Assessing the feasibility, acceptability, and initial efficacy of a multiple behavior change intervention addressing alcohol use, sexual risk taking, and bystander intervention.

OBJECTIVE: Prevention programs that address the intersecting health problems of risky alcohol use, unsafe sexual behaviors, and sexual violence are needed. This pilot project assessed the feasibility, acceptability, and preliminary efficacy of a two-session group-based intervention, Sex Positive Lifestyles: Addressing Alcohol & Sexual Health (SPLASH), targeting these highly interconnected risks for college students across genders. METHOD: A total of 217 participants (51.6% male, ages 18-24) took part in the SPLASH intervention or a nutrition/exercise control condition. SPLASH included three approaches aimed at reducing the incidence of alcohol problems, unsafe sex, and sexual victimization: normative feedback to modify misperceptions around peers' drinking, sexual behaviors, and support of bystander intervention; drinking and sexual-related protective behavioral strategy training to enhance safer drinking and sex-risk behaviors; and bystander intervention skills training to promote bystander efficacy and engagement. Participants completed baseline and follow-up (1-month and 6-month) online assessments. RESULTS: SPLASH demonstrated high acceptability and feasibility, as well as preliminary efficacy. SPLASH participants reported strong acceptability of the intervention, particularly its integrated content and interactive, in-person group format. Successful enrollment (70% randomized) and retainment point to the feasibility of recruiting students to this two-session in-person intervention. Results showed sustained trends toward more accurate perceived sex-related norms and indications of increasing bystander norms among intervention but not control participants. CONCLUSIONS: Results demonstrate the potential for SPLASH to effectively address the interrelated health risks of risky alcohol use, unsafe sex, and sexual violence on college campuses and point to the need for larger-scale studies.

Characteristics and Treatment of Cyberviolence Trauma in Children and Adolescents.

Cyberviolence is a new form of violence encompassing any online activity that results in harm to the psychological, emotional, financial, or physical well-being of an individual or group. These adverse activities often lead to serious offline and long-lasting negative impact, especially on children and adolescents whose development has not matured sufficiently. Therefore, it is more important for mental health professionals to be well informed about the rapidly evolving forms of cyberviolence and its risks and to respond appropriately. This article provides an overview of the concept and unique features of cyberviolence trauma in minors in South Korea while also examining ongoing efforts to explore and implement effective treatment programs. Cyberbullying and digital sexual abuse, the most common forms of cyberviolence experienced by minors in South Korea, are explored in detail. Additionally, this review proposes directions for future research and the efforts that clinicians should focus on.

Characterizing myths of sexual aggression in the young population in Spain.

BACKGROUND: Myths of sexual aggression have a negative influence in aggressive behavior against women, in the institutional approaches to sexual violence and in how women cope with it. The objective of this study is to describe acceptance of myths of sexual aggression in young women and men residing in Spain. METHOD: Cross-sectional study carried out online with 2,515 women (50.2%) and men (49.8%) ages 18-35 in Spain in 2020. Information on myths was collected using the Acceptance of Modern Myths About Sexual Aggression Scale (AMMSA). We described the myths most prevalent among women and men. The variables associated with myths were identified using multiple regression. The regression models were adjusted by sociodemographic and sexual orientation variables. RESULTS: The average AMMSA values were higher among men [mean: 3.11; standard deviation (sd):1.23] than among women (mean 2.49 sd:1.11). In both sexes, the myths with greater acceptance showed the presence of patriarchal gender roles in sexual contacts. Men were more likely than women to accept myths that question allegations and severity of violence. Having a higher level of educational studies (ß -0.350 sd: 0.046) was associated with lower average AMMSA values. Being born in Latin America (ß 0.047 sd: 0.063) was associated with higher average AMMSA values. Among heterosexual men, AMMSA values were greater than among gay and bisexual men. Among women, there was no difference in average AMMSA values based on sexual orientation. CONCLUSIONS: Myths persist during youth that question and trivialize sexual violence against women. It is necessary to implement strategies that reduce these myths, particularly in heterosexual men, in those of foreign-born origin and among those with low levels of education.

"I Think You Covered the Three Levels of Drugs and Consent": Qualitatively Testing Different Operationalizations of an Alcohol and Other Drugs-Involved Sexual Violence.

Substance-involved rape is increasing among college students, particularly women (Koss et al., 2022). Addressing rape requires first measuring it accurately in surveys to understand its true scope and nature. We used cognitive interviews with 40 young adults to qualitatively test the construct validity of an alcohol- and other drugs (AOD)-involved rape item in the Sexual Experiences Survey by asking participants to comment on different operationalizations of this construct. Our findings revealed that different phrasings elicited different interpretations of the items by participants. Specifically, the results indicated that (1) respondents viewed the different operationalizations as a sequence of events with varying severity; (2) some participants focused on the intentionality and responsibility of the perpetrator as opposed to opportunistic perpetration; and (3) study participants consistently chose one of the operationalizations as describing "being roofied" (being drugged without consent). Participants also contributed additional scenarios not described in the questionnaire and shared their interpretations of the items. The results underscore the importance of refining survey language to properly measure AOD-involved rape and allow us to understand how to tailor appropriate questions for best comprehension. The findings indicate the benefit in including several items about AOD-involved rape in questionnaires such as the Sexual Experiences Survey, with each item addressing different scenarios of victim intoxication. The results could also have important implications for sexual violence prevention programs, which should discuss consent, intentions, and responsibility specifically in the context of AOD consumption.

Whom Would You Help? The Impact of Perpetrator and Victim Gender on Bystander Behavior During a Sexual Assault.

We examined the impact of perpetrator and victim gender on bystander helping choices and assault perceptions. Participants (32 females, 37 males) read about two simultaneously occurring sexual assaults, indicated which victim they would help, and gave their perceptions of the assaults. We used a within-participants design that fully manipulated the perpetrator and victim gender for both assaults. Results showed female victims of male perpetrators and male victims of female perpetrators were most and least likely to be chosen for help, respectively. Cognitive networks derived from open-ended responses provided insight into the rationale used by participants to make helping decisions in ways that differed by perpetrator and victim gender.

Development and Usability of a Mobile Support Application for Sexual Violence Victims Connecting With Formal Support Organizations.

The lack of awareness and accessibility about the support organizations for preventing sexual violence and assisting victims hampers the effectiveness of the social safety net. A mobile application based on a connection to support agencies was developed and evaluated for usability. A group of 15 experts and a group of 30 users evaluated usability. The developed mobile application focused on "Emergency Report," "Support Agencies and Services," and "Counseling for Support." The strength of the application was acknowledged in providing easy-to-find, reliable, useful, and necessary information, highlighting the positive usability and applicability of the mobile support application for sexual violence victims.

A Study on Economic Stressors During the COVID-19 Pandemic Among Intimate Partner and Sexual Violence Survivors in the United States.

Systemic racism and racialized poverty are socially produced structural determinants that shape health outcomes during infectious disease outbreaks. Public health emergencies compound vulnerabilities for survivors of intimate partner violence (IPV) and sexual violence (SV) and those who self-identify as people from racial and ethnic minority groups. We describe findings from an online survey designed to collect data on financial conditions faced by survivors of IPV and SV to understand these conditions during the COVID-19 pandemic. Our analyses were limited to a sample of women in the United States (91.4%, n = 523) who reported IPV or SV to whom we refer as survivors. We characterize the differences of economic stressors across White and aggregated categories of self-identified race, i.e., Black and Brown Latinx women and non-Black or non-Brown Latinx women of color, to highlight disparities between White and non-White populations in our sample. Logistic regressions were used to examine the relationships among racial categories, food insecurity, housing insecurity, and economic insecurity during the COVID-19 pandemic. Black and Brown Latinx women survivors were twice as likely as White women to report housing, financial, and economic insecurity during the COVID-19 pandemic. Approximately one-third of all survivors anticipated taking on more debt than they would want to cover their expenses due to COVID-19. The results of this study have implications for public health responses that involve coordinating economic relief measures among populations disparately affected by public health crises and disasters to ensure that the economic needs of the most impacted are addressed.

"It is like a curse". The lived experiences of the intersection of intergenerational violence, pregnancy, and intimate partner violence among urban Wisconsin Indigenous women.

BACKGROUND: Intimate Partner Violence (IPV) is a significant public health concern that disproportionately impacts Indigenous American women more than any other ethnic/racial group in the United States. PURPOSE: This study aims to inform the work of nurses and allied health professionals by providing insight into the lived realities of Indigenous women in urban areas and how IPV manifests in the lives of Indigenous women. METHODS: Postcolonial and Indigenous feminist frameworks informed this qualitative study. Using thematic analysis, we analyzed data from semi-structured individual interviews with 34 Indigenous women in large urban areas in the upper Midwest. FINDINGS: This manuscript discusses one broad theme: experiences of IPV during pregnancy and the devastating impacts on women and their children in the form of intergenerational trauma. Under this broad theme, we identified two sub-themes: impacts of IPV on individual pregnancy experiences and linkages to adverse pregnancy-related outcomes related to physical IPV during the childbearing years. CONCLUSION: This Indigenous-led study informs the development of effective Indigenous-specific interventions to minimize barriers to accessing prenatal care and help-seeking when experiencing IPV to reduce the devastating consequences for Indigenous women and their families.

Unveiling the Elephant in the Room: How do Psychologists Perceive Individuals Convicted of Sexual Offenses?

The societal reintegration of individuals with criminal records, particularly involving sexual offenses, faces challenges due to moral condemnation. Professionals' perspectives are pivotal in facilitating this reintegration process. This study surveyed 314 psychologists via a web-based experiment to assess their judgments regarding allegations of sexual violence and perpetrator's denial. Psychologists with experience in working with individuals convicted of sexual offenses showed a decreased propensity to grant prison benefits upon the progressive disclosure of the sexual offense, which diminished further in the presence of denial. For psychologists lacking such professional experience, judgment worsened solely with the discovery of the sexual offense, but not with denial. Psychologists not experienced in working with individuals with sexual convictions were generally found to have higher levels of malignant satisfaction than their experienced counterparts. Additionally, experienced psychologists exhibited a greater willingness to manage forensic cases and endorsed the effectiveness of treatment, while non-experts displayed less confidence in treatment efficacy, hesitancy in working with such individuals, and a propensity to delegate the case. Availability to handle the case diminished as more information surfaced for both groups. These findings highlight differences in professionals' attitudes based on experience and suggest implications for understanding punitive attitudes towards individuals with sexual convictions.

Bodily Autonomy and Trauma: Understanding the Nature of the Association Between Sexual Trauma, an External Locus of Control, and Depressive Symptoms.

There is growing evidence suggesting an increased perception of control is associated with reduced psychological distress among survivors of sexual trauma. The current study advances the extant literature by investigating the association between depressive symptoms, sexual trauma, and an external locus of control or the perception life events are outside one's own control. To do so, we analyze data from the New Family Structures Study, a nationally representative survey of U.S. adults ages 18-39. Results from ordinary least square regression analyses suggest sexual trauma and an external locus of control are associated with significantly greater depressive symptoms and that external control exacerbates the association between sexual trauma and depression. Such findings suggest future research should investigate environmental control for sexual trauma survivors in areas such as prenatal care and the justice system.

Drug-facilitated sexual assault in youth nightlife contexts in Spain.

OBJECTIVES: This study aimed to provide epidemiological information on drug-facilitated sexual assault in Spanish youth partying, with a focus on prevalence rates and associated sociodemographic factors. STUDY DESIGN: Cross-sectional study. METHODS: Quota sampling was used to recruit 1601 young people aged 18-35 years in Spain from a digital panel. A validated questionnaire on drug-facilitated sexual assault was used to assess five types of lifetime victimisation experiences while partying. Chi-square and the exact Fisher tests were used to describe the prevalence of victimisation, drug use patterns, and perpetrator profiles. Generalised ordered logistic regression was used to explore factors associated with victimisation, analysed by gender. RESULTS: Half of young women and one-quarter of young men had experienced drug-facilitated sexual assault in their lifetime. Female victimisation due to touching and kissing was notably high, whereas men comprised almost half of the victims of more invasive DFSA experiences involving masturbation, penetration, and oral sex. Opportunism prevailed as the assault tactic, consisting of taking advantage of the victims' incapacity derived from voluntary alcohol use. Among women, risk of victimisation was associated with a lower education level, foreign-born status, and being non-heterosexual. Male victimisation risk was highest among non-heterosexual men. CONCLUSIONS: Drug-facilitated sexual violence in youth nightlife contexts is a serious public health issue in Spain, which requires urgent action. Most assaults involve taking advantage of victims who are incapacitated by the effects of voluntary alcohol consumption. This sexual violence primarily affects women with lower educational levels or those who are foreign-born and non-heterosexual men and women.

Online sexual violence prevention on a female college campus in India: Evaluation of the RISE-ON program.

Background: Sexual violence represents a severe problem for young Indian women and requires effective prevention. Since face-to-face prevention programs are limited in reach, we developed the online sexual violence prevention program RISE-ON consisting of three modules, namely Gender, Sexual Violence, and Bystander Education. The study's objective is to investigate the short-term effects of the RISE-ON modules on participants' knowledge and attitudes. Method: A total of N = 244 female college students from Delhi aged 17 to 22 were randomly assigned to 1 of 3 groups with two of the three modules. By design, each group functions as a treatment group for the two included modules and as a control group for the third, missing module. Results: From pre- to posttest, there were significantly larger increases of participants' knowledge on gender, sexual violence, and bystander education in the treatment than in the control group. Concerning attitudes, we found significant increases for gender awareness and bystander attitudes across all groups. Conclusions: This study demonstrates that the RISE-ON modules are effective in terms of increasing knowledge, but there were no module-specific changes of attitudes. Thus, future online prevention programs need to focus increasingly on attitudes, especially attitudes about sexual violence, and behavior change.

The Association Between Sexual Violence and Suicidal Ideation Among Transgender Women and the Role of Gender-Affirming Healthcare Providers in Seven Urban Areas in the United States, 2019 to 2020.

Transgender women are disproportionately affected by sexual violence and corresponding mental health sequelae; however, many do not access healthcare due to experiences with transphobia. This analysis evaluated the association between sexual violence and suicidal ideation and the moderating effect of having a healthcare provider (HCP) with whom transgender women were comfortable discussing gender-related issues ("gender-affirming HCP"). We analyzed cross-sectional data from the Centers for Disease Control and Prevention's National HIV Behavioral Surveillance among Transgender Women (NHBS-Trans). Transgender women were recruited using respondent-driven sampling from seven urban areas from 2019 to 2020 and participated in an HIV biobehavioral survey. This analysis was restricted to transgender women who visited a HCP in the past 12 months ("healthcare-seeking transgender women" [HSTW]) (N = 1,489). Log-linked Poisson regression models provided adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) to estimate the association between sexual violence and suicidal ideation in the past 12 months. The interaction between sexual violence and having a gender-affirming HCP was statistically significant (p-value = .034). Among 1,489 HSTW, 225 (15.1%) experienced sexual violence and 261 (17.5%) reported suicidal ideation; 1,203 (80.8%) reported having a gender-affirming HCP. Sexual violence was associated with suicidal ideation (aPR = 2.65, 95% CI [2.08, 3.38]); the association was notably higher among those who did not have a gender-affirming HCP (aPR = 3.61, [2.17, 6.02]) than among those who did (aPR = 1.87, [1.48, 2.37]). Eliminating transphobia and promoting trauma- and violence-informed approaches in healthcare are necessary for sexual violence and suicide prevention among HSTW.

Preventing Sexual Violence: A Behavioral Problem Without a Behaviorally Informed Solution.

What solutions can we find in the research literature for preventing sexual violence, and what psychological theories have guided these efforts? We gather all primary prevention efforts to reduce sexual violence from 1985 to 2018 and provide a bird's-eye view of the literature. We first review predominant theoretical approaches to sexual-violence perpetration prevention by highlighting three interventions that exemplify the zeitgeist of primary prevention efforts at various points during this time period. We find a throughline in primary prevention interventions: They aim to change attitudes, beliefs, and knowledge (i.e., ideas) to reduce sexual-violence perpetration and victimization. Our meta-analysis of these studies tests the efficacy of this approach directly and finds that although many interventions are successful at changing ideas, behavior change does not follow. There is little to no relationship between changing attitudes, beliefs, and knowledge and reducing victimization or perpetration. We also observe trends over time, including a shift from targeting a reduction in perpetration to targeting an increase in bystander intervention. We conclude by highlighting promising new strategies for measuring victimization and perpetration and calling for interventions that are informed by theories of behavior change and that center sexually violent behavior as the key outcome of interest.

Examining Parental Abilities to Recognize Sexual Grooming Behaviors of Child Sexual Abusers.

PURPOSE: Identifying sexual grooming behaviors holds potential to reduce the occurrence of child sexual abuse (CSA) and increase disclosure rates. Given the influential role parents play in CSA prevention and the lack of previous research examining parent-specific sexual grooming recognition abilities, this study examined both generalized adult (i.e., parent and nonparent) and parent special abilities to recognize sexual grooming behaviors as identified in the Sexual Grooming Model (SGM), as well as the relationship between reported confidence in recognition abilities and measured abilities. METHODS: The current study used an experimental vignette design among a sample of 420 parents and 445 nonparents to measure abilities to associate sexual grooming behaviors with CSA. Participants also rated how confident they felt in their abilities to recognize signs of sexual grooming. RESULTS: Parental status did not have a significant impact on sexual grooming recognition abilities. However, the sample as a whole (i.e., parents and nonparents combined) were more likely to recognize sexual grooming when presented with behaviors from all of the SGM's stages or behaviors related to desensitization to touch and sexual content. Participant confidence in their recognition abilities did not predict measured abilities. CONCLUSION: Regardless of parental status, the sample did not strongly associate sexual grooming behaviors with CSA perpetration except when behaviors related to sexual content and physical touch were presented. This suggests heightened associations of more overt sexual grooming behaviors with CSA. The discrepancy found between confidence and recognition abilities calls for targeted educational efforts to increase awareness in types of behaviors that may be indicative of abuse.

Sexual violence among female survivors in Goma, in the Democratic Republic of the Congo: epidemiology, clinical features, and circumstances of occurrence.

Sexual violence (SV) is a major public health issue in Goma, Democratic Republic of the Congo, especially in the eastern part of the country where women have been victims of SV for many years. The objective of this study is to provide an overview of the survivor and perpetrator characteristics, as well as the circumstances surrounding SV incidents in Goma. We conducted a retrospective, descriptive cross-sectional study using data from all SV survivors who sought medical care at four hospitals in Goma from January 2019 to December 2020. The analysis of the data was carried out using STATA 16 software. A total of 700 women sought medical attention for SV in the four hospitals. The survivors' age range was 12-67 years with a mean age of 31.7 ± 14.6 years. Women aged 20-29 years were the most affected (28%). The majority of SV survivors experienced their first assault (88.29%) and sought medical attention within 72 h (60.6%). The assaults occurred mostly outside the SV survivors' homes under armed threat (84.29%), predominantly by men in civilian clothes (61.43%) compared to men in military uniform (38.57%). More than half of the survivors were assaulted by a stranger (64.71%), and of those, more than half were committed by a single perpetrator (57.29%). The findings underscore the urgent need to address this pervasive issue, emphasizing the necessity of targeted interventions to protect survivors and prevent future incidents. The circumstances surrounding these assaults, such as the prevalence of armed threats and attacks outside survivors' homes, highlight the complex challenges in combating SV in this region.

Intimate Partner Sexual Violence in Emerging Adulthood: Exploring Sexual Consent Attitudes as a Target for Sexual Coercion Prevention.

While intimate partner violence is now recognized as a major societal and international issue, sexual violence between partners remains understudied despite its significant prevalence rates and the specific contexts in which it occurs. The aim of this study was to analyze the links between different dimensions of sexual consent and sexual coercion experienced within intimate relationships in order to identify targets for prevention campaigns. The study was carried out during a time of transition in the sociopolitical and legislative context in Belgium linked to the implementation of a reform to the sexual criminal law, which has made the expression of sexual consent central to the qualification of sexual offenses. A total of 431 young adults (88.40% female; Mage = 22.19 years; SDage = 1.79) were recruited from the general population through an online survey to analyze the links between attitudes and beliefs toward sexual consent, attachment style, mental health, and sexual victimization between partners. Results showed that a lack of perceived behavioral control over establishing sexual consent, as well as the avoidance of intimacy, predicted sexual victimization. The clinical implications of these findings are discussed and potential public policy responses for prevention and awareness are suggested. Future research should further investigate and conceptualize sexual consent as it relates to sexual coercion in a more representative sample from an intersectional perspective.

Individual and contextual determinants of early access to post-rape care: A retrospective cohort study of 4048 women in the Democratic Republic of Congo from 2014 to 2019.

BACKGROUND: Armed conflict in the eastern Democratic Republic of Congo (DRC) has significantly increased the incidence of sexual violence against women. Victims who manage to access health care within 72 h of experiencing rape can receive critical preventive care to mitigate the consequences of such violence. Despite this, a disproportionately small number of victims are able to obtain medical care within this crucial time frame. This study aimed to identify both individual and contextual factors that influence the likelihood of accessing post-rape care within 72 h in the eastern DRC. METHODS: This retrospective cohort study utilized patient records from Panzi Hospital along with contextual data provided by the South Kivu Provincial Ministry of Health. It encompassed rape victims residing in South Kivu province who sought post-rape care between 2014 and 2019. To identify individual and contextual factors influencing timely access to care (within 72 h), multilevel logistic regression analysis was employed. RESULTS: The study included a total of 4,048 women, with 30 % being under 18 years old and 40 % married. Around 13 % accessed care within 72 h of rape. Multivariate analysis revealed that timely access to care (within 72 h) was negatively influenced by factors such as the isolation of the victim's health zone of residence (aOR = 0.29 [0.14-0.63], p = 0.002), the distance between the home health zone and the hospital (aOR = 0.75 [0.54-0.99], p = 0.041), instances of rape occurring in 2015 or earlier (aOR = 0.44 [0.34-0.57], p < 0.001), and referrals to the hospital from other health facilities or organizations (aOR = 0.78 [0.61-1.00], p = 0.049). Conversely, being single was positively associated with access to care within this critical period (aOR = 1.29 [1.03-1.61], p = 0.024). Furthermore, statistical trends indicate that the presence of Panzi partner NGOs in the victim's health zone might facilitate access to care (aOR = 1.33 [0.99-1.80], p = 0.057), highlighting an area of interest, while being internally displaced at the time of rape was associated with a trend towards reduced access to care (aOR = 0.78 [0.59-1.02], p = 0.068), underscoring the need for further research and targeted interventions. CONCLUSION: To enhance access to post-rape care, our study highlights the need for strengthened collaboration with all partnering organizations and focused efforts on raising awareness, particularly among married women and their husbands. Enhancing security measures, constructing or upgrading roads to better connect major cities with currently inaccessible or isolated areas, bolstering the efforts of both local and international NGOs, and offering comprehensive reproductive health services to internally displaced women and those residing in the victims' health zones, are crucial steps toward ensuring access to post-rape care within the critical 72-hour window.

Unveiling the shadows: Investigating the interplay of stalking and sexual homicide-A case study.

Stalking can be defined as a pattern of fixated, repeated, and unwanted behaviours. Stalking is not an isolated incident and was associated to sexual violence. While the relationship between sexual violence and stalking is scarcely explored, no studies have tested the relationship between stalking and sexual homicide, which both involves elements of obsession. The aim of this paper was to study the relationship between stalking and sexual homicide using an exploratory case study analysis of 7 males convicted for sexual homicide. Results revealed: (1) The presence of obsession prior to the homicide; (2) The victims were ex-intimate partners or acquaintances; (3) The victims were followed several times prior to the index offence; (4) Stalking elements were not always considered by the authorities, which has led to an escalation of behaviours. This study expands our understanding between stalking and sexual violence, supporting the design of prevention and treatments.