Using Twitter-Based Data for Sexual Violence Research: Scoping Review.

BACKGROUND: Scholars have used data from in-person interviews, administrative systems, and surveys for sexual violence research. Using Twitter as a data source for examining the nature of sexual violence is a relatively new and underexplored area of study. OBJECTIVE: We aimed to perform a scoping review of the current literature on using Twitter data for researching sexual violence, elaborate on the validity of the methods, and discuss the implications and limitations of existing studies. METHODS: We performed a literature search in the following 6 databases: APA PsycInfo (Ovid), Scopus, PubMed, International Bibliography of Social Sciences (ProQuest), Criminal Justice Abstracts (EBSCO), and Communications Abstracts (EBSCO), in April 2022. The initial search identified 3759 articles that were imported into Covidence. Seven independent reviewers screened these articles following 2 steps: (1) title and abstract screening, and (2) full-text screening. The inclusion criteria were as follows: (1) empirical research, (2) focus on sexual violence, (3) analysis of Twitter data (ie, tweets or Twitter metadata), and (4) text in English. Finally, we selected 121 articles that met the inclusion criteria and coded these articles. RESULTS: We coded and presented the 121 articles using Twitter-based data for sexual violence research. About 70% (89/121, 73.6%) of the articles were published in peer-reviewed journals after 2018. The reviewed articles collectively analyzed about 79.6 million tweets. The primary approaches to using Twitter as a data source were content text analysis (112/121, 92.5%) and sentiment analysis (31/121, 25.6%). Hashtags (103/121, 85.1%) were the most prominent metadata feature, followed by tweet time and date, retweets, replies, URLs, and geotags. More than a third of the articles (51/121, 42.1%) used the application programming interface to collect Twitter data. Data analyses included qualitative thematic analysis, machine learning (eg, sentiment analysis, supervised machine learning, unsupervised machine learning, and social network analysis), and quantitative analysis. Only 10.7% (13/121) of the studies discussed ethical considerations. CONCLUSIONS: We described the current state of using Twitter data for sexual violence research, developed a new taxonomy describing Twitter as a data source, and evaluated the methodologies. Research recommendations include the following: development of methods for data collection and analysis, in-depth discussions about ethical norms, exploration of specific aspects of sexual violence on Twitter, examination of tweets in multiple languages, and decontextualization of Twitter data. This review demonstrates the potential of using Twitter data in sexual violence research.

Lessons learned from COVID-19: provider suggestions for improving service delivery in sexual violence resource centers and children's advocacy centers in Kentucky

The COVID-19 pandemic has presented unique challenges for human service providers, especially as face-to-face services were limited by both formal and informal efforts to protect public health. Telehealth has emerged as a main strategy to ensure continuity of care. This study explored adaptations to services in child advocacy centers (CACs) and sexual violence resource centers (SVRCs) across the Commonwealth of Kentucky, particularly using telehealth. This study highlights respondents' suggestions about improving these service delivery systems and the particular emphasis on challenges and strengths of telehealth for reaching those in rural areas.

Does routine activity theory still matter during COVID-19 restrictions? The geography of sexual assaults before, during, and after COVID-19 restrictions.

On March 10, 2020, the Governor of the State of Michigan, USA, declared a state of emergency in response to COVID-19. Within days, schools were closed; in-person dining was restricted; and lockdowns and precautionary stay-at-home orders were issued. These restrictions dramatically impacted the mobility of offenders and victims through space and time. As routine activities were forced to change and crime generators were closed, did hot spots and risky locations for victimization change as well? The purpose of this research is to analyze potential shifts in high-risk areas for sexual assaults before, during, and after COVID-19 restrictions. Using data from the City of Detroit, Michigan, USA, optimized hot spot analysis and Risk Terrain Modeling (RTM) were used to identify critical spatial factors for the occurrence of sexual assaults before, during, and after COVID-19 restrictions. The results suggested that hot spot areas for sexual assaults were more concentrated during the COVID timeframe, compared to the Pre-COVID timeframe. While blight complaints, public transit stops, points of sale for liquor, and the locations of drug arrests were consistent risk factors for sexual assaults before and after COVID restrictions, other factors, such as casinos and demolitions, were only influential in the COVID period.

Prevalence and Correlates of Non-Dating Sexual Violence, Sexual Dating Violence, and Physical Dating Violence Victimization among U.S. High School Students during the COVID-19 Pandemic: Adolescent Behaviors and Experiences Survey, United States, 2021.

The COVID-19 pandemic created an environment of disruption and adversity for many adolescents. We sought to establish the prevalence of non-dating sexual violence, sexual dating violence, and physical dating violence victimization among adolescents during the COVID-19 pandemic and to investigate whether experiences of disruption and adversity placed adolescents at greater risk for these forms of interpersonal violence. We conducted a secondary analysis of data from the Adolescent Behavior and Experiences Survey, collected January to June 2021 from a nationally representative sample of U.S. high school students (N = 7,705). Exposures included abuse by a parent; economic, housing, and food and nutrition insecurity; interpersonal connectedness; and personal well-being. Among female students, 8.0% experienced non-dating sexual violence; 12.5% experienced sexual dating violence; and 7.7% experienced physical dating violence. Among male students, 2.2% experienced non-dating sexual violence; 2.4% experienced sexual dating violence; and 4.9% experienced physical dating violence. Among female students, both emotional and physical abuse by a parent was related to non-dating sexual violence, emotional abuse was related to sexual dating violence, and physical abuse was related to physical dating violence. Among males, emotional abuse by a parent was related to physical dating violence and physical abuse by a parent was related to sexual dating violence. Hunger was associated with sexual and physical dating violence among female students and homeless was associated with physical dating violence among male students. Although there were differences by sex, abuse by a parent, hunger, and homelessness created precarity that may have increased the likelihood that adolescents would be exposed to risky peer or dating relationships. Adolescents need support that stops and prevents experiences of non-dating sexual and dating violence connected to interventions that address adversities experienced during the COVID-19 pandemic.

Prevalence, Perpetrators, and Factors Associated With Intimate Partner Violence Among Adolescents Living in Urban Slums of Kampala, Uganda.

Intimate partner violence (IPV) poses a public health burden, yet few studies have assessed co-existence of physical, emotional, and sexual IPV among adolescents. We assessed recent IPV victimization and associated factors and described IPV patterns and perpetrators among young people from urban slums in Kampala, Uganda. We conducted a prospective cohort study among 14 to 19-year-old individuals enrolled from March 2019 to March 2020 and followed quarterly for 12 months. We collected data on socio-demographics, sexual behavior, and substance use through interviews. Recent IPV victimization was documented at all visits if a participant reported experiencing physical, emotional, and/or sexual IPV in the past 3 months. Baseline factors associated with recent IPV victimization were determined using multivariable logistic regression. We enrolled 490 adolescents (60.6% female) with median age 18 years (Interquartile range (IQR) 17-18 years), 91.0% had less than secondary level education. Females mainly engaged in sex work (17.5%) and selling fruits/snacks (9.1%) while males commonly earned from sale of metal scrap or plastic waste (28.5%), 41% reported ≥10 life-time sexual partners, 16.1% were high-risk alcohol drinkers and 34.9% used illicit drugs in the past 3 months. Overall, 27.8% reported recent IPV victimization (20.0% females) with emotional IPV being common (17.8%). At baseline, recent IPV victimization was associated with high-risk alcohol consumption (adjusted odds ratio [aOR] 2.57; 95% confidence interval [CI] [1.44, 4.58]), reported paid sex in the past 3 months (aOR 1.82; [1.02, 3.22]) and being separated (aOR 2.47; [1.29, 4.73]). Recent IPV victimization declined from baseline to month 9 and increased at month 12 visits which coincided with the COVID-19 pandemic. IPV victimization is high among young people living in urban slums with emotional IPV being prevalent. IPV interventions are needed and should also address excessive alcohol consumption.

Emergency department visits in Connecticut for survivors of sexual assault before and during the COVID-19 pandemic.

STUDY OBJECTIVE: We evaluate the impact of the COVID-19 pandemic on care for survivors of sexual assault in three urban Emergency Departments (ED) in the United States. METHODS: A retrospective chart review was conducted on patients who presented after sexual assault to three EDs during 6-month intervals before and during the COVID-19 pandemic. We excluded individuals <18 years old. We performed a structured chart review to ascertain demographics, ED treatments, and adherence to guidelines for care of sexual assault survivors. RESULTS: Of 105 patients who received care after a sexual assault, 57 presented during the COVID-19 pandemic. The majority were female, White/Caucasian, and presented within 120 h of sexual assault. There was an increase in ED presentations for sexual assault during the pandemic. While there was no difference in medical care, there were fewer sexual assault advocates called during the pandemic. In addition, there was an increase in non-White survivors in the first 3 months of the pandemic that did not remain at 6 months. CONCLUSION: The care of survivors in the ED was disrupted by the COVID-19 pandemic. While medical care remained similar, fewer calls to sexual assault advocates, a key component of ED and long-term care of survivors, demonstrate a disruption in their care.

The Impacts of COVID-19 on Criminal Legal Proceedings and Victim Advocacy for Sexual Assault Survivors

This study examines how sexual assault criminal legal proceedings and victim advocacy services for survivors have been impacted by the COVID-19 pandemic. We interviewed 12 victim advocates at a sexual assault service organization in a large Midwestern city that was particularly impacted by the pandemic. Results indicate that there have been major disruptions to sexual assault case timelines and communication with victims. Victim advocacy for survivors has also been affected, especially the provision of court advocacy and accompaniment. We discuss implications of these findings for sexual assault survivors, service providers, and future emergency preparedness planning for the criminal legal system.

The Relationship between Sextortion during COVID-19 and Pre-pandemic Intimate Partner Violence: A Large Study of Victimization among Diverse U.S Men and Women

In a large and diverse sample of U. S. adults, we assessed participants' experience with pre-COVID in-person intimate partner violence (IPV) victimization and with sextortion victimization during COVID to better understand the relationship between these phenomena. Experiencing sexual IPV pre-COVID increased the likelihood that men and women would experience sextortion during COVID. Men, Black and Native women, LGBTQ individuals, and emerging adults more often experienced sextortion during COVID than other groups. Implications for research on technology-facilitated sexual violence and practice with survivors are explored.

EHealth for Sexual Assault: A Systematic Scoping Review.

Providing efficient psychosocial support for survivors of sexual assault is of critical societal importance. Around the globe, technology-based solutions (eHealth) are increasingly being used to accomplish this task, especially following COVID-19. Despite increased importance and reliance on eHealth for sexual assault, minimal efforts have been made to systematically synthesize research in this area. The present study therefore sought to synthesize what is known about eHealth targeting sexual assault survivors' psychosocial needs using a systematic scoping review methodology. To this end, five databases (CINAHL, Embase, PsycINFO, MEDLINE, and Scopus) were systematically searched for studies published from 2010 onwards using terms such as "sexual assault", "eHealth", "digital health", "telehealth", and variations thereof. Of the 6,491 records screened for eligibility, 85 studies were included in the review. We included empirical studies from all countries pertaining to eHealth for sexual assault for survivors 13 years or older. Many innovative eHealth applications for sexual assault exist today, and the included studies suggested that survivors generally experience eHealth positively and seem to benefit from it. Nevertheless, much more clinical and empirical work is needed to ensure accessible and effective solutions for all.

"So many extra safety layers:" Virtual service provision and implementing social distancing in interpersonal violence service agencies during COVID-19.

The coronavirus pandemic necessitated rapid shifts in approach for service providers working with survivors of interpersonal violence. To reduce the spread of the virus, providers and agencies implemented a rapid and unplanned expansion of virtual services while also developing new protocols to support safe and socially distant in-person services. To understand how these shifts have impacted victim service professionals and the survivors they serve, to provide guidance for on-going efforts, and to inform planning for future public health emergencies, this study asks the question: What approaches did the interpersonal violence workforce use to address social distancing needs during COVID-19? Semi-structured interviews were conducted from July to December 2020 with 33 interpersonal violence service providers from across the United States, and data were analyzed via conventional content analysis with additional steps for data credibility. Findings fall within two primary categories: 1) Technology and Virtual Service Provision; and 2) Social Distancing for In-person Services. Within each category, a number of themes emerged illustrating strengths and challenges of each approach, and the complex web of technological, safety, and public health considerations being balanced in interpersonal violence service agencies. These results provide guidance for the implementation of virtual services in an on-going manner, as well as underscoring the importance of future planning to facilitate effective in-person but physically distant services. There is also a clear need for agencies to support the interpersonal violence workforce to reduce occupational stress and enhance skills and capacities with new forms of services.

An evaluation of a rapid conversion to teleSANE in response to COVID-19.

Sexual Assault Nurse Examiners (SANEs) provide expert, comprehensive medical forensic care to patients who present for services following a sexual assault. Because SANEs are not consistently available, telehealth technology is being explored as a means to provide access to this expert care (i.e., teleSANE). During the COVID-19 pandemic, teleSANE offered additional potential benefits by reducing the length of time spent and number of providers in patient exam rooms, the need for personal protective equipment that was in high demand and short supply, and provider anxiety related to providing in-person care. In the summer of 2020, the Massachusetts SANE program rapidly and temporarily converted five hospitals from in-person SANE care to teleSANE. An evaluation team interviewed 23 providers using a rapid research and evaluation methods approach to assess the temporary model and inform the future of SANE care. Evaluation findings reveal it is possible to rapidly and temporarily convert hospitals from in-person to teleSANE care in a time of broad uncertainty, and that such a change requires intensive and thoughtful planning; a shared commitment to being supportive, flexible, and responsive; and specific experience and expertise. Considerations for communities exploring how best to ensure consistent, equitable access to SANEs are discussed.

Depression, Stress and the Mediating Role of Intimate Partner Violence (IPV) Among Israeli Women of Childbearing Age in the Shadow of the COVID-19 Pandemic.

Dealing with the outbreak of the new coronavirus has generated unprecedented challenges around the world, including in Israel. Women of childbearing age may be forced to live under particularly difficult circumstances during the pandemic. The current study among Israeli women of childbearing age has three main objectives related to the specific period of the COVID-19 pandemic: to study the prevalence and predictors of intimate partner violence (IPV); to investigate the prevalence and predictors of depression; to examine whether IPV mediates the association between general stress, fear of COVID-19 and depression as an outcome. In a cross-sectional study, 722 married women, Jewish and Arab residents of Israel, were recruited to answer an online self-completion questionnaire during the first wave of the COVID-19 pandemic. The questionnaire included an assessment of their degree of general stress and depression, fear of COVID-19, experiences of IPV and demographic variables. The results of the current study show that a high percentage of women reported IPV (with Muslim women reporting higher IPV than Jewish women), perceived stress (PSS), perceived COVID-19 stress and depression. The findings also show that IPV and its three dimensions mediate the relationship between COVID-19 stress and depression, such that higher stress was related to higher IPV, raising the odds for depression. Moreover, the total scores for IPV and emotional violence were found to mediate the relationship between stress and depression. That is, domestic violence explains part of the association between stress and depression during the COVID-19 pandemic. Indeed, the current pandemic has resulted in an increase in IPV and depression, and especially in the specific stress associated with the disease itself. Based on the findings of the current study, preventing violence will reduce stress-related depression. The Muslim population, and especially those who are more religious, is in particular need of intervention.

Intimate Partner Violence During COVID-19 Restrictions: A Study of 30 Countries From the I-SHARE Consortium.

Intimate partner violence (IPV) causes substantial physical and psychological trauma. Restrictions introduced in response to the COVID-19 pandemic, including lockdowns and movement restrictions, may exacerbate IPV risk and reduce access to IPV support services. This cross-sectional study examines IPV during COVID-19 restrictions in 30 countries from the International Sexual HeAlth and REproductive Health (I-SHARE) study conducted from July 20th, 2020, to February, 15th, 2021. IPV was a primary outcome measure adapted from a World Health Organization multicountry survey. Mixed-effects modeling was used to determine IPV correlates among participants stratified by cohabitation status. The sample included 23,067 participants from 30 countries. A total of 1,070/15,336 (7.0%) participants stated that they experienced IPV during COVID-19 restrictions. A total of 1,486/15,336 (9.2%) participants stated that they had experienced either physical or sexual partner violence before the restrictions, which then decreased to 1,070 (7.0%) after the restrictions. In general, identifying as a sexual minority and experiencing greater economic vulnerability were associated with higher odds of experiencing IPV during COVID-19 restrictions, which were accentuated among participants who were living with their partners. Greater stringency of COVID-19 restrictions and living in urban or semi-urban areas were associated with lower odds of experiencing IPV in some settings. The I-SHARE data suggest a substantial burden of IPV during COVID-19 restrictions. However, the restrictions were correlated with reduced IPV in some settings. There is a need for investing in specific support systems for survivors of IPV during the implementation of restrictions designed to contain infectious disease outbreaks.

Special Issue: COVID-19 and vulnerable populations volume/section 1. (Special Issue: COVID-19 and vulnerable populations volume/section 1.)

This special issue consists of 12 papers that explore how synergistic connections between COVID-19 and many health and well-being variables unfolded across the world with different vulnerable populations, including survivors of sexual assault, people with disabilities, college students, Black Americans, caregivers, survivors of domestic violence, pregnant women, and people living in low-income neighborhoods.

Impacts of the COVID-19 pandemic on reporting of rape, serious sexual offences, and domestic abuse in one English police force

Research suggests that during the COVID-19 pandemic reports of rapes and serious sexual offences to the authorities have declined while calls to domestic violence helplines have soared. This article focuses on the impacts of the COVID-19 outbreak on reporting to the police in cases of rape, serious sexual offences and domestic abuse in one police force in England. Data from the force’s crime reporting system was provided from 2018 to 2021, including over 10,000 reports of rapes and serious sexual offences and over 5,000 reports of domestic abuse. An Interrupted Time Series analysis was used to evaluate the impact of lockdown on reporting rates, with segmented regression to measure the changes in reporting before and after the start of the pandemic in March 2020. This article is the first of its kind to explore the impact of COVID-19 on sexual and domestic violence at more than an aggregate level, demonstrating how COVID-19 has had a variable impact on different groups of victims, and how stay at home orders specifically have impacted on reporting rates. These data provide novel and valuable insights into the effects of the COVID-19 pandemic on the reporting of sexual violence and domestic abuse.

Campus Sexual Violence Prevention and Response: Lessons from a Pandemic to Inform Future Efforts.

The COVID-19 pandemic forced institutions of higher education to transition and work in ways that were new and innovative. Even though most colleges and universities transitioned to a virtual platform, the issues that students face continued, including sexual violence (SV). For many campus prevention and response professionals, reaching students during the pandemic posed unique challenges. The COVID-19 pandemic began when the project team was 18-months into a 4-year grant to administer and evaluate the efficacy of a SV prevention and response app, uSafeUS®, at 15 4-year colleges. In this paper, we describe the transition of engaging students with the app in traditional in-person settings to remote and hybrid learning settings. The project team, in collaboration with the campus partners, devised new ways to use the app to support victims of SV and their allies, along with campus professionals in their efforts to support students. These efforts included changes to collaboration (e.g., virtual platforms) and student engagement strategies. We describe how the lessons learned from this transition are important for continuing to engage campus communities in SV prevention and response, even as campuses slowly transitioned back to hybrid and in-person activities. The knowledge gained from this transition are attributable to an ongoing and open collaboration between campus practitioners and the project team.

#MeToo in South Korea: Public Health Meets a Global Movement

Eleven years later, in 2017, #MeToo went viral in response to sexual assault allegations against director Harvey Weinstein.1 Across the world, individuals shared their stories of experiencing gender-based violence and harassment;as of December 2019, the hashtag had more than 24 million impressions.1 Sexual violence is not regularly framed as a social determinant of health, even though the literature linking sexual violence to mental health outcomes such as depression, anxiety, and eating disorders is abundant.2 The momentum resulting from #MeToo prompted a larger question: could a global social movement potentially play a role in improving mental health outcomes for victims of gender-based violence? In 2018, the South Korean government increased both maximum sentence time and the statute of limitations for sexual harassment and sex crimes involving abuse of power.4 However, some of the discourse surrounding #MeToo in South Korea has received pushback and spurred support for men's rights groups.5 #MeToo AS A FAVORABLE HEALTH EXPOSURE The authors' findings suggest that the #MeToo movement had a beneficial effect on depressive symptoms among female survivors of gender-based violence. Social stigma remains a key driver in normalizing sexual violence, potentially lowering reporting rates;it has also been shown to worsen mental health disorders that result from gender-based violence.8 Encouraging discourse and acknowledging the issue's prevalence could have an impact on both the isolation and lack of support survivors typically experience.

IS IT SAFE TO PROVIDE 28 DAY POST-EXPOSURE PROPHYLAXIS (PEP) PACKS IN SEXUAL HEALTH SERVICES, EMERGENCY DEPARTMENTS AND SEXUAL ASSAULT REFERRAL CENTRES?

Introduction Since the beginning of COVID lockdown, we have provided 28 day PEP packs from sexual health clinics, emergency departments and sexual assault referral centres to minimise number of patient contacts. This study is to look at the provision of PEP since the new initiative. Methods Patients who attended our hospital emergency department, sexual assault referral centre, and sexual health clinics between March 2020 and October 2021 were randomly selected. Retrospective patient records were reviewed and the BHIVA 2015 PEP standards were used. Results 434 patients and 468 PEP prescriptions were included. 384 (88%) were male, in whom 337 (87.8%) were MSM. 166 (38.2%) were from our emergency department. 401 (85.7%) were after sexual exposure, 56 (20.0%) were occupational exposure. 413 (88.2%) prescriptions met criteria for initiation, 43 (9.2%) did not and 3 (0.6%) had insufficient information. 448 (95.7%) had baseline blood tests. 28 (6%) did not attend sexual health clinic for follow up. 255 (54.5%) had repeat HIV test after 8-12 weeks of exposure. 213 (45.5%) did not have repeat test. STI screening was performed in 368 (78%) attendances and 106 infections were identified. Discussion The majority of PEP was prescribed appropriately and baseline testing was performed in most cases. Out study demonstrates the safety of 28-day PEP pack being issued in settings other than sexual health clinics. Post-PEP HIV testing remains poor, which is consistent with other national audits. This highlights the need for focussed work to improve followup attendance.

DOMESTIC ABUSE AND/OR VIOLENCE (DA/V) REPORTING BY SERVICE USERS (SUS) OF A REGIONAL ONLINE SEXUALLY TRANSMITTED INFECTION (STI) TESTING SERVICE (E-SERVICE), DURING THE COVID-19 PANDEMIC

Introduction DA/V increased over the pandemic Our e-service widened access during the crisis and introduced three questions to adult SUs enquiring about DA/V. An analysis of SUs triggering these questions is provided. Method E-notes review of SUs who triggered question(s) about current DA/DV, whilst ordering a kit between 17.8.21- 28.2.22. SUs that trigger are automatically offered access to supportive online information. The e-service team don't directly contact these SUs unless there's another reason (e.g. relaying positive STI results). If safe to do so, the triggers are discussed during these calls and further support/counselling offered. Results 3846/231460(1.7%) SU triggered DA/V question(s) between 17.8.21-28.2.22. The first 202 SU e-notes were reviewed: median age 28yrs (18-73yrs);66%(134/202) female;72%(145/202) heterosexual;75%(152/202) UK born. 264 triggers were selected: 27%(55/202) physical/emotional abuse, 81%(164/202) coercive control, and 22%(45/202) sexual abuse. Ten (5%) SUs triggered three DA/V questions, 42(21%) two and 150(74%) one. STI positivity was 4%. 77%(156/202) engaged in high-risk activity. 26%(52/202) had never visited a clinic. Telephonic discussion with the e-service took place in 10%(20/202) SUs: 50%(10/20) received counselling/signposting;10%(2/20) referred to independent DA/V advocate, 30% (6/20) stated historic abuse, 10%(2/20) mistakenly triggered, 5%(1/10) declined support for current abuse and 5%(1/10) disengaged. Of 29%(58/202) SUs who ordered further e-kit(s) 38%(22/58) continued to trigger and 9%(5/58) disclosed sexual assault. Discussion 1.7% SUs reported current DA/V. After attempted contact a supportive DA/V discussion was accepted by 80% SUs. Despite providing online support 38% continued to disclose abuse. Efforts to explore/evaluate safe methods of engaging and supporting DA/V survivors using e-services are required.

Experiences of Women Accessing Violence Against Women Outreach Services in Canada During the COVID-19 Pandemic: a Brief Report.

The COVID-19 pandemic has had significant impacts on violence against women (VAW), including increased prevalence and severity, and on VAW service delivery. The purpose of this research was to study women's experiences with VAW services in the first stages of the pandemic and describe their fears and concerns. This cross-sectional study was conducted from May through October 2020. Our VAW agency partners across Ontario, Canada invited women using outreach services to participate in a study about their experiences during the pandemic. In total, 49 women from 9 agencies completed an online survey. Quantitative data were analyzed with descriptive statistics and open-ended responses are presented to supplement findings. Women's experiences with VAW services during the pandemic varied greatly; some found technology-facilitated services (phone, video, text) more accessible, while others hoped to return to in-person care. Over half of women reported poorer wellbeing, access to health care, and access to informal supports. Many women reported increased relationship-related fears, some due specifically to COVID-19 factors. Our results support providing a variety of technology-based options for women accessing VAW services when in-person care options are reduced. This research also adds to the scant literature examining how some perpetrators capitalized on the pandemic by using new COVID-19-specific forms of coercive control. Although the impacts of the pandemic on women varied, our findings highlight how layers of difficulty, such as less accessible formal and informal support, as well as increased fear - can compound to make life for women experiencing abuse exceptionally difficult.