Domestic, family and sexual violence polyvictimisation and health experiences of Australian nurses, midwives and carers: a cross-sectional study.

BACKGROUND: Domestic, family and sexual violence is a prevalent health and social issue. Nurses may be exposed to higher rates of this violence in their personal lives compared to the community, but little is known about their polyvictimisation experiences or health and well-being impacts. METHODS: An online descriptive, cross-sectional survey of women nurses, midwives and carer members of the Australian Nursing and Midwifery Federation (ANMF) (Victorian Branch) (response rate: 15.2% of nurses sent an invitation email/28.4% opened the email). Violence survey measures included: intimate partner violence (Composite Abuse Scale); child abuse and sexual violence (Australian Bureau of Statistics Personal Safety Survey items). Health measures included: Short Form-12; Fast Alcohol Screening Test; Patient Health Questionnaire-4; Short Screening for DSM-IV Posttraumatic Stress Disorder; well-being measures included: Connor-Davidson Resilience Scale, social support, and financial stress. Proportions were used to describe the prevalence of violence by sociodemographic characteristics and health and well-being issues; logistic regression predicted the odds of experiencing overlapping types of violence and of experiencing health and well-being outcomes. RESULTS: 5,982 participants (from a parent study of 10,674 nurses, midwives and carers) had experienced at least one type of lifetime violence; half (50.1%) had experienced two or three types (polyvictimisation). Survivors of child abuse were three times more likely to experience both intimate partner violence and non-partner adult sexual assault. Any violence was associated with poorer health and well-being, and the proportion of affected participants increased as the types of violence they had experienced increased. Violence in the last 12-months was associated with the poorest health and well-being. CONCLUSIONS: Findings suggest a cumulative, temporal and injurious life course effect of domestic, family and sexual violence. The polyvictimisation experiences and health and well-being associations reported by survivor nurses, midwives and carers underscores the need for more accessible and effective workplace interventions to prevent and mitigate psychosocial ill health, especially in the recent aftermath of violence.

Assessment of Sexual Violence Risk Perception in Men Who Have Sex With Men: Proposal for the Development and Validation of "G-Date".

BACKGROUND: Sexual violence (SV) is a significant problem for sexual minorities, including men who have sex with men (MSM). The limited research suggests SV is associated with a host of syndemic conditions. These factors tend to cluster and interact to worsen one another. Unfortunately, while much work has been conducted to examine these factors in heterosexual women, there is a lack of research examining MSM, especially their SV risk perception. Further, MSM are active users of dating and sexual networking (DSN) mobile apps, and this technology has demonstrated usefulness for creating safe spaces for MSM to meet and engage partners. However, mounting data demonstrate that DSN app use is associated with an increased risk for SV, especially given the higher likelihood of using alcohol and other drugs before sex. By contrast, some researchers have demonstrated that DSN technology can be harnessed as a prevention tool for HIV; unfortunately, no such work has progressed regarding SV. OBJECTIVE: This study aims to (1) use qualitative and quantitative methods to tailor an existing laboratory paradigm of SV risk perception in women for MSM using a DSN mobile app framework and (2) subject this novel paradigm to a rigorous validation study to confirm its usefulness in predicting SV, with the potential for use in future prevention endeavors. METHODS: To tailor the paradigm for MSM, a team of computer scientists created an initial DSN app (G-Date) and incorporated ongoing feedback about the usability, feasibility, and realism of this tool from a representative sample of MSM. We used focus groups and interviews to assist in the development of G-Date, including by identifying relevant stimuli, developing the cover story, and establishing the appropriate study language. To confirm the paradigm's usefulness, we are conducting an experimental study with web-based and face-to-face participants to determine the content, concurrent, and predictive validities of G-Date. We will evaluate whether certain correlates of SV informed by syndemics and minority stress theories (eg, history of SV and alcohol and drug use) affect the ability of MSM to detect SV risk within G-Date and how paradigm engagement influences behavior in actual DSN app use contexts. RESULTS: This study received funding from the National Institute on Alcohol Abuse and Alcoholism on September 10, 2020, and ethics approval on October 19, 2020, and we began app development for aim 1 immediately thereafter. We began data collection for the aim 2 validation study in December 2022. Initial results from the validation study are expected to be available after December 2025. CONCLUSIONS: We hope that G-Date will enhance our understanding of factors associated with SV risk and serve as a useful step in creating prevention programs for this susceptible population.

Feelings expressed by professionals caring for children and teenagers victims of sexual violence.

OBJECTIVE: to describe the feelings expressed by health professionals when caring for child and adolescent victims of sexual violence from the theoretical perspective of Symbolic Interactionism. METHOD: qualitative research carried out with 30 female health professionals. An instrument was used consisting of closed questions for sociodemographic data and a script with open questions for interviews. The data was organized and analyzed using Nvivo software version 12, according to Bardin's proposal, from the perspective of Symbolic Interactionism in the work of Charles Morris. The project was approved by the Research Ethics Committee. RESULTS: five thematic categories emerged, revealing feelings of empathy, fear, indignation, suffering, and consternation. These feelings remained in the interviewees' memories, making caring for child and adolescent victims of sexual violence a moving and difficult experience that deeply marks the life of the health professional. CONCLUSION: there is a need to adopt strategies to support the mental health of professionals who work in services that provide general care to children and adolescents, considering that there is a possibility that they will provide care to child and adolescent victims of sexual violence in compliance with pre-existing public policies. HIGHLIGHTS: (1) Feelings stem from individual impressions in line with social interaction. (2) Caring for child and adolescent victims has a negative impact on professionals' emotions. (3) Service managers need to pay attention to the health of professionals who assist victims.

Family Therapy for Kosovar Mothers Who Experienced Conflict-Related Sexual Violence and Their Children in Postwar Times: A Pilot Randomised Waitlist-Controlled Trial.

Women who have experienced conflict-related sexual violence report significant long-term effects, including posttraumatic stress disorder (PTSD), depression and relationship difficulties. Research has demonstrated that maternal trauma is associated with children's behavioural difficulties and challenges in family functioning, such as impaired communication and harsh parenting. This pilot study is aimed at evaluating the preliminary effectiveness of family therapy for Kosovar mothers who experienced conflict-related sexual violence in 1998-1999 and later developed PTSD and their children in improving family functioning and reducing behavioural difficulties in postwar times. Sixty-four mothers were randomised to an intervention group or a waitlist control group. Data was collected during a screening phase, at baseline before intervention initiation, after the intervention group completed family therapy and once the waitlist control group received the intervention. Generalised linear mixed models were used to analyse group differences in family functioning and children's behaviours over time. At follow-up, mothers in the intervention group reported improved family functioning. However, mothers in the waitlist control group reported significantly fewer behavioural difficulties than mothers in the intervention group before the control group had started family therapy. There was no significant interaction between group condition and time for child-rated family functioning. Overall, this pilot study suggests that family therapy could be effective in reducing the effects of intergenerational trauma related to PTSD and conflict-related sexual violence. Future research should evaluate the long-term effects of family therapy to assess if immediate effects were maintained.

How do young men narrate the redemption story of a sexual assault perpetrator?

Background: Little is known about how young men who have committed sexual assault might acknowledge wrongdoing and eventually change and make amends. There are practical barriers to seeking the real redemption stories of perpetrators.Objective: To explore hypothetical pathways to young men's accountability-taking and amends (i.e. redemption) after perpetration of sexual assault.Method: In a pre-registered, qualitative story completion study, we presented heterosexual, cisgender college men (N = 54) with a date-based sexual assault story written by a fictional male perpetrator. Participants were prompted to complete the story so that the protagonist, who initially denies wrongdoing, eventually changes and becomes a violence prevention advocate.Results: A thematic analysis of the redemption stories revealed that this study's speculative task was a challenging one. Half of the stories did not provide an explanation for how the perpetrator was able to acknowledge wrongdoing. Overall, individualistic themes (e.g. he introspected) were more common than relational, community, or societal facilitators of redemption.Conclusions: Without infrastructure for accountability-taking and repair, or narrative exemplars to draw from in public life, it is difficult to envision redemption from violence. Rare gender-based, structurally attuned analyses of sexual violence in the stories point the way towards a more transformative vision of redemption.

In this qualitative story completion study, college men wrote the redemption story of a fictional sexual assault perpetrator.Men had difficulty explaining how the perpetrator would acknowledge wrongdoing.Redemption themes tended to be individualistic versus rooted in community.

Unlocking What Makes Military Behavioral Health Interventions Work, Stumble, or Fade Away.

INTRODUCTION: The Office of the Secretary of Defense and each of the services have made an unprecedented commitment to the prevention of sexual assault and related behavioral health phenomena. Indeed, the Department of Air Force has selected, in some cases tailored, and disseminated a wide array of evidence-based preventative programs, policies, and practices (EBPs) over the last few decades. However, many of these efforts seem to follow a predictable life course. EBPs are initially implemented with great enthusiasm, supported for a few years, then fall out of favor, and are replaced by a different effort. This research effort aims to build on the existing civilian implementation science research to (1) offer a military-specific model of sustained, high-quality implementation and (2) test this model in a series of interconnected studies. MATERIALS AND METHODS: New York University's Institutional Review Board approved the study protocols, and the Army's Human Research Protection Office provided permission to collect data. We conducted interviews first with prevention leaders in the services and at the Office of the Secretary of Defense level regarding factors that they thought helped or hurt the sustainment of EBPs. We used these interviews to identify EBPs currently implemented in Department of Air Force and selected four EBPs out of the 25 identified for intensive study. We then interviewed implementers of those four EBPs regarding what they thought helped or hurt the sustainment of that EBP. We also gathered information about the 25 currently implemented EBPs themselves and gathered policy and guidance, as well as leadership communication about those EBPs and the target problems they focus on. We coded this information to allow us to test EBP parameters and policy and leader communication that predict sustained high-quality implementation. We conducted over 100 observations of the 4 EBPs we are studying intensively and have collected quantitative data from implementers and participants to help us test factors related to sustained high-quality implementation within each of those 4 EBPs and across the EBPs. RESULTS: Several military-specific factors were nominated for inclusion in the military-specific model of implementation sustainment. The implementation of even highly standardized EBPs varies greatly. Implementers and participants are generally highly engaged, but implementers vary in the extent to which they understand the mechanisms of action for the EBP they are implementing. CONCLUSIONS: We recommend training implementers in the mechanisms of action in the EBPs they are expected to implement and including quality assurance as a component of prevention efforts in a manner more similar to how the military addresses aspects of the operational mission. By moving beyond counting classes and attendance, and specifying how to engage participants in the EBPs in the manner that produces the key outcomes, it is likely that EBPs will have more robust implementations that can be better sustained over time.

Sexual Assault Research in the Military: Is Oversampling Necessary for Representativeness?

INTRODUCTION: Sexual assault in the U.S. Military is a serious concern. Recruiting representative samples of service members to participate in sexual assault research is essential for understanding the scope of the problem and generating data that can inform prevention and intervention efforts. Accordingly, the current study aims to examine response and completion rates of an anonymous survey of sexual assault and alcohol use among active duty sailors aged 18 to 24 with the overarching goal of achieving a representative sample and informing future recruitment efforts. MATERIALS AND METHODS: This study was approved by the Institutional Review Board at the Naval Health Research Center. The study involved an anonymous survey of sexual assault and alcohol use among 612 active duty sailors aged 18 to 24. Since 79.6% of Navy service members are men and 20.4% are women, women were oversampled to achieve sufficient representation. Survey invitations were emailed to 12,031 active duty sailors: 64.3% (n = 7,738) men and 35.7% (n = 4,293) women. RESULTS: Response rates were disproportionate, with 3.0% (n = 234) of male and 8.8% (n = 377) of female sailors responding to the study invitation. Survey completion rates, however, were similar between male and female sailors (81.2% and 80.1% for male and female personnel, respectively). CONCLUSION: Results demonstrated that female sailors were significantly more likely than male sailors to participate in a study of sexual assault and alcohol use. However, once enrolled in the study, male and female sailors completed the 234-item questionnaire at a similar rate. Study findings highlight the challenges of engaging male service members in sexual assault-related research. Despite the disproportionately high representation of men in the military, sexual assault researchers may need to sample according to the overall distribution of gender in the military or perhaps even oversample men to achieve a representative sample.

Protocol for a discrete choice experiment: understanding preferences for seeking health services for survivors of sexual violence in Uganda.

INTRODUCTION: Sexual violence is a significant public health concern with severe physical, social and psychological consequences, which can be mitigated by health service utilisation. However, in Uganda and much of sub-Saharan Africa, these services are significantly underused, with 9 out of 10 survivors not seeking care due to a range of psychological, cultural, economic and logistical factors. Thus, there is a strong need for research to improve health service utilisation for survivors of sexual violence. METHODS AND ANALYSIS: The proposed study seeks to address the underutilization of health services for female survivors of sexual violence using a discrete choice experiment (DCE). The study will be conducted in the greater Masaka region of southwestern Uganda and target adult female survivors of sexual violence. We will first undertake qualitative interviews with 56 survivors of sexual violence to identify the key attributes and levels of the DCE. In order to ensure a sufficiently powered sample, 312 women who meet inclusion criteria will be interviewed. Our primary analysis will employ a mixed (random parameters) logit model. We will also model the role of individual-specific characteristics through latent class models. ETHICS AND DISSEMINATION: The study protocol was reviewed and approved by the following ethics review boards in Uganda and the USA: the Uganda Virus Research Institute (UVRI), the Uganda National Council for Science and Technology (HS2364ES), Washington University in St Louis and the University of Michigan. Our methods conform to established guidelines for the protection of human subjects involved in research. Our dissemination plan targets a broad audience, ranging from policymakers and government agencies to healthcare providers, academic communities and survivors themselves.

Expanding the Sexual Experiences Survey to Include Technology Facilitated Sexual Exploitation.

The Sexual Experiences Survey is the most widely used measure of sexual assault victimization and perpetration among college students. To improve comprehensiveness and inclusiveness, the current revision of the victimization items of the SES (SES-V; Koss et al., 2024) included the addition of a module focusing on Technology Facilitated Sexual Exploitation (TFSE). The current paper outlines why the inclusion of items related to TFSE was necessary, and describes the development of the items making up this module of the SES-V. The module consists of 10 items that map onto seven domains: receipt of sexual materials, target of unwanted sexual comments, threatened sharing of sexually explicit images, actual sharing of sexually explicit images, target of sexual solicitation, threatened sharing of images of sexual exploitation, and actual sharing of images of sexual exploitation. Consistent with how the other types of sexual exploitation are assessed in the SES-V (Koss et al., 2024), respondents indicate how many times they have experienced these events since their 14th birthday and use an 11-point response format ranging from 0 to 10 or more times per experience. The addition of the new module on TFSE to the SES-V will ensure researchers assess both in-person and cyber modalities of sexual exploitation.

Words Can Hurt: A Taxonomy of Verbally Pressured Sexual Exploitation in the SES-V.

This article describes the development of the Verbally Pressured Sexual Exploitation module of the Sexual Experiences Survey (SES)-Victimization (introduced by Koss et al., 2024). This module assesses the use of verbal or nonphysical, paraverbal pressure to obtain sexual acts without freely given permission. An interdisciplinary team of seven sexual exploitation researchers collaborated to create this module, with consultation from the full 15 member SES-V revision collaboration team. In this paper, we describe our process for developing this module. We briefly review empirical literature and theoretical frameworks (e.g., rape scripts, normative sexual scripts, intersectionality, and sex-positivity) that informed this work. Summary tables compare the SES-V items to verbal pressure items in prior versions of the SES and to other existing measures of violence. The comprehensive taxonomy developed herein includes six domains of Verbally Pressured sexual exploitation across 11 item stems. The components of the taxonomy include: positive verbal pressure, neutral verbal pressure, negative verbal pressure, substance-related pressure, postural violence, and threats to critical resources. The paper concludes with suggestions for future research, with priority on intersectional research that can illuminate the phenomenology and contexts of sexual exploitation against marginalized groups.

Exploratory rasch analysis of a static-99R clinical cohort assessment.

Modern test theory supplements the more prevalent classic methods for assessing test properties. However, such an assessment of the commonly used sexual recidivism risk assessment instrument, Static-99R, has yet to be attempted. This study evaluated the psychometric properties of said instrument using Rasch analysis. The clinical cohort assessed consisted of individuals with mental disorders convicted of a sexual offense (N = 146). Results showed that the original ten-item Static­99R did not meet the Rasch model requirements, and revisions of the instrument with seven and nine items each only marginally improved performance. More reliable results could likely have been obtained with a larger, non-clinical sample and a more randomized distribution of missing data. Despite the consistently poor performance of item 3 ("Index non-sexual violence") in all three analyses, reliability was slightly improved by dichotomizing the only two polytomous items in the Static-99R; items 1 ("Age at release from index offense") and 5 ("Prior sexual offenses"). These results may be of interest considering the significant change of splitting the formerly dichotomous item 1 into four different response categories in the revision of Static-99 to Static-99R.

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.

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.

[Legal abortion in cases of sexual violence pregnancy: perceptions and experiences of obstetricians]. / O aborto legal em casos de gravidez decorrente de violência sexual: percepções e vivências de médicas e médicos obstetras.

This study aimed to analyze the perceptions of obstetricians and gynecology-obstetrics residents at a federal school maternity hospital regarding legal abortion in cases of sexual violence pregnancy, understand their motivations, strengths, and feelings, and identify their experience with this topic. The first stage consisted of answering a self-administered questionnaire. The selection criteria were: obstetricians linked to the obstetric center, director of the medical division, and residents of the institution's obstetrics-gynecology program. In total, 36 questionnaires were answered and returned. The second stage corresponded to an interview using a saturation sampling criterion. Six physicians were interviewed. The interviews were evaluated using a thematic content analysis. The questionnaires showed that all participants had already provided care to women in situations of sexual violence and that most of them had already participated in a legal abortion procedure in these cases. The interviews highlighted the dilemmas faced by professionals in providing care to these women and the lack of professional training to handle these cases. The speeches of women were sometimes seen as an object of suspicion regarding the veracity of sexual violence, and sometimes as an object that caused professionals to feel emotionally affected while listening to them, allowing professionals to approach the victims and offer more humanized care. The results pointed to the importance of addressing this topic in the areas of health and providing training beyond the technical-scientific focus in order to support the development of new care strategies.

Este estudo objetivou analisar as percepções de obstetras e residentes de ginecologia-obstetrícia, atuantes numa maternidade escola federal, sobre o aborto legal em casos de gravidez decorrente de violência sexual, desvelando suas motivações, resistências e sentimentos, e identificando suas experiências com o tema. A primeira etapa correspondeu ao preenchimento de um questionário autoaplicável. Os critérios de seleção foram: obstetras vinculados ao centro obstétrico; diretor da divisão médica; e residentes do programa de ginecologia-obstetrícia da instituição. Obtiveram-se 36 questionários respondidos. A segunda etapa correspondeu à realização de uma entrevista, tendo sido utilizado o critério de amostragem por saturação e foram entrevistados seis médicos. As entrevistas foram analisadas pelo método de análise de conteúdo, na modalidade temática. Os questionários retrataram que todos os participantes já haviam prestado assistência a mulheres em situação de violência sexual e que a maioria já havia participado da realização de um aborto legal. As entrevistas evidenciaram os dilemas enfrentados pelos profissionais na assistência a esses casos e a escassez da formação profissional em relação à temática. A palavra da mulher foi tida ora como objeto de suspeição em relação à veracidade do estupro, ora como capaz de suscitar afetação das profissionais em suas escutas, o que possibilitou que essas se aproximassem das vítimas e ofertassem uma assistência mais humanizada. Os resultados apontaram para a importância da temática ser abordada nos campos da saúde e da formação para além do enfoque técnico-científico, visando produzir novas estratégias de cuidado.

El estudio tuvo como objetivo analizar las percepciones de obstetras y residentes de gineco-obstetricia de una maternidad escolar federal sobre el aborto legal en casos de embarazo resultante de violencia sexual, revelar sus motivaciones, resistencias y sentimientos, e identificar sus experiencias con el tema. La primera etapa consistió en completar un cuestionario autoadministrado. Los criterios de selección fueron los siguientes: obstetras vinculados al centro obstétrico; director de la división médica; y residentes del programa de gineco-obstetricia de la institución. Se obtuvieron 36 cuestionarios cumplimentados. La segunda etapa consistió en una entrevista, utilizando un criterio de muestreo por saturación. Se entrevistó a 6 médicos. Las entrevistas se analizaron mediante el método de análisis de contenido, en la modalidad temática. Los cuestionarios mostraron que todos los participantes ya habían brindado asistencia a mujeres en situación de violencia sexual y que la mayoría ya había participado en la realización de un aborto legal en estos casos. Las entrevistas pusieron de manifiesto los dilemas que enfrentan los profesionales en la asistencia a estos casos y la escasa formación profesional con relación al tema. La palabra de la mujer fue vista a veces como objeto de sospecha con respecto a la veracidad de la violación, y a veces como un objeto capaz de suscitar la afectación de las profesionales en sus escuchas, lo que les permitió acercarse a las víctimas y ofrecer una asistencia más humanizada. Los resultados señalaron la importancia de que la temática sea abordada en los campos de la salud y de la formación más allá del enfoque técnico-científico, con el objetivo de producir nuevas estrategias de cuidado.

Breaking the spiral of silence: News and social media dynamics on sexual abuse scandal in the Japanese entertainment industry.

Highlighting minorities and crime survivors through public discourse is essential for their support and protection. However, advocating for minorities is challenging due to the fear of potential isolation from one's social circles. This reluctance contributes to the societal phenomenon known as the "spiral of silence," significantly impeding efforts to support socially vulnerable individuals. This study centers on a pivotal instance where the silence surrounding sexual abuse in the Japanese entertainment industry was disrupted, in which the late company president had allegedly abused idol trainees of the company for decades. Utilizing extensive data from news media and social media, the study probes the engagement dynamics of public attention to this scandal. Results indicate that users on social media provided earlier and greater coverage for this scandal compared to news media outlets. Furthermore, television demonstrated a significant delay in addressing this issue compared to other news media, such as tabloids, magazines, and online news. Regarding social media engagement, idol fans exhibited a more subdued response to the issue compared to the general public. Notably, fans more loyal to the company tended to be slower to mention the issue, with a higher likelihood of standing in defense of the perpetrators. Moreover, conflicting attitudes were observed within the fan communities, culminating in an observable "echo chamber" phenomenon. This paper presents a novel examination of the process of disruption of social silence and offers critical insights for aiding vulnerable individuals in environments dominated by an unacknowledged spiral of silence. This study is novel in that it suggests a reinterpretation of the "spiral of silence theory" in the age of social media, through a comprehensive analysis of relevant social media data and news media data. This contributes to the body of research that has analyzed the spiral of silence theory online.

Physical, Sexual, and Intimate Partner Violence Among Transgender and Gender-Diverse Individuals.

Importance: Transgender and gender-diverse (TGD) communities experience disproportionate levels of violence, yet due to limitations in measuring TGD identity, few state-representative estimates are available. Objective: To assess gender identity differences in experiences of violence among adults. Design, Setting, and Participants: Cross-sectional data from the 2023 California Violence Experiences (CalVEX) survey, weighted to provide state-representative estimates, was used to assess associations between gender identity and past-year experiences of violence among adults 18 years and older. Data were analyzed from June to December 2023. Exposure: Gender identity (cisgender women, cisgender men, transgender women, transgender men, and nonbinary individuals). Main Outcomes and Measures: Experience of physical violence (including physical abuse and threat or use of a weapon), sexual violence (verbal sexual harassment, homophobic or transphobic slurs, cyber and physically aggressive sexual harassment, and forced sex), and intimate partner violence (IPV; emotional, physical, or sexual violence) using age-adjusted logistic regression. Results: In total 3560 individuals (weighted cumulative response rate, 5%) completed the 2023 CalVEX survey, with 1978 cisgender women, 1431 cisgender men, 35 transgender women, 52 transgender men, and 64 nonbinary respondents (mean [SD] age, 47.1 [17.5] years; 635 [17%] were Asian, 839 [37%] were Hispanic, and 1159 [37%] were White). Past-year physical violence was reported by 22 transgender men (43%), 9 transgender women (24%), and 9 nonbinary respondents (14%). Past-year sexual violence was reported by 23 transgender men (42%), 11 transgender women (14%), and 31 nonbinary respondents (56%). Compared with cisgender women, transgender women and transgender men had greater risk of past-year physical violence (any form) (transgender women adjusted incidence rate ratio [AIRR], 6.7; 95% CI, 2.5-18.2; transgender men AIRR, 9.7; 95% CI, 5.3-17.7), as well as past-year IPV (any form) (transgender women AIRR, 3.2; 95% CI, 1.3-8.0; transgender men AIRR, 6.7; 95% CI, 4.0-11.3). Relative to cisgender women, transgender men (AIRR, 3.0; 95% CI, 1.7-5.1) and nonbinary respondents (AIRR, 3.3; 95% CI, 2.1-5.2) had greater risk of past-year sexual violence (any form). Conclusions and Relevance: In this survey study of adults in California, results showed that TGD individuals, especially transgender men, are at higher risk of experiencing all forms of violence relative to cisgender women. Results highlight the need for gender-affirming violence prevention and intervention services as well as policies that protect TGD individuals from discriminatory violence.

Sexual assault and the matrix of harm: Sexual assault survivors narrate their whole lives in more negative ways.

This paper uses data from the American Voices Project, an interview study based on a random population sample, to explore the relationship between assault experiences and how people narrate their lives. Using quantitative sentiment analysis, we find that survivors of assault express significantly greater negative sentiment when asked to tell their life stories. These negative sentiments are observable throughout the entire interview, including before questions of assault are asked. Survivors of assault narrate their experiences with more anger, disgust, fear, and sadness, and less anticipation, joy, and trust than those who do not report assault experiences. We provide evidence that the negative sentiment associated with sexual violence is greater than having lost a parent and less than having experienced a significant financial hardship within the last month. We contextualize these findings with a qualitative evaluation of the interview transcripts, further substantiating our finding. Overall, this paper suggests that sexual violence is part of what we have called, drawing inspiration from the work of Beth Richie, a "matrix of harm" that structures people's lives. While our finding is consistent with what we might expect given the negative life experiences and sequalae associated with sexual assault, it has important implications. Sentimental differences in narrating life experience are an important yet relatively understudied phenomenon, and experiences of assault are rarely asked about yet may be consequential to both quantitative and qualitative accounts of social processes.

Uncovering community needs regarding violence against women and girls in southern Ethiopia: An explorative study.

BACKGROUND: Violence against women and girls (VAWG) is a significant global public health problem and a violation of human rights experienced by one in three women worldwide. This study explores community perceptions of and responses to VAWG and challenges in accessing support services among female violence survivors in Arbaminch City. METHODS: We adopted a phenomenological explorative qualitative study design. A total of 62 participants including female violence survivors, religious leaders, service providers, police, women, and men in participated in interviews, focus group discussions, and observations in August 2022. Participants were selected purposively, and the findings were analyzed thematically. We applied data source and respondent triangulation to increase the findings' trustworthiness. RESULTS: Community perceptions of VAWG, specifically of intimate partner violence (IPV) and non-partner sexual violence (NPSV), varied depending on gender, age, and social position. IPV and NPSV were normalized through tolerance and denial by young and married men, while resistance to all forms of violence was common among women. Survivors of violence responded to the act of violence by leaving their homes, separating from their husbands, or taking harsh actions against their husbands, such as murder. Support for VAWG survivors was available through health care, free legal services, and a temporary shelter. Yet factors ranging from individual to societal levels, such as fear, lack of knowledge, lack of family and community support, and social and legal injustice, were barriers to accessing existing services. Nonetheless, violence survivors desired to speak about their experiences and seek psychosocial support. CONCLUSIONS: Our qualitative evidence gathered here can inform tailored VAWG prevention and response services such as interventions to shift social norms and the perception towards VAWG among different population group through raising awareness in schools, health care settings, faith-based venues, and using social media.