Transgressive women don't deserve protection: Young men's narratives of sexual violence against women in rural Papua New Guinea

Sexual violence against women and girls is commonplace in Papua New Guinea (PNG). While the experiences of women are rightly given central place in institutional responses to sexual violence, the men who perpetrate violence are often overlooked, an oversight that undermines the effectiveness of prevention efforts. 

This paper draws on interviews conducted with young men as part of a qualitative longitudinal study of masculinity and male sexuality in a rural highland area of PNG. It explores one aspect of male sexuality: men's narratives of sexual violence. Most striking from the data is that the collective enactment of sexual violence against women and girls is reported as an everyday and accepted practice amongst young men. However, not all women and girls were described as equally at risk, with those who transgress gender roles and roles inscribed and reinforced by patriarchal structures, at greater risk. 

To address this situation, efforts to reduce sexual violence against women and girls require an increased focus on male-centred intervention to critically engage with the forms of patriarchal authority that give license to sexual violence. Understanding the perceptions and experiences of men as perpetrators of sexual violence is a critical first step in the process of changing normative perceptions of gender, a task crucial to reducing sexual violence in countries such as PNG.

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By:  Kelly-Hanku A1,2, Aeno H1, Wilson L3, Eves R4, Mek A1, Nake Trumb R1, Whittaker M5, Fitzgerald L5, Kaldor JM1, Vallely A2.

• 1 Sexual and Reproductive and Maternal Health Unit , Papua New Guinea Institute of Medical Research , Goroka , Papua New Guinea.
• 2 Kirby Institute, UNSW Australia , Sydney , Australia.
• 3 School of Political Science and International Studies , University of Queensland , St Lucia , Australia.
• 4 State, Society and Governance in Melanesia Program , Australian National University , Canberra , Australia.
• 5 School of Public Health , University of Queensland , Herston , Australia.
• Cult Health Sex. 2016 Jun 2:1-14. 

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Correlates of Sexual Violence among Men Who Have Sex with Men in Tijuana, Mexico

Sexual violence among men who have sex with men (MSM) is prevalent in developing countries and is associated with increased HIV/STI risk. Despite high HIV prevalence (20 %) among MSM in Tijuana, Mexico, little attention has been paid to the occurrence of sexual violence in this high-risk group. 

The present study used a syndemic conditions framework to examine correlates of sexual violence victimization in a sample of 201 MSM surveyed in Tijuana, Mexico during 2012 and 2013. Participants were recruited through respondent-driven sampling and underwent a 2-h baseline interview and testing for HIV and syphilis. Sexual violence was defined as any incident during the past year in which the participant had been raped, sexually molested, or sexually harassed. 

The majority of participants self-identified as gay or bisexual, had never married, were employed, and had a high school education or greater. The average age was 29.7 years. Thirty-nine percent reported sexual violence in the past year. A hierarchical multiple linear regression model predicting more experiences of sexual violence was tested. In a final model, a higher number of experiences of sexual violence was associated with a history of childhood sexual abuse, more adult experiences of homophobia, more depression and hostility symptoms, and not living with a spouse or steady partner. 

The findings from this study support a model of co-occurring psychosocial factors that increase the likelihood of sexual violence experiences among MSM. Multi-level approaches to the prevention of childhood and adult experiences of sexual violence and homophobia are needed to avert the development of adverse mental and physical health outcomes associated with sexual violence victimization.

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By:  Semple SJ1, Stockman JK2, Goodman-Meza D3, Pitpitan EV2, Strathdee SA2, Chavarin CV1, Rangel G4, Torres K5, Patterson TL6.

• 1Department of Psychiatry, University of California San Diego, Mail Code 0680, 9500 Gilman Drive, La Jolla, CA, 92093-0680, USA.
• 2Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
• 3Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
• 4US-Mexico Border Health Commission, Tijuana, Mexico.
• 5Agencia Familiar Binacional, A.C., Tijuana, Mexico.
• 6Department of Psychiatry, University of California San Diego, Mail Code 0680, 9500 Gilman Drive, La Jolla, CA, 92093-0680, USA. tpatterson@ucsd.edu. 
• Arch Sex Behav. 2016 May 13. 

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Social Support, Sexual Violence, and Transactional Sex among Female Transnational Migrants to South Africa

OBJECTIVES:

To examine the relationship between sexual violence and transactional sex and assess the impact of social support on this relationship among female transnational migrants in Cape Town, South Africa.

METHODS:

In 2012 we administered a behavioral risk factor survey using respondent-driven sampling to transnational migrant women aged between 16 and 39 years, born outside South Africa, living in Cape Town, and speaking English, Shona, Swahili, Lingala, Kirundi, Kinyarwanda, French, or Somali.

RESULTS:

Controlling for study covariates, travel-phase sexual violence was positively associated with engagement in transactional sex (adjusted prevalence ratio [APR] = 1.38; 95% confidence interval [CI] = 1.07, 1.77), and social support was shown to be a protective factor (APR = 0.84; 95% CI = 0.75, 0.95). The interaction of experienced sexual violence during migration and social support score was APR = 0.85 (95% CI = 0.66, 1.10). In the stratified analysis, we found an increased risk of transactional sex among the low social support group (APR = 1.56; 95% CI = 1.22, 2.00). This relationship was not statistically significant among the moderate or high social support group (APR = 1.04; 95% CI = 0.58, 1.87).

CONCLUSIONS:

Programs designed to strengthen social support may reduce transactional sex among migrant women after they have settled in their receiving communities. 

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By:  Giorgio M1, Townsend L1, Zembe Y1, Guttmacher S1, Kapadia F1, Cheyip M1, Mathews C1.

• 1At the time of this study, Margaret Giorgio, Sally Guttmacher, and Farzana Kapadia were with the Department of Nutrition, New York University, New York, NY. Loraine Townsend, Yanga Zembe, and Catherine Mathews are with the Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa. Mireille Cheyip is with the Centers for Disease Control and Prevention, Pretoria, South Africa. 
• Am J Public Health. 2016 Apr 14:e1-e7

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A Prospective Cohort Study of Intimate Partner Violence and Unprotected Sex in HIV-Positive Female Sex Workers in Mombasa, Kenya

We conducted a prospective cohort study to test the hypothesis that intimate partner violence (IPV) is associated with unprotected sex in HIV-positive female sex workers in Mombasa, Kenya. 

Women completed monthly visits and quarterly examinations. Any IPV in the past year was defined as ≥1 act of physical, sexual, or emotional violence by the current or most recent emotional partner ('index partner'). Unprotected sex with any partner was measured by self-report and prostate specific antigen (PSA) test. 

Recent IPV was associated with significantly higher risk of unprotected sex after adjusting for age, alcohol use, and sexual violence by someone besides the index partner. 

Addressing IPV in comprehensive HIV programs for HIV-positive women in this key population is important to improve wellbeing and reduce risk of sexual transmission of HIV.

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By:  Wilson KS^1,2, Deya R³, Yuhas K³, Simoni J⁴, Vander Stoep A⁵, Shafi J^6,7, Jaoko W⁶, Hughes JP⁸, Richardson BA^3,8, McClelland RS^3,5,9,6.

Author information

¹Department of Global Health, University of Washington, Box 359931, Seattle, 98104, USA. ksw@uw.edu.

²Department of Epidemiology, University of Washington, Seattle, USA. ksw@uw.edu.

³Department of Global Health, University of Washington, Box 359931, Seattle, 98104, USA.

⁴Department of Psychology, University of Washington, Seattle, USA.

⁵Department of Epidemiology, University of Washington, Seattle, USA.

⁶University of Nairobi, Nairobi, Kenya.

⁷Coast Province General Hospital, Mombasa, Kenya.

⁸Department of Biostatistics, University of Washington, Seattle, USA.

⁹Department of Medicine, University of Washington, Seattle, USA.

AIDS Behav. 2016 Apr 19. [Epub ahead of print]

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The impact of violence on sex risk and drug use behaviors among women engaged in sex work in Phnom Penh, Cambodia

HIGHLIGHTS

• Almost half the women engaged in sex work reported violence in the past 12 months.
• Prior physical violence exposure associated with subsequent sexual risk taking.
• Physical violence was associated with amphetamine type stimulant (ATS) use.
• Sexual violence was associated lower levels of condom use with non-paying partners.

BACKGROUND:

Violence, substance use, and HIV disproportionately impact female entertainment and sex workers (FESW), but causal pathways remain unclear.

METHODS:

We examined data from an observational cohort of FESW age 15-29 in Phnom Penh, Cambodia for associations between violence exposure and sexual risk and drug use. Validated measures of physical and sexual violence were assessed at baseline. Self-reported outcomes measured quarterly over the next 12-months included past month sexual partners, consistent condom use by partner type, sex while high, and amphetamine type stimulant (ATS) use. Biomarkers measured quarterly included prostate specific antigen (PSA) and urine toxicology. Generalized estimating equations were fit adjusting for age, education, marital status and sex work venue.

RESULTS:

Of 220 women, 48% reported physical or sexual violence in the preceding 12-months. Physical violence was associated with increased number of sex partners (adjusted incidence rate ratio [aIRR] 1.33; 95% CI: 1.04-1.71), greater odds of sex while high (adjusted odds ratio [aOR] 2.42; 95% CI: 1.10-5.33), increased days of ATS use (aIRR 2.74; 95% CI: 1.29-5.84) and increased odds of an ATS+ urine screen (aOR 2.80, 95%CI: 1.38-5.66). Sexual violence predicted decreased odds of consistent condom use with non-paying partners (aOR 0.24; 95% CI: 0.10-0.59) and greater odds of a PSA+ vaginal swab (aOR 1.83; 95% CI: 1.13-2.93).

CONCLUSIONS:

Physical and sexual violence are prevalent among Cambodian FESW and associated with subsequent sexual risk and drug use behaviors. Clinical research examining interventions targeting structural and interpersonal factors impacting violence is needed to optimize HIV/AIDS prevention among FESW.

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By:  Draughon Moret JE1, Carrico AW2, Evans JL3, Stein ES4, Couture MC5, Maher L6, Page K7; Young Women’s Health Study Collaborative.

• 1The Betty Irene Moore School of Nursing at UC Davis, 4610 X Street, #4202 Sacramento, CA 95817, United States. Electronic address: jdmoret@ucdavis.edu.
• 2University of California San Francisco, School of Nursing, 2 Koret Way, San Francisco, CA 94143, United States. Electronic address: adam.carrico@ucsf.edu.
• 3UCSF Global Health Sciences/Prevention and Public Health Group, Mission Hall, 550 16th St., Third Fl., Box 1224, San Francisco, CA 94158, United States. Electronic address: jennifer.evans@ucsf.edu.
• 4UCSF Global Health Sciences/Prevention and Public Health Group, Mission Hall, 550 16th St., Third Fl., Box 1224, San Francisco, CA 94158, United States. Electronic address: ellen.stein@ucsf.edu.
• 5University of San Francisco, School of Nursing and Health Professions, Department of Population Sciences, 2130 Fulton St., San Francisco, CA 94117, United States. Electronic address: mcouture@usfca.edu.
• 6The Kirby Institute for Infection and Immunity, UNSW Australia, Sydney, NSW 2052, Australia. Electronic address: lmaher@kirby.unsw.edu.au.
• 7Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences Center, Department of Internal Medicine, MSC 10 5550, 1 University of New Mexico, Albuquerque, NM 87131, United States. Electronic address: pagek@salud.unm.edu.
• Drug Alcohol Depend. 2016 Apr 1;161:171-7. doi: 10.1016/j.drugalcdep.2016.01.028. Epub 2016 Feb 6. 

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The Prevalence of Sexual Violence: Results from a Population-Based Sample

Background

Sexual violence can cause severe mental and bodily harm. This is the first study of a population-based sample in Germany to assess both the frequency of the subjects’ having experienced sexual violence and the frequency of their having manifested sexually aggressive behavior themselves.

Methods

2513 persons (of whom 2422 were over age 18 and 91 were aged 14 to 18) were asked about their experiences with sexual violence in the past 12 months, either as the person committing sexual violence or as the victim of sexual violence at the hands of other adults or similarly aged adolescents.

Results

0.6% (n = 6) of the men and 1.2% (n = 16) of the women surveyed, and ca. 5% (n = 4) of the adolescents surveyed, reported having been the victim of some kind of sexual violence. 1.5% (n = 15) of the men and 1.0% (n = 13) of the women reported that they themselves had manifested sexually aggressive behavior. Women were over-represented and adolescents underrepresented in the sample, in comparison with the overall population.

Conclusion

These findings suggest that the prevalences of experiences of sexual violence and of sexually aggressive behavior are markedly underestimated in official crime statistics, particularly with respect to events in which women commit sexual violence and men are victims of it. Prevalences were assessed in this study from self-reported information; the findings may thus have been distorted by a tendency on the part of the informants to give answers they thought would be socially acceptable, particularly with respect to their own sexually aggressive behavior. Moreover, the small overall number of events complicates the interpretation of the findings.

Key Messages

• In 2015, 2513 persons in a population-based representative sample were asked questions about sexual violence.
• 0.6% of adult men and 1.2% of adult women reported having experienced sexual violence in the last 12 months.
• 1.5% of adult men and 1.0% of adult women reported having behaved in a sexually aggressive way themselves in the last 12 months.
• The present survey yielded higher percentages of women as perpetrators and of men as victims of sexual violence than the official crime statistics.
• Increased sensitivity for the prevalence of experienced sexual violence can help the affected persons obtain the help they need.

Full article at:   http://goo.gl/1mZWB2

By:  Marc Allroggen, Dr. med.,*,1 Miriam Rassenhofer, Dipl.-Psych.,1 Andreas Witt, Dipl.-Psych.,1 Paul L Plener, PD Dr. med.,1 Elmar Brähler, Prof. Dr. rer. biol. hum.,2,3 and Jörg M Fegert, Prof. Dr. med.1

¹Department of Child- and Adolescent Psychiatry and Psychotherapy, Ulm University Hospital

²Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center

³Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz

*Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Steinhövelstr. 5, D-89075 Ulm, Germany,

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Attitudes Toward Sexual Violence Survivors: Differences Across Professional Sectors in Kenya and the Democratic Republic of the Congo

Sexual violence survivors who decide to report their assault interact with health care, law enforcement, and legal and judicial professionals. Professionals' attitudes about sexual violence and survivors play an important role in caring for survivors and in the pursuit of justice. Despite evidence showing the relationship between service provider beliefs and survivor outcomes, relatively little is known about professionals' beliefs about sexual violence or their attitudes toward sexual violence survivors. 

Between June 2012 and December 2014, our study examined the beliefs and attitudes of 181 professionals from the health care, legal, and law enforcement sectors in the Eastern Democratic Republic of the Congo (DRC) and the Rift Valley region of Kenya, areas with a high prevalence of sexual violence. To determine correlates of beliefs and attitudes about sexual violence and sexual violence survivors, multiple logistic regression models were adjusted for demographic and occupational characteristics. 

Respondents who agreed that survivors got what they deserved (7%) or that survivors should feel ashamed (9%) were the minority, while those who would be willing to care for a family member with a history of sexual violence (94%) were the majority. Profession was significantly associated with beliefs and attitudes about sexual violence and survivors. Law enforcement professionals were more likely than health professionals and lawyers to indicate that survivors should feel ashamed. 

Our findings suggest a need for interventions that adequately address potentially harmful beliefs and attitudes of some professionals serving sexual violence survivors.

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By:  Ferdowsian H1, Kelly S2, Burner M3, Anastario M4, Gohlke G5, Mishori R6, McHale T7, Naimer K7.

• 1Georgetown University School of Medicine, Washington, DC, USA Physicians for Human Rights, Boston, MA, USA hopemd@gwu.edu.
• 2George Washington University, USA.
• 3Johns Hopkins University, Baltimore, MD, USA.
• 4RTI International, Research Triangle Park, NC, USA.
• 5Berkeley School of Law, Berkeley, CA, USA.
• 6Georgetown University School of Medicine, Washington, DC, USA.
• 7Physicians for Human Rights, Boston, MA, USA. 

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Sexual Violence Against Female and Male Children in the United Republic of Tanzania

During a household survey in Tanzania, a nationally representative sample of females and males aged 13-24 years reported any experiences of sexual violence that occurred before the age of 18 years. The authors explore the prevalence, circumstances, and health outcomes associated with childhood sexual violence. 

The results suggest that violence against children in Tanzania is pervasive, with roughly three in 10 females and one in eight males experiencing some form of childhood sexual violence, and its health consequences are severe. 

Results are being used by the Tanzanian government to implement a National Plan of Action.

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By:  Vagi KJ1, Brookmeyer KA2, Gladden RM2, Chiang LF2, Brooks A3, Nyunt MZ4, Kwesigabo G5, Mercy JA2, Dahlberg LL2.

• 1U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA kvagi@cdc.gov.
• 2U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.
• 3UNICEF Afrique de l'Ouest et du Centre/West and Central Africa Regional Office, Dakar-Yoff, Sénégal.
• 4United Nations Children's Fund, Laos.
• 5Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 
• Violence Against Women. 2016 Mar 14. pii: 1077801216634466

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Socioeconomic Marginalisation in the Structural Production of Vulnerability to Violence among People Who Use Illicit Drugs

OBJECTIVE:

Many people who use illicit drugs (PWUD) face challenges to their financial stability. Resulting activities that PWUD undertake to generate income may increase their vulnerability to violence. We therefore examined the relationship between income generation and exposure to violence across a wide range of income generating activities among HIV-positive and HIV-negative PWUD living in Vancouver, Canada.

METHODS:

Data were derived from cohorts of HIV-seropositive and HIV-seronegative PWUD (n=1876) between December 2005 and November 2012. We estimated the relationship between different types of income generation and suffering physical or sexual violence using bivariate and multivariate generalised estimating equations, as well as the characteristics of violent interactions.

RESULTS:

Exposure to violence was reported among 977 (52%) study participants over the study period. In multivariate models controlling for sociodemographic characteristics, mental health status, and drug use patterns, violence was independently and positively associated with participation in street-based income generation activities (ie, recycling, squeegeeing and panhandling), sex work, drug dealing, and theft and other acquisitive criminal activity. Engagement in regular, self-employment or temporary employment was not associated with being exposed to violence. Strangers were the most common perpetrators of violence (46.7%) and beatings the most common type of exposure (70.8%).

CONCLUSIONS:

These results suggest that economic activities expose individuals to contexts associated with social and structural vulnerability to violence. The creation of safe economic opportunities which can minimise vulnerability to violence among PWUD is therefore urgently required.

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By:  Richardson LA1, Long C2, DeBeck K3, Nguyen P4, Milloy MJ5, Wood E5, Kerr TH5.

• 1British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Department of Sociology, University of British Columbia, Vancouver, British Columbia, Canada.
• 2British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
• 3British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada School of Public Policy, Simon Fraser University, Burnaby, British Columbia, Canada.
• 4British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
• 5British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada Faculty of Medicine (Division of AIDS), University of British Columbia, British Columbia, Canada. 
• J Epidemiol Community Health. 2015 Jul;69(7):686-92. doi: 10.1136/jech-2014-205079. Epub 2015 Feb 17.

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Predicting Sexual Assault Perpetration among Heterosexually Active Young Men

Data from an online community sample of young men were analyzed to test predictors of sexual assault perpetration. 

We used structural equation modeling to test the relative contributions of specific sub-types of childhood adversity to subsequent sexual aggression. Mediators included hostile masculinity, impersonal sexual behavior and attitudes, and substance use variables. 

Findings suggested that childhood sexual abuse had direct and mediated effects on sexual assault perpetration, but hostile masculinity was the only proximal factor significantly related to aggression. 

Childhood polytrauma was also associated with increased perpetration risk, suggesting that prevention efforts may be aided by increased attention to childhood maltreatment.

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By:  Casey EA1, Masters NT2, Beadnell B2, Hoppe MJ2, Morrison DM2, Wells EA2.

• 1University of Washington, Tacoma, USA ercasey@uw.edu.
• 2University of Washington, Seattle, USA. 
• Violence Against Women. 2016 Mar 6. pii: 1077801216634467.

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Disability and Risk of Recent Sexual Violence in the United States

OBJECTIVES:

To examine the relative prevalence of recent (past 12 months) penetrative and nonpenetrative sexual violence comparing men and women with and without a disability.

METHODS:

Data are from the 2010 National Intimate Partner and Sexual Violence Survey, a national telephone survey of US adults, and includes an expansive measure of sexual violence victimization. A total of 9086 women and 7421 men completed the telephone survey in 2010.

RESULTS:

Compared with persons without a disability, persons with a disability were at increased risk for recent rape for women (adjusted odds ratio = 3.3; 95% confidence interval = 1.6, 6.7), and being made to penetrate a perpetrator for men (adjusted odds ratio = 4.2; 95% confidence interval = 1.6, 10.8). An estimated 39% of women raped in the 12 months preceding the survey had a disability at the time of the rape. For women and men, having a disability was associated with an increased risk of sexual coercion and noncontact unwanted sexual experiences.

CONCLUSIONS:

In this nationally representative sample, men and women with a disability were at increased risk for recent sexual violence, compared to those without a disability.

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By:   Basile KC1, Breiding MJ1, Smith SG1.

• 1Kathleen C. Basile and Sharon G. Smith are with the Division of Violence Prevention at the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention, Atlanta, GA. Matthew J. Breiding is with the Division of Unintentional Injury Prevention at the National Center for Injury Prevention and Centers for Disease Control and Prevention. 
• Am J Public Health. 2016 Feb 18:e1-e6

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