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Flashcards by Siddhi Deshpande, updated more than 1 year ago
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Created by Siddhi Deshpande
over 6 years ago
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| Question | Answer |
| Explain Background of sexual violence. | Sexual violence occurs throughout the world. Although in most countries there has been little research conducted on the problem, available data suggest that in some countries nearly one in four women may experience sexual violence by an intimate partner, and up to one-third of adolescent girls report their first sexual experience as being forced. Sexual violence has a profound impact on physical and mental health. As well as causing physical injury, it is associated with an increased risk of a range of sexual and reproductive health problems, with both immediate and long-term consequences. Its impact on mental health can be as serious as its physical impact, and may be equally long lasting. Deaths following sexual violence may be as a result of suicide, HIV infection or murder – the latter occurring either during a sexual assault or subsequently, as a murder of ‘‘honour’’ . Sexual violence can also profoundly affect the social wellbeing of victims; individuals may be stigmatized and ostracized by their families and others as a co |
| How is sexual violence Defined? | Sexual violence is defined as: any sexual act, attempt to obtain a sexual act, un wanted sexual comments or advances,or acts to traffic, or otherwise directed, against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting, including but not limited to home and work. |
| Explain forms and contexts of sexual violence. | A wide range of sexually violent acts can take place in different circumstances and settings. These include, for example: — rape within marriageor datingrelationships; — rape by strangers; — systematic rape during armed conflict; — unwanted sexual advances or sexual harassment, including demanding sex inreturn for favours; — sexual abuse of mentally or physically disabled people; — sexual abuse of children; — forced marriage or cohabitation, including the marriage of children; — denial of the right to use contraception or to adopt other measures to protect against sexually transmitted diseases; — forced abortion; CHAPTER 6. SEXUAL VIOLENCE . 149 — violent acts against the sexual integrity of women, including female genital mutilation and obligatory inspections for virginity; — forced prostitution and trafficking of people for the purpose of sexual exploitation. There is no universally accepted definition of trafficking for sexual exploitation. The term encompasses the organized movement of people, usually women, between countries and within countries for sex work. |
| Explain estimates of sexual violence. | Surveysofvictimsofcrimehavebeenundertakenin many cities and countries, using a common methodology to aid comparability, and have generally included questions on sexual violence. Table 6.1 summarizes data from some of these surveys on the prevalence of sexual assault over the preceding 5 years. According to these violence. |
| Explain sexual violence by intimate patterns. | In many countries a substantial proportion of women experiencing physical violence also experience sexual abuse. In Mexico and the United States, studies estimate that 40–52% of women experiencing physical violence by an intimate partner have also been sexually coerced by that partner ( 3 9 , 4 0 ). Sometimes,sexualviolenceoccurswithoutphysical violence. In the Indian state of Uttar Pradesh, in a representative sample of over 6000 men, 7% reported having sexually and physically abused their wives, 22% reported using sexual violence without physical violence and 17% reported that they had used physical violence alone. |
| Explain gang rape. | Rape involving at least two or more perpetrators is widely reported to occur in many parts of the world. Systematic information on the extent of the problem, however, is scant. In Johannesburg, South Africa, surveillance studies of women attending medico-legal clinics following a rape found that one-third of the cases had been gang rapes ( 61 ). National data on rape and sexual assault in the United States reveal that about 1 out of 10 sexual assaults involve multiple perpetrators. Most ofthese assaults are committedbypeople unknown to their victims. This pattern, though, differs from that in South Africa where boyfriends are often involved in gang rapes. |
| Explain forced sexual initiation. | A growing number of studies, particularly from sub-Saharan Africa, indicate that the first sexual experience of girls is often unwanted and forced. In a case–control study, for example, of 191 adolescent girls (mean age 16.3 years) attending an antenatal clinic in Cape Town, South Africa, and 353 nonpregnant adolescents matched for age and neighbourhood or school, 31.9% of the study cases and 18.1% of the controls reported that force was used duringtheirsexualinitiation.Whenaskedaboutthe consequences of refusing sex, 77.9% of the study casesand72.1%ofthecontrolssaidthattheyfeared being beaten if they refused to have sex ( 4 ). Forced sexual initiation and coercion during adolescence have been reported in many studies of young women and men (see Table 6.3 and Box 6.1). Where studies have included both men and women in the sample, the prevalence of reported rape or sexual coercion has been higher among the women than the men.For example, nearly half of the sexually active adolescent women in a multi-country study in the Caribbean reported that their first sexual intercourse was forced |
| Explain sexual trafficking. | Each year hundreds of thousands of women and girlsthroughouttheworldareboughtandsoldinto prostitution or sexual slavery. Research in Kyrgyzstan has estimated that around 4000 people were trafficked from the country in 1999, with the principal destinations being China, Germany, Kazakhstan, the Russian Federation, Turkey and the United Arab Emirates. Of those trafficked, 62% reported being forced to work without pay, while over 50% reported being physically abused or tortured by their employers . A World Organization against Torture (OMCT) report suggested that more than 200000 Bangladeshi women had been trafficked between 1990 and 1997. Some 5000–7000 Nepali women and girls are illegally traded to India each year and trafficking of Thai women to Japan has also been reported ( 32 ). Trafficking of women also takes place internally within some countries, often from rural areas to cities. |
| Explain sexual violence against sex workers. | Whether trafficked or not, sex workers are at high risk for both physical and sexual violence, particularly where sex work is illegal ( 67 ). A survey of female sex workers in Leeds, England, and Glasgow and Edinburgh, Scotland, revealed that 30% had been slapped, punched or kicked by a client while working, 13% had been beaten, 11% had been raped and 22% had experienced an attempted rape ( 68 ).Only34%of those who had suffered violence at the hands of a client reported it to police.A survey of sex workers in Bangladesh revealed that 49% of the women had been raped and 59% beaten by police in the previous year; the men reported much lower levels of violence.In Ethiopia, a studyof sex workers also found high rates of physical and sexual violence from clients, especially against the child sex workers |
| Explain sexual violence in schools. | the most common place where sexual coercion and harassment are experienced is in school. In an extreme case of violence in 1991, 71 teenage girls were raped by their classmates and 19 others were killed at a boarding school in Meru, Kenya ( 71 ). While much of the research in this field comes from Africa, it is not clear whether this reflects a particularly high prevalence of the problem or simply the fact that the problem has had a greater visibility there than in other parts of the world. Harassment of girls by boys is in all likelihood a global problem. In Canada, for example, 23% of girls had experienced sexual harassment while attending school ( 72 ). The research done in Africa, however, has highlighted the role of teachers there in facilitating or perpetrating sexual coercion. A report by Africa Rights ( 28 ) found cases of schoolteachers attempting to gain sex, in return for good grades or for not failing pupils, in the Democratic Republic of the Congo, Ghana, Nigeria, Somalia, South Africa, Sudan, Zambia and Zimbabwe. |
| Explain sexual violence in health care setting. | Sexual violence against patients in health facilities has been reported in many places ( 74–79 ). A study of physicians disciplined for sexual offences in the United States, for instance, found that the number of cases had increased from 42 in 1989 to 147 in 1996, with the proportion of all disciplinary action that was sex-related rising from 2.1% to 4.4% over the same period ( 76 ). This increase, though, could reflect a greater readiness to lodge complaints. Other documented forms of sexual violence against female patients include the involvement of medical staff in the practice of clitoridectomy in Egypt ( 80 ), forced gynaecological examinations and the threat of forced abortions in China ( 81 ), and inspections of virginity in Turkey ( 82 ). Sexual violence is part of the broader problem of violence against women patients perpetrated by health workers that has been reported in a large number of countries and until recently has been much neglected. Sexual harassment off e male nurses by male doctors has also been reported. |
| Explain sexual violence armed conflicts and refugee setting. | Rape has been used as a strategy in many conflicts, including in Korea during the Second World War and in Bangladesh during the war of independence, as well as in a range of armed conflicts such as those in Algeria, India (Kashmir) , Indonesia, Liberia, Rwanda and Uganda . In some armed conflicts – for example, the ones in Rwanda and the states of the former Yugoslavia – rape has been used as a deliberate strategy to subvert community bonds and thus the perceived enemy, and furthermore as a tool of ‘‘ethnic cleansing’’. In East Timor, there were reports of extensive sexual violence against women by the Indonesian military. |
| Explain "customary" forms of sexual violence child marriage. | Marriage is often used to legitimize a range of forms of sexual violence against women. The custom of marrying off young children, particularly girls, is found in many parts of the world. This practice – legal in many countries – is a form of sexual violence, since the children involved are unable to give or withhold their consent. The majority of them know little or nothing about sex before they are married. They therefore frequently fear it and their first sexual encounters are often forced. Early marriage is most common in Africa and South Asia, though it also occurs in the Middle East and parts of Latin America and Eastern Europe. In Ethiopia and parts of West Africa, for instance, marriage at the age of 7 or 8 years is not 156 . WORLD REPORT ON VIOLENCE AND HEALTH uncommon. In Nigeria, the mean age at first marriage is 17 years, but in the Kebbi State of northern Nigeria, the average age at first marriage is just over 11 years . High rates of child marriage have also been reported in the Democratic Republic of the Congo, Mali, Niger and Uganda. |
| Explain factors increasing women's vulnerability. | One of the most common forms of sexual violence around the world is that which is perpetrated by an intimate partner, leading to the conclusion that one of the most important risk factors for women – in termsoftheirvulnerabilitytosexualassault–isbeing married or cohabiting with a partner. Other factors influencing the risk of sexual violence include: — being young; — consuming alcohol or drugs; — having previously been raped or sexually abused; — having many sexual partners; — involvement in sex work; — becoming more educated and economically empowered, at least where sexual violence perpetrated by an intimate partner is concerned; — poverty. |
| Explain Alcohol and drug consumption. | Increased vulnerability to sexual violence also stems from the use of alcohol and other drugs. Consuming alcohol or drugs makes it more difficult for women to protect themselves by interpreting and effectively acting on warning signs. Drinking alcohol may also place women in settings where their chances of encountering a potential offender are greater |
| Explain having many sexual partners. | Young women who have many sexual partners are at increased risk of sexual violence. It is not clear, though, if having more sexual partners is a cause or consequence of abuse, including childhood sexual abuse. For example, findings from a representative sample of men and women in Leo ´n, Nicaragua, found that women who had experienced attempted or completed rape during childhood or adolescence were more likely to have a higher number of sexual partners in adulthood, compared with non-abused or moderately abused women ( 110 ). Similar findings have been reported in longitudinal studies of young women in New Zealand and Norway. |
| Explain Educational level. | Women are at increased risk of sexual violence, as theyareofphysical violence byanintimatepartner, when they become more educated and thus more empowered.Womenwithnoeducationwerefound in a national survey in South Africa to be much less likely to experience sexual violence than those with higher levels of education ( 34 ). In Zimbabwe, women who were working were much more likely toreportforcedsexbyaspousethanthosewhowere not ( 42 ). The likely explanation is that greater empowerment brings with it more resistance from womentopatriarchalnorms( 111 ),sothatmenmay resort to violence in an attempt to regain control. The relationship between empowerment and physical violence is an inverted U-shape – with greater empowerment conferring greater risk up to a certain level, beyond which it starts to become protective. It is not known, though, whether this is also the case for sexual violence. |
| Explain Poverty. | Poor women and girls may be more at risk of rape in the course of their daily tasks than those who are better off, for example when they walk home on their own from work late at night, or work in the fields or collect firewood alone. Children of poor women may have less parental supervision when not in school, since their mothers may be at work and unable to afford child care. The children themselves may, in fact, be working and thus vulnerable to sexual exploitation. Poverty forces many women and girls into occupations that carry a relatively high risk of sexual violence, particularly sex work. It also creates enormous pressures for them to find or maintain jobs, to pursue trading activities and, if studying, to obtain good grades – all of which render them vulnerable to sexual coercion from those who can promise these things. Poorer women are also more at risk of intimate partner violence, of which sexual violence is often a manifestation |
| Explain factors increasing men's risk of committing rape. | Data on sexually violent men are somewhat limited and heavily biased towards apprehended rapists, except in the United States, where research has also been conducted on male college students. Despite the limited amount of information on sexually violent men,itappears thatsexual violenceisfound in almost all countries (though with differences in prevalence), in all socioeconomic classes and in all age groups from childhood onwards. Data on sexually violent men also show that most direct their act sat women whom they already know.Among the factors increasing the risk of a man committing rape are those related to attitudes and beliefs, as well as behaviour arising from situations and social conditions that provide opportunities and support for abuse |
| Explain Alcohol and drug consumption. | Alcohol has been shown to play a dis-inhibiting role in certain types of sexual assault ( 118 ), as have some drugs, notably cocaine ( 119 ). Alcohol has a psycho-pharmacological effect of reducing inhibitions,clouding judgement s and impairing the ability to interpret cues( 120 ). The biologicallinksbetween alcohol and violence are, however, complex ( 118 ). Research on the social anthropology of alcohol consumption suggests that connections between violence, drinking and drunkenness are socially learnt rather than universal ( 121 ). Some researchers have noted that alcohol may act as a cultural ‘‘break time’’, providing the opportunity for antisocial behaviour. Thus men are more likely to act violently when drunk because they do not consider that they will be held accountable for their behaviour. Some forms of group sexual violence are also associated with drinking. In these settings, consuming alcoholics an act of group bonding, where inhibitions are collectively reduced and individual judgement ceded in favour of that of the group. |
| Explain peer and family factors. | Gang rape, Early childhood Environment, family honor and sexual purity. |
| Explain family honor and sexual purity. | family response to sexual violence that blames women without punishing men, concentrating instead on restoring ‘‘lost’’ family honour. Such a response creates an environment in which rape can occur with impunity. While families will often try to protect their women from rape and may also put their daughters on contraception to prevent visible signs should it occur ( 136 ), there is rarely much social pressure to control young men or persuade them that coercing sex is wrong. Instead, in some countries, there is frequently support for family members to do whatever is necessary – including murder – to alleviate the ‘‘shame’’ associated with a rape or other sexual transgression. In a review of all crimes of honour occurring in Jordan in 1995 ( 137 ), researchers found that in over 60% of the cases, the victim died from multiple gunshot wounds – mostly at the hands of a brother. In cases where the victim was a single pregnant female, the offender was either acquitted of murder or received a reduced sentence. |
| Explain physical and social environment in community factor. | While fear of rape is typically associated with being outside the home, the great majority of sexual violence actually occurs in the home of the victim or the abuser. Nonetheless, abduction by a stranger is quite often the prelude to a rape and the opportunities for such an abduction are influenced by the physical environment. The social environment within a community is, however, usually more important than the physical surrounding. How deeply entrenched in a community beliefs in male superiority and male entitlement to sex are will greatly affect the likelihood of sexual violence taking place, as will the general tolerance in the community of sexual assault and the strength of sanctions, if any, against perpetrators. For instance, in some places, rape can even occur in public, with passersby refusing to intervene . Complaints of rape may also be treated leniently by the police, particularly if the assault is committed during a date or by the victim’s husband. |
| Explain social norms in community factors. | Sexual violence committed by men is to a large extent rooted in ideologies of male sexual entitlement. These belief systems grant women extremely few legitimate options to refuse sexual advance. Many men thus simply exclude the possibility that their sexual advances towards a woman might be rejected or that a woman has the right to make an autonomous decision about participating in sex. In many cultures women, as well as men, regard marriage as entailing the obligation on women to be sexually available virtually without limit though sex may be culturally proscribed at certain times, such as after childbirth or during menstruation. Societal norms around the use of violence as a means to achieve objectives have been strongly associated with the prevalence of rape. In societies where the ideology of male superiority is strong – emphasizing dominance, physical strength and male honour – rape is more common. Countries with a culture of violence, or where violent conflict is taking place, experience an increase in almost all forms of violence, including sexual violence. |
| Explain pregnancy and gynacological complications in community factors. | Pregnancy may result from rape, though the rate varies between settings and depends particularly on the extent to which non-barrier contraceptives are being used. A study of adolescents in Ethiopia found that among those who reported being raped, 17% became pregnant after the rape , a figure which is similar to the 15–18% reported by rape crisis centres in Mexico ( 1 5 5 , 1 5 6 ). A longitudinal study in the United States of over 4000 women followed for 3 years found that the national rape related pregnancy rate was 5.0% per rape among victims aged 12–45 years, producing over 32000 pregnancies nationally among women from rape each year .In many countries, women who have been raped are forced to bear the child or else put their lives at risk with back-street abortions. |
| Explain Mental health. | Sexual violence has been associated with a number of mental health and behavioural problems in adolescence and adulthood. In one population-based study, the prevalence of symptoms or signs suggestive of a psychiatric disorder was 33% in women with a history of sexual abuse as adults, 15% in women with a history of physical violence by an intimate partner and 6% in non-abused women . Sexual violence by an intimate partner aggravates the effects of physical violence on mental health |
| What can be done to prevent sexual violence. | Psychological care and support, Programs for perpetrators, life skills and other educational programs. |
| Explain developmental approaches. | Research has stressed the importance of encouraging nurturing, with better and more gender balanced parenting, to prevent sexual violence . At the same time, Schwartz has developed a prevention model that adopts a developmental approach,with interventions before birth, during childhood and in adolescence and young adulthood. In this model, the prenatal element would include discussions of parenting skills, the stereotyping of gender roles, stress, conflict and violence. In the early years of childhood, health providers would pursue these issues and introduce child sexual abuse and exposure to violence in the media to the list of discussion topics, as well as promoting the use of non-sexist educational materials. In later childhood, health promotion would include modelling behaviours and attitudes that avoid stereotyping, encouraging children to distinguish between‘‘good’’and‘‘bad’’ touching, and enhancing their ability and confidence to take control over their own bodies. This intervention would allow room for talking about sexual aggression. During adolescence and young a |
| Explain training for health care profession. | In the Philippines, the Task Force on Social Science and Reproductive Health, a body that includes doctors, nurses and social scientists and is supported by the Department of Health, has produced training modules for nursing and medical students on gender-based violence. The aims of this programme are: . To understand the roots of violence in the context of culture, gender and other social aspects. . To identify situations, within families or homes that are at a high risk for violence, where it would be appropriate to undertake: — primary interventions, in particular in collaboration with other professionals; — secondary interventions, including identifying victims of violence, understanding basic legal procedures and how to present evidence, referring and following up patients, and helping victims reintegrate into society. These training modules are built into the curricula for both nursing and medical students. For the nursing curriculum, the eleven modules are spread over the 4 years of formal instruction, and for medical students over their final 3 years of practical training. |
| Explain raped during armed conflicts. | In 1995, the Office of the United Nations High Commissioner for Refugees released guidelines on the prevention of and response to sexual violence among refugee populations ( 211 ). These guidelines include provisions for: — the design and planning of camps, to reduce susceptibility to violence; — documenting cases; — educating and training staff to identify, respond to and prevent sexual violence; — medical care and other support services, including procedures to avoid further trauma to victims. The guidelines also cover public awareness campaigns, educational activities and the setting up of women’s groups to report and respond to violence. Based on work in Guinea and the United Republic of Tanzania , the International Rescue Committee has developed a programme to combat sexual violence in refugee communities |
| Explain addressing sexual abuse within the health sector. | Sexual violence against patients in the health sector exists in many places, but is not usually acknowledged as a problem. Various steps need to be taken to overcome this denial and to confront the problem, including the following ( 8 3 , 8 5 ): — incorporating topics pertaining to gender and sexual violence, including ethical considerations relevant to the medical profession, in the curricula for basic and postgraduate training of physicians, nurses and other health workers; — actively seeking ways to identify and investigate possible cases of abuse of patients within health institutions; — utilizing international bodies of the medical and nursing professions, and nongovernmental organizations (including women’s organizations) to monitor and compile evidence of abuse and campaign for action on the part of governments and health services; — establishing proper codes of practice and complaints procedures, and strict disciplinary procedures for health workers who abuse patients in health care settings. |
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