the need for interventions to address the moral and spiritual dimensions of IPSV.

Bisexual+ Women and Gender Nonbinary Survivors of Sexual Violence: Comparisons of Substance Use, PTSD Symptoms, and In-Person Social Reactions to Sexual Violence Disclosure

ABSTRACT The current study examined whether in-person social reactions to disclosure of sexual violence vary as a function of sexual identity (heterosexual vs. bisexual+ survivors) and gender (women vs. nonbinary survivors). A secondary aim of the current study was to examine whether sexual identity and/or gender moderated the relation between social reactions to disclosure and various negative psychological/behavioral outcomes. (i.e. symptoms of posttraumatic stress disorder (PTSD), heavy episodic drinking, cannabis use). Participants were 472 bisexual+ or heterosexual survivors who identified as women (cisgender and transgender women) or gender nonbinary. Independent sample t-tests and three simple linear regressions were used to examine the study aims. Nonbinary survivors reported higher levels of social reactions that involved turning against the survivor and providing unsupportive acknowledgment of the sexual violence experience, compared to women survivors. Both bisexual+ and nonbinary survivors reported higher levels of PTSD symptoms and greater cannabis use compared to heterosexual and women survivors, respectively. For bisexual+ survivors, reactions that turned against the survivors were associated with lower levels of PTSD symptoms and higher levels of heavy episodic drinking. For bisexual+ survivors, reactions involving unsupportive acknowledgment were associated with higher levels of PTSD symptoms and lower heavy episodic drinking. The current study highlights how identification as bisexual+ or as nonbinary may influence in-person social reactions received upon disclosure of sexual violence as well as psychological outcomes following sexual violence.

Barriers and enablers towards integrated care for survivors of sexual violence in humanitarian settings: A real-time qualitative Delphi study

ABSTRACT In humanitarian settings with high levels of sexual violence (SV), care is often offered through fragmented silos, exacerbating the burden on the health workforce and survivors. We aimed to identify contextual and health systems barriers and enablers to providing integrated medical and mental health & psychosocial support (MHPSS) in the care for SV survivors in humanitarian settings. Using Valentijn’s framework, a qualitative, real-time Delphi study (RTD) approach was conducted with 17 experts representing seven geographical subregions. Challenges and enablers identified across the participants’ contexts were consistent. Contextual challenges included volatile contexts, collapsed health systems, and insufficient basic infrastructure. Professional-related challenges included lacking expertise among healthcare professionals (HCPs), high staff attrition rates, and compassion fatigue. Health systems-related challenges included poor referral and coordination mechanisms, lack of funding and resources, misaligned donor priorities and low prioritisation of SV comprehensive care. Effective networking, community engagement, capacity building, co-locating services, participatory management, promoting employees’ sense of ownership, establishing a digital information system, and a unified joint patient file were key identified enablers. Further research should be conducted to assess HCPs’ and SV survivors’ perceptions and experiences of how best to integrate MHPSS services, and understand the challenges and opportunities in delivering integrated services.

Characterizing Engagement with Web-Based Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Traumatic Stress and Substance Misuse After Interpersonal Violence.

Screening, brief intervention, and referral to treatment (SBIRT) is a widely used public health approach for delivering early intervention for substance misuse. SBIRT adaptations that incorporate content on interpersonal violence and posttraumatic stress disorder (PTSD) symptoms may be warranted, as experiences of interpersonal violence are prevalent and associated with greater substance misuse; however, more research is needed to refine the delivery of PTSD-substance use content within the SBIRT model. This study examined clinical data collected as part of a web-based SBIRT developed for co-occurring substance misuse and PTSD symptoms after interpersonal violence to characterize the clinical symptoms and responses of adults presenting to agencies serving intimate partner and sexual violence survivors. The respondents (N = 52) completed self-report measures during the SBIRT tool to personalize the recommendations, as well as motivational enhancement exercises. Descriptive statistics were conducted. The results underscored high rates of probable PTSD, substance use, and trauma-related motives for substance use. The respondents were ready to change their substance use on average after receiving personalized feedback. Many expressed values related to trauma recovery and self-empowerment, perceived these values as useful for substance use reduction, and set goals to seek mental health services or reduce their drinking quantity. The findings point to several clinical targets for integrated PTSD-substance misuse interventions for interpersonal violence survivors.

Healthcare workers' perspectives on trauma and mental health access for Rohingya refugees in Cox's Bazar.

In August 2017, the Rohingya population of northern Rakhine State in Myanmar fled to Bangladesh following "clearance operations" by the Myanmar security forces that were characterized by widespread and systematic violence, constituting severe human rights violations. The "clearance operations" were preceded by years of consistent denial of the human rights of the Rohingya people in Myanmar. This study examines the impact of these human rights violations on the trauma experiences of Rohingya survivors, their resulting mental health, and the availability and access to post-migration mental health services. Qualitative one-on-one interviews were conducted with 26 health care professionals who cared for Rohingya refugees after their arrival in Bangladesh. Trauma experienced by the Rohingya spanned the period before, during, and following migration and was ongoing at the time of data collection. The impact of Rohingya survivors' concurrent grief and trauma in relation to the violence they experienced in Myanmar as well as during and after their journey to Bangladesh that, at times, exacerbated survivors' trauma presentation. There were limited mental health services available in Bangladesh and additional structural and procedural barriers to care that limited responsiveness to Rohingya survivors' mental health needs. The Rohingya experienced traumatic human rights violations in Myanmar that led to their forced migration to Bangladesh. The Rohingya continued to experience trauma during their forced migration to Bangladesh and were exposed to additional stressors in the post-migration settings in refugee camps, including lack of access to adequate mental health services. These experiences have resulted in a spectrum of stress-and trauma-related symptoms. These findings show the mental health impact of protracted human rights violations on the Rohingya, revealing how trauma is not a singular event but a continuous experience. Detailing the limited mental health infrastructure and structural barriers facing Rohingya refugees in Bangladesh, the findings underscore the urgent need for trauma-informed interventions that address the complex psychological consequences of systemic violence and displacement. The findings emphasize the critical importance of holistic mental health support in refugee settings, providing evidence-based recommendations for the public health and humanitarian sector to consider when designing programs to address the mental health and psychosocial support needs of sexual violence survivors living in conditions of displacement.

The Importance of Gratitude and Hope for Coping in Times of Adversity: An Interpretative Phenomenological Analysis of the Meaning of Strength-Based Approaches for Survivors of Sexual Violence and Those Who Supported Them During the COVID-19 Pandemic

Whilst previous studies have begun to provide information regarding the benefits of gratitude and hope in relation to sexual violence survivors (SVS), the current understanding of how this facilitates coping is still limited and subject to narrow methods of inquiry. The purpose of this study was to explore how gratitude and hope impacted the well-being of three SVS and three support staff at Chester Sexual Abuse Support Services (CSASS) and is an important area for exploration due to the additional adversity of the recent COVID-19 pandemic. Data from semi-structured interviews were analysed using interpretative phenomenological analysis revealing two superordinate themes directly related to gratitude and hope. Understanding strengths-based strategies adopted by SVS and those who support them is critical when considering times of adversity. We, therefore, highlight how our findings might be used in future research and practice contexts.

Listening to young Asian sexual violence survivors’ voices through found poetry

ABSTRACT This paper explores found poetry as a method for listening to the voices of young Asian survivors. The survivors referenced in this paper were participants in the study, Young Asian Sexual Violence Survivors’ Experiences and Expectations of Support Systems Within New Zealand Schools. By integrating participants’ words into found poems, this study provides an authentic platform for participants’ stories. The poems emphasise the intersection of cultural expectations, generational divides, and the unique challenges faced by young survivors in seeking support. Through this approach, the research highlights the emotional weight and resilience embedded in these narratives. While found poetry powerfully conveys the emotional and experiential aspects of the data, it also raises challenges, such as the risk of generalisation and the potential omission of certain themes. Nevertheless, this method serves as a vital tool in amplifying marginalised voices, ensuring that the young survivors’ experiences are not only heard but deeply understood.

Sexual Violence and Shame: A Meta-Analysis.

Although sexual violence (SV) has been hypothesized to increase shame, the relationship between SV and shame has not been quantified. Addressing this gap is essential for developing targeted interventions for survivors, as shame is a transdiagnostic risk factor for numerous forms of psychopathology and a barrier to service-seeking. This meta-analysis first examines whether individuals exposed to SV demonstrate higher shame than individuals who reported no SV exposure. Second, we assessed the strength of the associations between SV severity and shame severity. Seven databases were searched for studies published from inception to June 2023. Original studies that assessed SV and shame in at least 10 participants were eligible for inclusion. Random effects models examined shame differences between SV survivors and non-SV-exposed individuals and quantified the association between SV severity and shame severity. Meta-analyses of 53 studies (97 effects, N = 15,110) indicated that individuals exposed versus those not exposed to SV experience higher shame (g = 0.55), with medium effects found across SV timing (childhood/adolescence or adulthood) and shame subtypes (trait, body, trauma-related). SV severity was moderately associated with shame (r = .20), with strong correlations found between child/adolescent SV severity and trauma-related shame, and small effects found between adolescent/adult SV severity and trauma-related and body shame. Risk of bias ratings, whether contact SV was experienced, sample type, and gender moderated some models. Our findings suggest that shame is a clinically significant correlate of SV. Interventions that address shame may contribute to more positive outcomes for survivors.

Enhancing support for survivors of sexual violence and abuse provided within integrated sexual health services

Enhancing support for survivors of sexual violence and abuse provided within integrated sexual health services

Enhancing support for survivors of sexual violence and abuse provided within integrated sexual health services.

Enhancing support for survivors of sexual violence and abuse provided within integrated sexual health services.