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1.
Am J Public Health ; 111(2): 318-326, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33351656

RESUMEN

Objectives. To estimate US nonlethal violent victimization rates for lesbian, gay, and bisexual (LGB) males and females aged 16 years and older and to compare disparities among LGB and straight males and females, controlling for other correlates of victimization.Methods. We used data from the 2017 and 2018 National Crime Victimization Survey (NCVS) to provide nationally representative rates of various forms of violent victimization for self-identified LGB and straight persons. Multivariable models assessed the risk for violence associated with LGB status.Results. Total violence rates were 2 to 9 times higher among LGB persons compared with heterosexuals. For some forms of violence (e.g., rape and sexual assault, violence with serious injuries, and multiple offender violence) there were notably high disparities between bisexuals and heterosexuals. With adjustment for covariates, LGB orientation was associated with odds ratios nearly 2 to 4 times those of heterosexuals.Conclusions. This is one of the first known uses of NCVS data to estimate LGB victimization, revealing substantially higher rates of violence directed at LGB individuals.Public Health Implications. Sexual orientation and gender identity questions in federal surveys such as the NCVS enable monitoring of violent victimization rates and should continue. Collecting these data can help researchers understand victimization risk and guide appropriate resources toward victim services, especially important given the high violent crime levels experienced by LGB individuals.


Asunto(s)
Acoso Escolar/estadística & datos numéricos , Víctimas de Crimen/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Minorías Sexuales y de Género/estadística & datos numéricos , Violencia/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto Joven
2.
Rev Saude Publica ; 54: 134, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33331528

RESUMEN

OBJECTIVE: This study aims to investigate the prevalence of adolescents and young adults who were victims of sexual violence at some point in their lives and to compare the presence of depressive and anxious symptoms, quality of life, and use of alcohol, tobacco, and illegal drugs among this population and those who were not abused. METHODS: Validated questionnaires and instruments were applied in a group of university students to assess: sexual profile and behavior, socioeconomic status, presence or not of sexual violence (Questionnaire on Exposure to Traumatizing Events), depressive (Beck Depression Inventory) and anxious symptoms (Beck Anxiety Inventory), quality of life (World Health Organization's Quality of Life Assessment) and the use or abuse of tobacco, alcohol, and illegal drugs (Smoking, Alcohol, and Substance Involvement Screening Test). RESULTS: Out of the 858 students who participated, 71 (8.3%) were victims of sexual violence, 52 girls (73.2%). In the victims of violence group there were more students who already had the first sexual intercourse (p = 0.029), students who already had become pregnant (p = 0.001), students with higher scores for depressive (p < 0.001) and anxious symptoms (p = 0.001), students with worse quality of life (p < 0.001), and who used more tobacco (p = 0.008) and marijuana (p = 0.025) as well as abused hypnotics or sedatives (p = 0.048) than in the non-victim group. CONCLUSION: The abuses are presented in several forms and affect, even in long term, the survivors' life. The sexual violence theme should be addressed and widely discussed in all spheres of society in order to mobilize, to sensitize, and provide society with knowledge, demystifying this subject and drawing attention to this important social issue.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Trastornos Relacionados con Alcohol/psicología , Ansiedad/psicología , Depresión/psicología , Calidad de Vida/psicología , Delitos Sexuales/psicología , Estudiantes/psicología , Trastornos Relacionados con Sustancias/psicología , Fumar Tabaco/psicología , Adolescente , Trastornos Relacionados con Alcohol/epidemiología , Ansiedad/epidemiología , Brasil/epidemiología , Niño , Abuso Sexual Infantil/psicología , Abuso Sexual Infantil/estadística & datos numéricos , Depresión/epidemiología , Femenino , Humanos , Drogas Ilícitas , Masculino , Embarazo , Delitos Sexuales/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Encuestas y Cuestionarios , Fumar Tabaco/epidemiología , Adulto Joven
3.
Rev Saude Publica ; 54: 97, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33146302

RESUMEN

OBJECTIVE: To identify the prevalence of violence during pregnancy and the association with the socioeconomic, behavioral and clinical characteristics of pregnant women. METHODS: Cross-sectional study in a low-risk maternity hospital in the municipality of Cariacica, Espírito Santo. A total of 330 puerperal women were interviewed from August to October 2017. Information on socioeconomic, behavioral, reproductive and clinical characteristics, as well as life experiences, was collected through a questionnaire. To identify the types of violence, the proper World Health Organization instrument was used. Gross bivariate and multivariate analysis was performed and adjusted for Poisson regression with robust variance. RESULTS: Prevalence was 16.1% (95%CI 2.5-20.4) for psychological violence, 7.6% (95%CI 5.1-11.0) for physical violence and 2.7% (95%CI 1.4-5.2) for sexual violence. Psychological violence remained associated with age, family income, beginning of sexual life, disease in pregnancy, desire to interrupt pregnancy and number of partners. Physical violence was associated with schooling, beginning of sexual life and disease in pregnancy. Sexual violence remained associated with marital status and desire to interrupt pregnancy (p < 0.05). CONCLUSIONS: Psychological violence by an intimate partner was the most prevalent among pregnant women. Women that were younger, had lower income and less schooling, who started their sexual life before the age of 14 and who wished to interrupt pregnancy, experienced violence more frequently during pregnancy.


Asunto(s)
Violencia de Pareja/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Abuso Físico/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Parejas Sexuales/psicología , Maltrato Conyugal/estadística & datos numéricos , Adulto , Brasil/epidemiología , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Violencia de Pareja/psicología , Abuso Físico/psicología , Embarazo , Prevalencia , Factores de Riesgo , Delitos Sexuales/psicología , Factores Socioeconómicos , Maltrato Conyugal/psicología
4.
MMWR Morb Mortal Wkly Rep ; 69(47): 1757-1761, 2020 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-33237890

RESUMEN

Sexual violence is prevalent and, for many victims, begins early in life (1). In the United States, one in five women and one in 38 men report completed or attempted rape victimization during their lifetime, with 43.2% of female and 51.3% of male victims reporting that their first rape victimization occurred before age 18 years (1). Media have been shown to act as a socializing agent for a range of health and social behaviors (2). Media portrayals might influence, reinforce, or modify how the public responds to incidents of sexual violence and their support for prevention efforts and media might construct a lens through which the public can understand who is affected by sexual violence, what forms it takes, why it happens, and who is responsible for addressing it (3). Media portrayals of sexual violence were assessed using a systematic random sample of newspaper articles from 48 of the top 50 distributed traditional print media outlets that were examined for sexual violence content and potential differences by geographic region and year of publication. Differences by year and region in type of sexual violence covered, media language used, and outcomes reported were identified, highlighting an opportunity for public health officials, practitioners, and journalists to frame sexual violence as a preventable public health issue and to incorporate best practices from CDC and the National Sexual Violence Resource Center's Sexual Violence Media Guide (4).


Asunto(s)
Medios de Comunicación de Masas/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Humanos , Estados Unidos
5.
Afr J AIDS Res ; 19(3): 242-248, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33119458

RESUMEN

The vulnerability of adolescents and young adults in South Africa to HIV and sexual violence is well documented. Post-exposure prophylaxis (PEP) is available for victims of sexual abuse in the country but awareness of this measure is required to maximise its HIV-prevention benefits. This study examined levels of PEP awareness and its correlates and the uptake of PEP among 772 students (16-24 years) in a South African university using stratified random sampling. Overall, we included more females (477) than males (295), reflecting the male-female ratio at the university. Adjusted and unadjusted logistic regression models were used to determine correlates of PEP awareness, which was low (24.1%), particularly among those who experienced sexual violence in the past year (19.8%) compared those who had not (24.8%). Only 2.6% of participants had used PEP, while 7.5% had seen it, and 14.6% knew where to get it. In the adjusted model, adequate family support (AOR: 2.22; CI: 1.54-3.20) and prior HIV testing (AOR: 2.65; CI: 1.59-4.42) were associated with a higher likelihood of PEP awareness. The study concluded that awareness of PEP was low in the study setting and especially among those who need it. Social marketing of PEP is needed in the study settings to realise the maximum benefits of PEP in preventing new HIV infections.


Asunto(s)
Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Profilaxis Posexposición/estadística & datos numéricos , Adolescente , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Humanos , Masculino , Delitos Sexuales/estadística & datos numéricos , Sudáfrica/epidemiología , Estudiantes , Universidades , Adulto Joven
6.
N Z Med J ; 133(1523): 55-64, 2020 10 09.
Artículo en Inglés | MEDLINE | ID: mdl-33032303

RESUMEN

AIMS: The aim of this study was to investigate the number and correlates of sexual assault among students at a campus-based university in Aotearoa New Zealand and to determine how often students disclose such experiences to health professionals, other services and family/friends. METHODS: An online survey based on the Administrator-Researcher Campus Climate Consortium tool was emailed to all students at the main campus of a large university in Aotearoa/New Zealand. It was completed by 1,540 students (8.1% of those emailed) of any gender in July-August 2019. RESULTS: During their time at university to-date, 28% of the sample had experienced at least one form of sexual assault with 14.9% reporting experiences that meet a definition of rape. Sixty-six percent of victims in the sample and 53% of the reported perpetrators had been using alcohol at the time of the assault. Only 8% of those reporting sexual assault in the sample disclosed the assault to a health professional. CONCLUSIONS: Considering the low number of university students disclosing sexual assaults to health professionals or support services, the results of this survey suggest more work is needed to facilitate greater disclosures to health professionals enabling victims to access the services they need regardless of alcohol use.


Asunto(s)
Revelación/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Universidades , Adulto Joven
7.
Reprod Health ; 17(1): 152, 2020 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-33028424

RESUMEN

BACKGROUND: As the global pandemic of corona virus (COVID-19) spreads across continents and communities, people are forced to respond with strict preventive measures such as staying at home and keeping social distance. In relation with these measures, particularly with the staying at home, increasing rates of domestic violence are beginning to surface. Hence, this study was aimed at determining the prevalence of intimate partner violence against reproductive age women in northern Ethiopia during the COVID-19 pandemic. METHODS: A community-based cross-sectional study design was employed. The data were collected during the period of April to May, 2020 using interviews and a self-administered standard questionnaire. The data were entered into the Epi-data manager version 4.2 and exported to SPSS 22 for analysis. The descriptive analysis such as frequency distribution, percentage, and measures of central tendency were used. This was followed by binary and multiple logistic regression analysis to infer the association between the outcome and independent variables. RESULTS: A total of 682 participants were included in the study. The prevalence of intimate partner violence against women was found to stood at 24.6% with psychological violence being the most prevalent (13.3%), followed by physical (8.3%) and sexual violence (5.3%). Women were more likely to suffer from violence if they were housewives (AOR, 95% CI (18.062 (10.088, 32.342))), age less than 30 (AOR, 95% CI (23.045 (5.627, 94.377))), women with arrange marriage (AOR, 95% CI (2.535 (1.572, 4.087))) and women with husband's age being "between" 31-40 (AOR, CI 95% (2.212 (1.024, 4.777))). CONCLUSIONS: This study showed the presence of a relatively high prevalence of intimate partner violence against women. Thus, public reporting of any cases or concerns of abuse is critical and vital to mitigate the problem.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Investigación Participativa Basada en la Comunidad , Infecciones por Coronavirus/epidemiología , Violencia Doméstica/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Neumonía Viral/epidemiología , Delitos Sexuales/estadística & datos numéricos , Parejas Sexuales/psicología , Adulto , Infecciones por Coronavirus/virología , Estudios Transversales , Etiopía/epidemiología , Femenino , Humanos , Masculino , Pandemias , Neumonía Viral/virología , Prevalencia , Reproducción , Factores de Riesgo , Adulto Joven
8.
PLoS One ; 15(10): e0237965, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33044980

RESUMEN

BACKGROUND: Conflict and humanitarian crises increase the risk of both intimate partner violence and non-partner sexual violence against women and girls. We measured the prevalence and risk factors of different forms of violence against women and girls in South Sudan, which has suffered decades of conflict, most recently in 2013. METHODS: A population-based survey was conducted among women aged 15-64 in three conflict-affected sites in South Sudan: Juba, Rumbek, and the Protection of Civilian Sites (PoCs) in Juba between 2015 and 2016. FINDINGS: A total of 2,244 women between the ages of 15-64 were interviewed. Fifty percent (in the Juba PoCs) to 65% (in Juba and Rumbek) of all female respondents experienced either physical or sexual violence from a partner or non-partner in the course of their lifetimes. Approximately 35% of respondents have experienced rape, attempted rape or other forms of sexual violence by a non-partner during their lifetime. For ever-partnered women, lifetime prevalence of physical and/or sexual partner violence ranged between 54% in the Juba PoCs and 73% in Rumbek. Restrictive marital practices and gender norms, and experiences of conflict were major drivers of both partner and non-partner violence. CONCLUSION: Women and girls in South Sudan suffer among the highest levels of physical and sexual violence in the world. Although the prevalence of sexual assault by non-partners is four times the global average, women are still at greatest risk of physical and sexual assault from intimate partners. Conflict-related and intimate partner violence reinforce each other and are upheld by restrictive gender norms and marital practices. Expansion of comprehensive services, including health and psycho-social support for survivors is urgently needed. Moreover, policies and laws to prevent violence against women and provide survivors with access to justice should be given high priority within the ongoing peacebuilding process in South Sudan.


Asunto(s)
Violencia de Género , Adolescente , Adulto , Conflictos Armados/estadística & datos numéricos , Estudios Transversales , Violencia Étnica/estadística & datos numéricos , Femenino , Violencia de Género/estadística & datos numéricos , Humanos , Violencia de Pareja/estadística & datos numéricos , Persona de Mediana Edad , Prevalencia , Violación/estadística & datos numéricos , Factores de Riesgo , Delitos Sexuales/estadística & datos numéricos , Sudán del Sur/epidemiología , Encuestas y Cuestionarios , Violencia/estadística & datos numéricos , Adulto Joven
9.
Neurology ; 95(19): e2605-e2609, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33004606

RESUMEN

OBJECTIVE: Asylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers. METHODS: A retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics. RESULTS: A total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0-8.7) and depression (OR 2.5, 95% CI 1.1-5.7). CONCLUSIONS: We observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.


Asunto(s)
Ansiedad/epidemiología , Traumatismos Craneocerebrales/epidemiología , Depresión/epidemiología , Cefalea/epidemiología , Refugiados/estadística & datos numéricos , Trastornos por Estrés Postraumático/epidemiología , Violencia/estadística & datos numéricos , Adolescente , Adulto , Ansiedad/psicología , Conmoción Encefálica/epidemiología , Conmoción Encefálica/psicología , Traumatismos Craneocerebrales/psicología , Estudios Transversales , Depresión/psicología , El Salvador/etnología , Femenino , Guatemala/etnología , Haití/etnología , Cefalea/psicología , Honduras/etnología , Humanos , Masculino , Trastornos de la Memoria/epidemiología , Trastornos de la Memoria/psicología , México/etnología , Nicaragua/etnología , Oportunidad Relativa , Cuestionario de Salud del Paciente , Prevalencia , Trauma Psicológico/epidemiología , Trauma Psicológico/psicología , Refugiados/psicología , Estudios Retrospectivos , Distribución por Sexo , Delitos Sexuales/psicología , Delitos Sexuales/estadística & datos numéricos , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Trastornos por Estrés Postraumático/psicología , Inconsciencia/epidemiología , Inconsciencia/psicología , Estados Unidos/epidemiología , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/psicología , Adulto Joven
10.
PLoS One ; 15(9): e0239187, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32941533

RESUMEN

OBJECTIVES: Sexual violence can have a destructive impact on the lives of people. It is more common in unstable conditions such as during displacement or migration of people. On the Greek island of Lesvos, Médecins Sans Frontières provided medical care to survivors of sexual violence among the population of asylum seekers. This study describes the patterns of sexual violence reported by migrants and asylum seekers and the clinical care provided to them. METHODS: This is a descriptive study, using routine program data. The study population consisted of migrants and asylum seekers treated for conditions related to sexual violence at the Médecins Sans Frontières clinic on Lesvos Island (September 2017-January 2018). RESULTS: There were 215 survivors of sexual violence who presented for care, of whom 60 (28%) were male. The majority of incidents reported (94%) were cases of rape; 174 (81%) of survivors were from Africa and 185 (86%) of the incidents occurred over a month before presentation. Half the incidents (118) occurred in transit, mainly in Turkey, and 76 (35%) in the country of origin; 10 cases (5%) occurred on Lesvos. The perpetrator was known to the survivor in 23% of the cases. The need for mental health care exceeded the capacity of available mental care services. CONCLUSION: Even though the majority of cases delayed seeking medical care after the incident, it is crucial that access to mental health services is guaranteed for those in need. Such access and security measures for people in transit need to be put in place along migration routes, including in countries nominally considered safe, and secure routes need to be developed.


Asunto(s)
Refugiados/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Niño , Femenino , Grecia , Humanos , Masculino , Salud Mental/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Campos de Refugiados/estadística & datos numéricos , Refugiados/psicología , Sociedades Médicas/estadística & datos numéricos , Migrantes/psicología
11.
PLoS One ; 15(8): e0237060, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32750062

RESUMEN

BACKGROUND: Often neglected, male-directed sexual violence (SV) has recently gained recognition as a significant issue. However, documentation of male SV patients, assaults and characteristics of presentation for care remains poor. Médecins Sans Frontières (MSF) systematically documented these in all victims admitted to eleven SV clinics in seven African countries between 2011 and 2017, providing a unique opportunity to describe SV patterns in male cases compared to females, according to age categories and contexts, thereby improving their access to SV care. METHODS AND FINDINGS: This was a multi-centric, cross-sectional study using routine program data. The study included 13550 SV cases, including 1009 males (7.5%). Proportions of males varied between programs and contexts, with the highest being recorded in migratory contexts (12.7%). Children (<13yrs) represented 34.3% of males. Different SV patterns appeared between younger and older males; while male children and adolescents were more often assaulted by known civilians, without physical violence, adult males more often endured violent assault, perpetrated by authority figures. Male patients presented more frequently to clinics providing integrated care (medical and psychological) for victims of violence (odds ratio 3.3, 95%CI 2.4-4.6), as compared to other types of clinics where SV disclosure upon admission was necessary. Males, particularly adults, were disproportionately more likely to suffer being compelled to rape (odds ratio 12.9, 95%CI 7.6-21.8).Retention in SV care was similar for males and females. CONCLUSIONS: Patterns of male-directed SV varied considerably according to contexts and age categories. A key finding was the importance of the clinic setup; integrated medical and SV clinics, where initial disclosure was not necessary to access care, appeared more likely to meet males' needs, while accommodating females' ones. All victims' needs should be considered when planning SV services, with an emphasis on appropriately trained and trauma-informed medical staff, health promotion activities and increased psychosocial support.


Asunto(s)
Delitos Sexuales/estadística & datos numéricos , Adolescente , Adulto , África/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Hombres , Persona de Mediana Edad , Violación/estadística & datos numéricos , Adulto Joven
12.
Public Health Rep ; 135(5): 555-559, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32762635

RESUMEN

Young adults are at high risk for sexual harassment and sexual assault. Although attention has been given to prevention on college campuses, the need for prevention may be at least as high for young adults who do not attend college as for young adults who do. In October 2019, we administered a nationally representative survey of 893 adults to measure sexual harassment and sexual assault victimization during a recall period defined as "during college years" for respondents who had enrolled in college at any time or "ages 18-24" for respondents not in college. Reported rates of sexual harassment (32.7%) and sexual assault (24.6%) during early adulthood were similar for respondents who reported having ever enrolled in college and for respondents who reported never attending college. Women were more likely than men to report both sexual harassment (37.4% vs 22.4%) and sexual assault (36.0% vs 16.0%) during early adulthood. Compared with respondents aged ≥30, respondents aged 18-29 were 105% more likely to report sexual harassment and 65% more likely to report sexual assault. Moreover, sexual harassment experiences predicted sexual assault victimization (adjusted odds ratio = 18.1). This study highlights the importance of attending to sexual harassment and sexual assault risks for young adults through research, policy, and criminal justice structures beyond institutions of higher education. Evidence that sexual harassment is strongly associated with sexual assault victimization of young adults highlights the importance of naming and stemming early behavioral transgressions across the US population.


Asunto(s)
Víctimas de Crimen/estadística & datos numéricos , Medición de Riesgo/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Acoso Sexual/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Universidades/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto Joven
13.
S Afr Med J ; 110(5): 377-381, 2020 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-32657721

RESUMEN

BACKGROUND: South Africa (SA) is known to have high levels of sexual and gender-based violence (SGBV) and HIV. Studies that explore the intersections of the two phenomena tend to be done at sites that provide services for survivors of SGBV, but few have explored experiences of SGBV of individuals attending HIV testing and treatment health facilities. Although HIV voluntary counselling and testing (VCT) services are generally well practised at ensuring pre- and-post-test counselling, there is little evidence that SGBV is included in routine screening. There is therefore a gap in knowledge of the prevalence of SGBV among patient populations in HIV testing and treatment settings. OBJECTIVES: To assess levels of SGBV in a patient population of an HIV facility in SA. METHODS: This cross-sectional study used a screening tool and a longer in-depth questionnaire on the prevalence of SGBV. A random sample of VCT clients were screened. Prevalence questionnaires were administered to a convenience sample of patients attending treatment literacy classes. RESULTS: A total of 1 936 VCT clients completed the screening tool, of whom 2% reported forced sex without a condom or rape. Of the 436 patients who completed the in-depth prevalence questionnaire, 71% were women; 12% of women had been forced to have sex the last time that they had sexual intercourse. The lifetime prevalence of sexual violence was 14% and the lifetime prevalence of physical violence was 16%. CONCLUSIONS: Levels of SGBV are high among populations attending HIV testing and treatment facilities. Healthcare providers need to be able to identify SGBV and provide appropriate services to survivors of SGBV who are seen at HIV testing and treatment facilities.


Asunto(s)
Violencia de Género/estadística & datos numéricos , Infecciones por VIH/epidemiología , Delitos Sexuales/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Sudáfrica/epidemiología , Encuestas y Cuestionarios
15.
BMC Public Health ; 20(1): 937, 2020 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-32611321

RESUMEN

BACKGROUND: The study aimed to investigate the associations between physical partner violence victimization (IPV) and/or sexual violence victimization and various health risk behaviours and mental health in university students in 25 countries. METHODS: Using a cross-sectional study design, 18,335 university students with a median age of 20 years from 25 countries in Africa, the Americas and Asia, replied to self-reported measures of interpersonal violence, health compromising behaviours, mental health measures and protective factors. RESULTS: In adjusted logistic regression analysis, physical IPV and/or sexual violence victimization was associated, among men and/or among women, with sexual risk behaviours (multiple sexual partners, alcohol use in the context of sex, diagnosed with HIV and pregnancy), violence related behaviour (in a physical fight and carrying a weapon), poor mental health (depression, loneliness, post-traumatic stress disorder, sleeping problem and short sleep), addictive behaviour (binge drinking, tobacco and drug use), and other health risk behaviour (skipping breakfast and frequent salt intake). CONCLUSIONS: We found evidence that physical IPV and/or sexual violence victimization among female and/or male university students was associated with 4 of 5 sexual risk behaviours, 2 violence related behaviours, 5 of 5 poor mental health indicators, 3 of 3 addictive behaviours and 2 of 7 other health risk behaviours.


Asunto(s)
Víctimas de Crimen/psicología , Conductas de Riesgo para la Salud , Violencia de Pareja/psicología , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Delitos Sexuales/psicología , Estudiantes/psicología , Adulto , África/epidemiología , Asia/epidemiología , Víctimas de Crimen/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Violencia de Pareja/estadística & datos numéricos , Masculino , Embarazo , Factores de Riesgo , Autoinforme , Delitos Sexuales/estadística & datos numéricos , América del Sur/epidemiología , Estudiantes/estadística & datos numéricos , Universidades , Indias Occidentales/epidemiología , Adulto Joven
16.
Proc Natl Acad Sci U S A ; 117(24): 13421-13427, 2020 06 16.
Artículo en Inglés | MEDLINE | ID: mdl-32482858

RESUMEN

Although the backlog of untested sexual assault kits in the United States is starting to be addressed, many municipalities are opting for selective testing of samples within a kit, where only the most probative samples are tested. We use data from the San Francisco Police Department Criminalistics Laboratory, which tests all samples but also collects information on the samples flagged by sexual assault forensic examiners as most probative, to build a standard machine learning model that predicts (based on covariates gleaned from sexual assault kit questionnaires) which samples are most probative. This model is embedded within an optimization framework that selects which samples to test from each kit to maximize the Combined DNA Index System (CODIS) yield (i.e., the number of kits that generate at least one DNA profile for the criminal DNA database) subject to a budget constraint. Our analysis predicts that, relative to a policy that tests only the samples deemed probative by the sexual assault forensic examiners, the proposed policy increases the CODIS yield by 45.4% without increasing the cost. Full testing of all samples has a slightly lower cost-effectiveness than the selective policy based on forensic examiners, but more than doubles the yield. In over half of the sexual assaults, a sample was not collected during the forensic medical exam from the body location deemed most probative by the machine learning model. Our results suggest that electronic forensic records coupled with machine learning and optimization models could enhance the effectiveness of criminal investigations of sexual assaults.


Asunto(s)
Víctimas de Crimen , Ciencias Forenses/economía , Aplicación de la Ley/métodos , Delitos Sexuales , Manejo de Especímenes/economía , Adulto , Análisis Costo-Beneficio , Víctimas de Crimen/estadística & datos numéricos , ADN/análisis , Bases de Datos de Ácidos Nucleicos , Femenino , Ciencias Forenses/estadística & datos numéricos , Humanos , Aprendizaje Automático , Masculino , San Francisco , Delitos Sexuales/estadística & datos numéricos , Manejo de Especímenes/estadística & datos numéricos
17.
Rev Bras Epidemiol ; 23: e200038, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32491050

RESUMEN

INTRODUCTION: Sexual violence has emerged in the health field with changes in the epidemiological profiles of populations. METHODOLOGY: An ecological study with 5,565 Brazilian municipalities between 2010 and 2014. A descriptive analysis of the variables (Population rate of sexual violence reporting, household income per capita and HDI) and their stratification by quintile was performed. In order to explore the factors associated with changes in social inequalities regarding the rate of reporting of sexual violence, the Slope Index of Inequality and Relative Index of Inequality were adopted. An Equiplot was constructed for the outcome on each independent variable. RESULTS: The mean rate of reports of sexual violence in Brazil was 4.38 reports/100,000 inhabitants for the period. There was an increase in the rate of sexual violence and improvement in socioeconomic conditions. There was a higher rate of reporting in the quintile with better living conditions. An increase in the inequality of the rate of sexual violence as a function of household income and the HDI was observed. Several factors seem to influence the increase of reports of sexual violence in the country, among them the improvement in the living conditions of the population and greater moral sensitivity to violence. However, there is still a disparity in reporting among municipalities according to their socioeconomic status. CONCLUSION: The lack of public policies on social equity in health has interfered with reports of sexual violence in the country and has widened health inequities.


Asunto(s)
Disparidades en el Estado de Salud , Delitos Sexuales/tendencias , Determinantes Sociales de la Salud/tendencias , Factores Socioeconómicos , Brasil/epidemiología , Ciudades/epidemiología , Femenino , Humanos , Modelos Lineales , Masculino , Notificación Obligatoria , Delitos Sexuales/estadística & datos numéricos , Condiciones Sociales/tendencias , Factores de Tiempo
18.
Womens Health Issues ; 30(5): 374-383, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32571623

RESUMEN

BACKGROUND: Although sexual assault survivors are at increased risk for adverse physical and mental health outcomes and tend to use more health care services, little is known about women veterans' lifetime history of experiencing sexual assault (lifetime sexual assault [LSA]) and emergency department (ED) use. We sought to examine associations between experiencing LSA, mental health diagnoses, and ED use among women veterans. METHODS: Computer-assisted telephone interviews were conducted with 980 women veterans enrolled at two Veterans Affairs (VA) Medical Centers to assess history of experiencing LSA, health care use, sociodemographic characteristics, and military history. Administrative data provided VA use, mental health, and medical diagnoses. Logistic regression analyses examined associations between experiencing LSA and mental health diagnoses and past 5-year ED use. Classification tree analysis characterized ED use in participant subgroups. RESULTS: Sixty-four percent of participants visited a VA or non-VA ED during the previous 5 years. Women veterans with histories of mental health diagnoses and who experienced sexual assault had an odds of ED use almost two times greater than those with no history of experiencing sexual assault and no mental health diagnoses. The odds were similar for experiencing attempted (adjusted odds ratio, 1.85) and completed (adjusted odds ratio, 1.95) sexual assault. Classification tree analysis identified reliance on VA care and the composite variable representing experiencing LSA and mental health diagnoses as factors that best discriminated ED users from nonusers. CONCLUSIONS: Experiencing LSA is associated with greater ED use in women veterans enrolled in the VA. Whether finding this reflects greater emergent health care needs, suboptimal access and treatment for conditions that could be managed in other settings, lack of health care coordination, or some combination of these factors is unclear.


Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Veteranos/estadística & datos numéricos , Adulto , Femenino , Estado de Salud , Humanos , Salud Mental , Persona de Mediana Edad , Estados Unidos , United States Department of Veterans Affairs , Salud de los Veteranos , Adulto Joven
19.
PLoS One ; 15(5): e0233185, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32413081

RESUMEN

BACKGROUND: People with a history of interpersonal trauma, including intimate partner violence, sexual assault, and adverse childhood experiences, are disproportionately affected by the current opioid epidemic. Interpersonal trauma has been shown to increase risk for chronic pain conditions, prescription opioid use, and opioid misuse. Stress, cognition, and affective function have been examined as potential mechanisms that may influence opioid misuse among individuals with a history of interpersonal trauma. However, no studies have examined these factors simultaneously, despite their interrelatedness. OBJECTIVE: The purpose of this study was to 1) examine perceived stress, perceived cognitive function, depressive symptoms, and PTSD symptoms as potential mechanisms of opioid misuse among individuals with a history of interpersonal trauma, 2) examine the types of interpersonal trauma that are associated with opioid misuse, and 3) assess the mediating role of pain and opioid prescription. METHODS: A cross-sectional, observational study design was conducted. Data were collected through a confidential self-report online survey using validated instruments (n = 230). A series of regression analyses were conducted to identify mechanistic factors and interpersonal trauma types associated with opioid misuse, opioid prescription, and pain intensity. Structural equation modeling was used to examine mediating effects of pain intensity and opioid prescription. RESULTS: Opioid prescription, depressive symptoms, and intimate partner violence increased the odds of reporting opioid misuse. Pain intensity and adverse childhood experiences increased the odds of opioid prescription. Higher levels of perceived stress and depressive symptoms were associated with increased pain intensity. Pain intensity emerged as a mediator of the relationship between depressive symptoms and opioid misuse. CONCLUSIONS: Our work shows that there are likely several pathways through which interpersonal trauma can lead to opioid misuse. Interventions aimed at improving depressive symptoms and coping with traumatizing events should be included as part of comprehensive trauma-informed pain management practices.


Asunto(s)
Violencia de Pareja/estadística & datos numéricos , Trastornos Relacionados con Opioides/epidemiología , Mal Uso de Medicamentos de Venta con Receta/estadística & datos numéricos , Trauma Psicológico , Adulto , Analgésicos Opioides/uso terapéutico , Ciencias Bioconductuales , Dolor Crónico/psicología , Cognición/fisiología , Estudios Transversales , Depresión/epidemiología , Depresión/etiología , Depresión/psicología , Femenino , Humanos , Masculino , Trastornos Relacionados con Opioides/etiología , Autoinforme , Delitos Sexuales/psicología , Delitos Sexuales/estadística & datos numéricos , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Encuestas y Cuestionarios , Adulto Joven
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