Coformulated Bictegravir/Emtricitabine/Tenofovir Alafenamide for Postexposure Prophylaxis After Sexual Assault: A Retrospective Real-World Study.

We report the experience of bictegravir/emtricitabine/tenofovir alafenamide for nonoccupational postexposure prophylaxis in sexual assault cases. Between June 2021 and October 2023, 39 individuals completed the 28-day follow-up; 41% experienced some side effects, and 1 person discontinued the drug because of a rash. No individuals seroconverted to HIV during the follow-up period.

Sexual Victimization and Sexually Transmitted Infections Among a Nationally Representative Sample of Adolescents and Young Adults in Haiti.

Sexual assault victims are at major risk of being infected by sexually transmitted infections (STI). This article aims to examine and compare the prevalence of eight STIs (e.g., chlamydia, gonorrhea, hepatitis B, HIV/AIDS, human papillomavirus) among victims and non-victims of sexual abuse. A national cross-sectional study was conducted in Haiti, using a multistage sampling frame, stratified by geographical department, urban or rural setting, gender, and age groups (15-19 and 20-24 years). The final sample included 3586 household participants (47.6% female). A weighted sample of 3945 individuals was obtained and used in the following analyses. Overall, 21.75% (95% CI 19.91-23.59) of participants reported having been diagnosed with at least one STI in their lifetime, with a higher prevalence among men (25.70%; 95% CI 22.89-28.52), compared to women (18.11%; 95% CI 15.73-20.49), χ2 = 16.43; p < 0.001). Sexual abuse victims were more likely to report STIs (31.27%; 95% CI 29.21-33.34), compared to non-victims (18.40%; 95% CI 16.68-20.13), χ2 = 27.89; p < .001. Sexual abuse was associated to an increased risk of contracting at least one STI (OR = 1.74; 95% CI 1.35, 2.24). The results demonstrate that sexual abuse is associated with a general increase of reporting STIs. They indicate the need for national sexual abuse prevention programs at early ages. These programs should be implemented in schools and churches, focusing on the role of families in sexuality education. Finally, programs must be developed to eradicate community violence-especially in the cities-as increased political and social violence has always been associated with increased sexual abuse in Haiti.

Profile of female survivors of sexual violence in the first 6 months of the COVID-19 quarantine in the city of Campinas, Brazil: A cross-sectional retrospective study.

OBJECTIVES: Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID-19 pandemic in a Brazilian city. METHODS: This is a cross-sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women's Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher's exact tests were used to compare groups; the significance level was 5%. RESULTS: Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months. CONCLUSION: The COVID-19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic.

Characteristics of Pediatric Concussion across Different Mechanisms of Injury in 5 through 12-Year-Olds.

OBJECTIVE: To investigate characteristics of sport-related concussion (SRC), recreation-related concussion (RRC), and nonsport or recreation-related concussion (non-SRRC) in patients 5 through 12 years old, an understudied population in youth concussion. STUDY DESIGN: This observational study included patients aged 5 through 12 years presenting to a specialty care concussion setting at ≤28 days postinjury from 2018 through 2022. The following characteristics were assessed: demographics, injury mechanism (SRC, RRC, or SRRC), point of healthcare entry, and clinical signs and symptoms. Kruskal-Wallis and chi-square tests were used to assess group differences. Posthoc pairwise comparisons were employed for all analyses (α = 0.017). RESULTS: One thousand one hundred forty-one patients reported at ≤28 days of injury (female = 42.9%, median age = 11, interquartile range (IQR) = 9-12) with the most common mechanism being RRC (37.3%), followed by non-SRRC (31.9%). More non-SRRCs (39.6%) and RRC (35.7%) were first seen in the emergency department (P < .001) compared with SRC (27.9%). Patients with RRC and non-SRRC were first evaluated at specialists 2 and 3 days later than SRC (P < .001). Patients with non-SRRC reported with higher symptom burden, more frequent visio-vestibular abnormalities, and more changes to sleep and daily habits (P < .001) compared with RRC and SRC (P < .001). CONCLUSIONS: In concussion patients 5 through 12 years, RRCs and non-SRRC were more prevalent than SRC, presenting first more commonly to the emergency department and taking longer to present to specialists. Non-SRRC had more severe clinical features. RRC and non-SRRC are distinct from SRC in potential for less supervision at time of injury and less direct access to established concussion health care following injury.

Interaction between PTSD-PRS and trauma affects PTSD likelihood in women victims of sexual assault.

OBJECTIVE: Post-traumatic stress disorder (PTSD) is triggered by traumatic events, but genetic vulnerability and a history of childhood trauma are additional factors that may increase the risk of PTSD. Thus, our study focused on exploring the interaction between genetic susceptibility, as assessed by polygenic risk score (PRS), and traumatic events. METHODS: We evaluated 68 women with PTSD who had been sexually assaulted and 63 healthy controls without a history of sexual assault. DNA was genotyped using the Infinium Global Screening Array (Illumina), and PRS analysis was performed using PRSice. Furthermore, logistic regression models were employed to examine the interaction between childhood trauma, traumatic life events, and PTSD-PRS and how they contribute to the risk of developing PTSD. RESULTS: We found a significant association between PRS, childhood trauma (p = 0.03; OR = 1.241), and PTSD. Additionally, an interaction was observed between PRS, traumatic life events, and childhood trauma, particularly relating to physical and emotional neglect (p = 0.028; OR = 1.010). When examining neglect separately, we found a modest association between emotional neglect and PTSD (p = 0.014; OR = 1.086). CONCLUSIONS: Our findings highlight the importance of considering genetic vulnerability and traumatic experiences in understanding the etiology of PTSD.

A conduta do odontopediatra em UTI perante casos de abuso sexual infantil / The course of action of the ICU pediatric dentist towards children sexual abuse incidents

O referido trabalho visa apresentar a importância do cirurgião dentista, especialista em odontopediatria, em ambiente hospitalar, esclarecendo sinais e manifestações orais que devam despertar a atenção de um possível abuso sexual infantil, a fim de que seja feita uma notificação plausível e baseada em evidências. Esta revisão de literatura tem bibliografia baseada em artigos da Constituição Federal e artigos científicos buscados na plataforma Scientific Electronic Library Online (SciELO). A busca foi feita por meio de palavras-chave em um intervalo de 2002 a 2022, não se resumindo a um período máximo de 10 anos devido à dificuldade em encontrar referências atuais. Cerca de 29 artigos foram encontrados e após a leitura do título e resumo de cada um, 14 foram excluídos em razão de seu conteúdo não estar relacionado ao tema proposto. 15 foram lidos na íntegra. 3 manuais disponibilizados para profissionais da saúde e artigos do Estatuto da Criança e do Adolescente, bem como 1 lei municipal do Rio de Janeiro foram utilizados. Como resultado geral, foram encontradas manifestações orais e Infecções Sexuais Transmissíveis (ISTs) mais recorrentes, sinais apresentados por pacientes vítimas de abuso sexual, quais condutas obrigatórias a seguir e a importância do odontopediatra, em ambiente hospitalar, mais precisamente na Unidade de Terapia Intensiva.

This work aims to present the importance and role of the dental surgeon, specialist in pediatric dentistry, in a hospital environment, clarifying which signs, and oral manifestations should draw attention to a possible child sexual abuse, in order to make a plausible report and evidence-based. A literature review was carried out with bibliography based on articles of the Federal Constitution and scientific articles found in platform Scientific Electronic Library Online (SciELO). The search was carried out using keywords in a range from 2002 to 2022, not limited to a maximum period of 10 years due to the difficulty in finding current references. About 29 articles were found and after reading the title and abstract of each one, 14 were excluded because their content was not related to the proposed theme. 15 were read in full. 3 manuals made available to health professionals and articles from the Child and Adolescent Statute, as well as 1 municipal law of Rio de Janeiro were used. As a general result, more recurrent oral manifestations and Sexually Transmitted Infections (STIs) were found, signs presented by patients victims of sexual abuse, what mandatory conducts to follow and the importance of the pediatric dentist in a hospital environment, more precisely in the Intensive Care Unit.

Combining surface-enhanced Raman spectroscopy and paper spray mass spectrometry for the identification and confirmation of psychotropic substances in alcoholic beverages.

Criminal practices in which an individual becomes vulnerable and prone to sexual assault after ingesting drinks spiked with doping substances have become a social concern globally. As forensic protocols require a multi-tiered strategy for chemical evidentiary analysis, the backlog of evidence has become a significant problem in the community. Herein, a fast, sensible, and complementary dual analytical methodology was developed using a single commercial paper substrate for surface-enhanced Raman spectroscopy (SERS) and paper spray mass spectrometry (PS-MS) analysis to identify psychotropic substances added to alcoholic beverages irrefutably. To study and investigate this criminal practice, pharmaceutical formulations containing distinct psychotropic substances (zolpidem, clonazepam, diazepam, and ketamine) were added to drinks typically consumed at parties and festivals (Pilsen beer, açaí Catuaba®, gin tonic, and vodka mixed with Coca-Cola Zero®). A simple liquid-liquid extraction with a low-temperature partitioning (LLE-LTP) procedure was applied to the drinks and effectively minimized matrix effects. As a preliminary analysis, SERS spectra combined with Hierarchical Clustering Analysis (HCA) provided sufficient information to investigate the samples further. The presence of the protonated species for the psychotropic substances in the spiked drinks was readily verified in the mass spectra and confirmed by tandem mass spectrometry. Finally, the results demonstrate the potential of this methodology to be easily implemented into the routine of forensic laboratories and to be further employed at harm reduction tends at parties and festivals to detect contaminated beverages promptly and irrefutably as an efficient tool to prevent such crimes.

Changes in attachment dimensions during the treatment of acute post-traumatic stress disorder in sexually assaulted Brazilian women.

Introduction: Attachment patterns are established during early childhood; however, extreme experiences throughout life may change this structure, either toward attachment security or insecurity. We analyzed changes in attachment dimensions in women with acute post-traumatic stress disorder (PTSD) following sexual assault, that were randomized to a 14-week treatment with either the medication sertraline or Interpersonal Psychotherapy. Methods: Seventy-four adult women who presented significant reduction in PTSD symptoms across the trial responded to the Revised Adult Attachment Scale at baseline, on week 8 of treatment, and at the end of the trial, on week 14. We fitted a generalized linear model to explain the attachment anxiety and avoidance scores at baseline. A generalized linear mixed model investigated how attachment dimensions changed over time. Socioeconomic data, treatment type, history of childhood trauma, and PTSD severity over the 14-week period were the considered covariates. Results: At baseline, attachment anxiety was associated with a history of early trauma. Attachment anxiety remained stable during the follow-up. Attachment avoidance, on the other hand, significantly increased from baseline to week 14. Higher avoidance was observed in patients with higher total PTSD scores and on the cluster of hyperarousal symptoms. Races other than White (black, mixed-race, or Asian) and younger age were associated with higher attachment avoidance. Discussion: Contrary to our expectations, attachment avoidance increased during follow-up, indicating changes in the interpersonal realm beyond the symptoms of PTSD.

Indicators of Eating Disorders in Sexually Abused Brazilian Adolescents: Family and School Contexts.

Eating disorders, characterized by abnormal eating behaviors, are among a wide variety of psychiatric conditions that mainly affect children and adolescents. These disorders have a multifactorial origin and can be associated with restrictive diets, negative feelings, harmful family relationships, and post-traumatic stress. Thus, this study's objective was to evaluate the association between indicators of eating disorders and family and school contexts in Brazilian adolescents who previously experienced sexual abuse and examine the findings based on sex. National School Health Survey data were utilized. Among 102,301 students between 11 and 19 years of age, 4124 reported having experienced sexual abuse and were included in this study. Self-report questionnaires were used to assess participants' health status and the presence of risk behaviors, which were examined through multivariate analysis using a Poisson regression model. The results indicated positive relationships between self-induced vomiting, laxative misuse, and other purgative methods and infrequent meals with family, hunger, and the presence of violence in students' daily lives, regardless of sex (p < 0.05). In addition, body dissatisfaction and negative feelings about one's body were associated with having been bullied or teased by schoolmates for both sexes (p < 0.05). Distant relationships with parents were associated with purgative methods and body dissatisfaction among female students (p < 0.05). In conclusion, body dissatisfaction, negative feelings about one's body, laxative misuse, self-induced vomiting, and purgative methods were found to be associated with factors in family and school contexts such as hunger, infrequent meals with family, family violence, distant relationships with parents, and bullying at school in adolescents who have previously experienced sexual abuse.

Peri-Traumatic Dissociation and Tonic Immobility as Severity Predictors of Posttraumatic Stress Disorder After Rape.

Some individuals show abnormal reactions to extreme fear and life-threatening situations, including tonic immobility (TI) and peri-traumatic dissociation (PTD). We aimed to investigate the association of TI and PTD with posttraumatic stress disorder (PTSD) in women who experienced sexual violence and the risk factors for PTD occurrence. We compared PTSD severity in 86 young adult women with PTSD after a sexual violence exposure grouped according to the presence of PTD and TI. In addition, we investigated whether PTD is associated with depression and anxiety symptoms and assessed potential risk factors for PTD reaction. We found a significant positive correlation between PTSD severity and PTD occurrence (R2 = .132; p = .001). PTD was also positively correlated with all clusters of PTSD symptoms except the Clinician-Administered PTSD Scale avoidance cluster (p = .058). PTD was strongly correlated with anxiety (R2 = .619; p < .001) and depressive symptoms (R2 = .547; p < .001). Multiple logistic regression showed that history of physical abuse (odds ratio [OR]: 1.386; p = .011) and sexual abuse (OR: 1.947; p = .004) during childhood were associated with PTD occurrence. Other risk factors for PTD were having less years of study (OR: 0.216; p = .016) and lower income (OR: 7.403; p = .028). TI measures were available for a subsample of 29 women. We found no association between TI and PTSD severity. PTD, but not TI, is significantly associated with more severe PTSD, depressive, and anxiety symptoms. Less-educated women with a history of childhood abuse and a lower income are at risk of PTD occurrence during a sexual violence episode.

The Relationship between Lifetime Exposure to Potentially Traumatic Events, Peritraumatic Dissociation, and PTSD in a Sample of Sexually Assaulted Women in Sao Paulo, Brazil.

Sexually assaulted women represent a particularly high-risk group for developing post-traumatic stress disorder (PTSD). Potentially traumatic events (PTEs) and peritraumatic dissociation (PD) are known risk factors for PTSD. However, little is known about how previous trauma affects PD and how this relationship affects PTSD. We aimed to investigate whether PD acts as a mediator between PTEs and PTSD severity in a sample of recently sexually assaulted women in Sao Paulo, Brazil. Seventy-four sexually assaulted women aged 18-44 completed questionnaires and structured interviews on PTSD, PD, and PTEs. We examined direct and indirect effects of variables using causal mediation analysis. Lifetime exposure to PTEs was a risk factor for PD, but PD was not a risk factor for PTSD symptom severity. Also, PD was not a mediator between PTEs and PTSD severity. We provided recommendations on how to further explore the relationship between lifetime traumatic exposure, PTSD, and peritraumatic dissociation.

Prevalence, Characteristics, and Factors Associated With Sexual Violence in Adulthood Among Brazilian MSM.

Most studies of sexual violence are with women, and although men who have sex with men (MSM) is the group of the men that has been most investigated for sexual violence, there are still several questions to be answered about sexual violence and sexual revictimization among MSM. This study aimed to estimate the prevalence of sexual violence in different stages of life and identify factors associated with sexual violence in adulthood among Brazilian MSM. We conducted an analysis with data from the study conducted in 2016 with 4,176 MSM from 12 Brazilian cities recruited through respondent-driven sampling (RDS), who answered a survey to a set of questions, among which some specific about sexual violence. Most participants were under 25 years old (56.5%), with more than 12 years of schooling (71.2%), mixed race (40.8%), single (86.2%), and belonging to some religion (50.9%). The lifetime prevalence of sexual violence was 20.3%. In our analyses, having experienced sexual violence in childhood and adolescence increased the odds of experiencing sexual violence in adulthood (prevalence ratio ratios [PRR] 4.93 (95% CI [1.99, 12.21]), as did experiencing physical violence (PRR 1.99; 95% CI [1.07, 3.71]) and receiving money for sex (PRR 2.26; 95% CI [1.17, 4.36]). In addition to violence in childhood and adolescence being risk factors for sexual violence in adulthood, we also observed that half of the sample experienced sexual violence repeatedly, characterizing sexual revictimization. It is important that health services are prepared to receive boys and men victims in order to reduce the chances of revictimization and other outcomes.

Interpersonal psychotherapy versus sertraline for women with posttraumatic stress disorder following recent sexual assault: a randomized clinical trial.

Background: Sexual assault often triggers posttraumatic stress disorder (PTSD), a potentially chronic severe mental disorder. Most guidelines recommend selective serotonin reuptake inhibitors (SSRIs) and trauma-focused psychotherapies as treatment options. Interpersonal Psychotherapy (IPT), adapted for PTSD (IPT-PTSD), focuses on interpersonal consequences of trauma rather than confronting the trauma itself. Studies have found IPT-PTSD efficaciously reduced PTSD symptoms with limited attrition. No efficacy trials have compared IPT-PTSD and SSRI. We hypothesized IPT would reduce PTSD, anxiety, and depressive symptoms more than sertraline among women with PTSD following a recent sexual assault. Objectives: To compare the efficacy of IPT-PTSD to SSRI sertraline in a 14-week randomized clinical trial for women with PTSD following a recent sexual assault. Methods: Seventy-four women with PTSD who had suffered sexual assault in the last six months were randomly assigned to 14 weeks of IPT-PTSD (n = 39) or sertraline (n = 35). Instruments assessed PTSD, anxiety, and depressive symptoms. This randomized clinical trial was conducted in São Paulo, Brazil, using the Clinician-Administered PTSD Scale-5 (CAPS-5) as the primary outcome measure. Results: Both treatments significantly reduced PTSD, anxiety, and depressive symptoms, without between-group outcome differences. CAPS-5 mean decreased from 42.5 (SD = 9.4) to 27.1 (SD = 15.9) with sertraline and from 42.6 (SD = 9.1) to 29.1 (SD = 15.5) with IPT-PTSD. Attrition was high in both arms (p = .40). Conclusions: This trial showed within-group improvements without differences between IPT-PTSD and sertraline treatment of PTSD. Our findings suggest that non-exposure-based psychotherapies may benefit patients with PTSD, although we did not directly compare these treatments to an exposure therapy. Brazilian Clinical Trials Registry RBR-3z474z.

Antecedentes: La agresión sexual con frecuencia gatilla un trastorno de estrés postraumático (TEPT), un trastorno mental severo potencialmente crónico. La mayoría de las guías clínicas recomiendan los inhibidores selectivos de la receptación de serotonina (ISRSs) y psicoterapias focalizadas en trauma como opciones de tratamiento. La Psicoterapia Interpersonal (PIP), adaptada para TEPT (PIP-TEPT), se focaliza en las consecuencias interpersonales del trauma en lugar de confrontar el trauma en sí. Los estudios han encontrado que la PIP-TEPT eficazmente redujo los síntomas de TEPT con una deserción limitada. Ningún ensayo de eficacia ha comparado PIP-TEPT e ISRS. Hipotetizamos que la PIP-TEPT puede reducir los síntomas de TEPT, ansiedad y depresión más que la sertralina entre las mujeres con TEPT después de una agresión sexual reciente.Objetivos: Comparar la eficacia de la PIP-TEPT con sertralina, un ISRS en un ensayo clínico aleatorizado de 14 semanas para mujeres con TEPT después de una agresión sexual reciente.Métodos: Setenta y cuatro mujeres con TEPT que habían sufrido de una agresión sexual en los últimos seis meses fueron asignadas aleatoriamente a 14 semanas de PIP-TEPT (n = 39) o sertralina (n = 35). Los instrumentos evaluaron síntomas de TEPT, ansiedad y depresión. Este ensayo clínico aleatorizado se realizó en San Pablo, Brasil, utilizando la Escala de TEPT administrada por el clínico (CAPS-5, por sus siglas en inglés) como medida de resultado primaria.Resultados: Ambos tratamientos redujeron significativamente los síntomas de TEPT, ansiedad y depresión, sin diferencias de resultados entre los grupos. La media del CAPS-5 se redujo de 42.5 (DE = 9.4) a 27.1 (DE = 15.9) con sertralina y de 42.6 (DE = 9.1) a 29.1 (DE = 15.5) con la PIP-TEPT. La deserción fue alta en ambos tratamientos (p = .40).Conclusiones: Este ensayo mostro mejoría entre grupos sin diferencias entre la PIP-TEPT y sertralina en el tratamiento del TEPT. Nuestros hallazgos sugieren que las psicoterapias no basadas en la exposición pueden beneficiar a los pacientes con TEPT, aunque no comparamos directamente estos tratamientos con una terapia de exposición.Registro Brasileño de Ensayos Clínicos RBR-3z474z.

¿En qué se diferencian las agresiones sexuales cometidas en solitario y en grupo? Una revisión sistemática / How are solo versus multiple perpetrator sexual assaults different? A systematic review

Resumen El estudio de las agresiones sexuales ha tenido una gran relevancia e interés en la literatura. Las agresiones sexuales en grupo representan una pequeña proporción de todas las agresiones sexuales cometidas, pero presentan unas características específicas. La presente revisión sistemática examinó las variables de los delitos de agresión sexual cometidos en solitario versus en grupo. Se realizó una búsqueda bibliográfica en las bases de datos Psycinfo, Academic Search (EBSCO) y Google Scholar, y se encontraron ocho documentos que cumplían las condiciones de inclusión. Los resultados muestran que existe evidencia de las diferencias cualitativas entre las agresiones sexuales cometidas según el número de infractores. Las dinámicas que se promueven en los grupos explican la participación de los sujetos en las agresiones sexuales en grupo. El comportamiento colectivo favorece las agresiones sexuales en grupo por los procesos inherentes a él. Los delincuentes son, en su mayoría, hombres. Los delincuentes solitarios tienen una mayor edad y, a medida que los grupos son más grandes, la edad de los agresores disminuye. En cuanto a las víctimas, son más jóvenes que los agresores, sobre todo en los casos perpetrados por múltiples sujetos, y ofrecen una mayor resistencia ante las agresiones en solitario. Se ha confirmado que en las agresiones en grupo se llevan a cabo más actos sexuales y se utiliza más la violencia. Por otro lado, no aparecen diferencias en cuanto al uso de alcohol y la presencia de armas en las agresiones. Estos resultados tienen implicaciones para la prevención del delito y el tratamiento de las víctimas.

Abstract The study of sexual assault has had great relevance and interest in the literature. Group sexual assaults represent a small proportion of all sexual assaults committed, but they have specific characteristics. Internationally, it is established that between 10 and 33 % of sexual assaults have been committed by multiple authors. Describing the differences between individual versus group sexual assaults has been a challenge for researchers. The literature has concluded that there is a difference in the etiology of sexual assaults committed according to the number of authors. While in solo sexual assaults personal vulnerability factors may explain why these crimes are committed, in group assaults group behavior dynamics explain the interaction between more subjects. This systematic review examined the variables of sexual assault crimes committed alone versus in a group. A literature search was conducted on the Psycinfo, Academic Search (EBSCO) and Google Scholar databases. In the first analysis a total of 34 studies were initially identified, and after filtering the reasons for exclusion the analysis was performed with eight investigations. The results show that there is evidence of qualitative differences between sexual assaults committed according to the number of offenders. The dynamics promoted in the groups explain the subjects' participation in group sexual aggressions. Collective behavior favors sexual aggressions in groups because of the processes inherent to the group. The most common group was two subjects (dyad) although the average group was usually composed of three subjects. The offenders are mostly men; the lone offenders are older, and as the groups become larger, the age of the offenders decreases. Research has shown that the majority of victims are female, both in single and group assaults. Victims are also younger than the perpetrators, especially in multi-subject attacks, and they are more resistant to single-aggression attacks. The place where the crime is committed presents significant differences. Some authors found that offenders in groups of three or more people often commit the assault in an indoor space, although others found that lone offenders were more likely than group offenders to rape the victim indoors, especially in the bedroom. It has been confirmed that in group aggressions more sexual acts are carried out and more violence is used. Vaginal penetration is the most committed sexual assault, followed by anal and oral rape. In all cases, vaginal rape is more prevalent among group sexual assaults, even more so when the assaults are committed by groups of three or more subjects. Studies of multiple perpetrator sexual assaults show that this type of act increases the probability of suffering more injuries and long-term health problems. Another conclusion that can be drawn is that there are significant differences in the timing of stranger assault, with a higher likelihood of a stranger assault in group rapes. On the other hand, there is also a relevance in the presence of other instrumental factors such as alcohol and weapons. As for alcohol, it showed a significant relationship in sexual assaults. Although the presence of weapons in sexual assaults is not very common, some research has confirmed that groups tend to threaten victims with a weapon to a greater extent, and the knife is often the most common weapon. The results found are particularly relevant to understanding sexual assault crimes and have implications for crime prevention and the treatment of victims.

Sexual Violence Suffered by Women in Early and Late Adolescence: Care Provided and Follow-Up / Violência sexual sofrida por mulheres na adolescência precoce e tardia: Cuidado dispensado e seguimento

Abstract Objective To compare the sexual violence suffered by women in early and late adolescence, the reactions triggered after the aggression, and the care provided. Methods A retrospective study in which we reviewed the medical records of 521 female adolescents treated by a multidisciplinary team at a reference hospital in the city of Campinas, state of São Paulo, Brazil. We analyzed sociodemographic variables, and those pertainin to the characteristics of the episodes of violence, the emergency care, and the physical and psychological reactions observed during the follow-up. For the analysis, the sample was divided into groups of early (10 to 14 years) and late (15 to 18 years) adolescence. We used the Chi-squared/Fisher Exact, Mann-Whitney, and Kruskal-Wallis tests to compare the groups; the level of significance adopted was 5%. Results The early group (n= 242) contained more adolescents who were enrolled in school (p< 0.001), suffered more daytime aggressions (p= 0.031), in their residences (p< 0.001), by an aggressor with whom they were acquainted (p< 0.001), had greater need of legal protection (p= 0.001), and took longer to seek care (p= 0.048). Feelings of guilt, shame, and the perception of violence were similar between the groups. In the late group (n= 279), there was greater consumption of alcohol during the aggression (p= 0,005); they received significantly more prophylaxis treatments; reported more physical symptoms (p= 0.033), sleep disorders (p= 0.003), symptoms of anxiety (p= 0.045), and feelings of anguish (p= 0.011); and had more prescriptions of psychotropics (p= 0.005). Only 52% completed the 6-month follow-up, with no differences between the groups. Conclusion The age groups showed differences in the characteristics of the episodes of violence; early adolescents took longer to seek help, and the late group presented more intense symptoms and psychological worsening during the follow-up. Measures of prevention and specific care aimed at this population are needed.

Resumo Objetivo Comparar a violência sexual sofrida por vítimas no início e no final da adolescência, as reações desencadeadas após a agressão, e o cuidado de saúde dispensado. Métodos Estudo retrospectivo, em que foram revisados os prontuários de 521 mulheres adolescentes atendidas por equipe multiprofissional em hospital de referência em Campinas, São Paulo, Brasil. As variáveis foram sociodemográficas, e aquelas relativas às características da violência, ao atendimento de emergência, e às reações físicas e psicológicas observadas durante o seguimento nos grupos de adolescentes de idade precoce (10a 14 anos) e tardia (15 a 18 anos). Utilizamos os testes do Qui-quadrado/Exato de Fisher, Mann-Whitney e Kruskal-Wallis para comparar os grupos; adotamos o nível de significância de 5%. Resultados O grupo precoce (n= 242) continha maior número de estudantes (p< 0,001), que sofreram mais agressões diurnas (p= 0,031), em suas residências (p< 0,001), por agressor conhecido (p< 0,001), tiveram maior necessidade de proteção legal (p= 0,001), e demoraram mais a procurar atendimento (p= 0,048). Sentimentos de culpa, vergonha e a percepção da violência foram similares entre os grupos. No grupo tardio (n= 279) houve maior consumo de álcool durante a agressão (p= 0,005); as adolescentes receberam significativamente mais tratamentos de profilaxia; relataram mais sintomas físicos (p= 0,033), distúrbios do sono (p= 0,003), sintomas de ansiedade (p= 0,045), e sentimentos de angústia (p= 0,011); e receberam mais prescrições de psicotrópicos (p= 0,005). Apenas 52% completaram o seguimento de 6 meses, sem diferenças entre os grupos. Conclusão Os grupos apresentaram diferenças nas características da violência; as adolescentes precoces chegaram mais tardiamente ao serviço, e o grupo tardio apresentou maior sintomatologia e piora psicológica no seguimento. São necessárias medidas de prevenção e cuidados específicos voltados a essa população.

Shorter Telomeres Related to Posttraumatic Stress Disorder Re-experiencing Symptoms in Sexually Assaulted Civilian Women.

Telomeres are short tandem repeats of "TTAGGG" that protect the chromosome ends from deterioration or fusion of chromosomes. Their repeat length shortens with cell division acting as a biomarker of cellular aging. Traumatic stress events during adulthood or childhood have been associated with posttraumatic stress disorder (PTSD) and short leukocyte telomere length (LTL). This study investigated whether LTL was associated with PTSD in a Brazilian sample of sexually assaulted civilian women at two time points: baseline and 1-year follow-up. At baseline, we assessed 64 women with PTSD following sexual assault (cases) and 60 women with no previous history of sexual trauma or mental disorders (healthy controls - HC). At follow-up visit, 13 persistent PTSD cases, 11 HCs, and 11 PTSD remitters patients were evaluated. PTSD diagnosis and severity were assessed using Mini International Neuropsychiatric Interview (Diagnostic and Statistical Manual of Mental Disorders III/IV criteria) and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), respectively. LTL was measured using multiplex real-time polymerase chain reaction (PCR). In the baseline analysis, we observed that LTL was associated with re-experiencing symptoms (B = -0.16; confidence interval (CI) 95% = -0.027--0.005; Bonferroni-adjusted p-value = 0.02), but no association was observed between other PTSD symptoms and LTL. In the longitudinal analysis, telomere shortening was no longer observed in patients with PTSD and PTSD remitters. In conclusion, our findings indicate that shorter baseline LTL is associated with early stage of PTSD re-experiencing symptoms in recently sexually assaulted women.

Editorial: Agresión sexual en menores de 18 años / Editorial: Sexual assault in children under 18 years of age

El Estado panameño ratificó en el año 1990 la Convención sobre los Derechos del Niño y con ello asumió el compromiso de crear mecanismos para la protección de la niñez y la adolescencia, pero las actuales estadísticas señalan que los derechos de protección del menor siguen siendo vulnerados y van en aumento especialmente en las regiones comarcales indígenas en el país. Como vemos en el informe anual del Ministerio Público de Panamá para el año 2021 se registraron un total de 2,257 casos de "acceso sexual con una persona mayor de catorce (14) años y menor de dieciocho (18)" (artículo 176 del código penal) que representó un aumento del 18 % comparado a los 1,913 casos en 2020.

The Panamanian State ratified the Convention on the Rights of the Child in 1990 and thereby assumed the commitment to create mechanisms for the protection of children and adolescents, but current statistics indicate that the protection rights of minors continue to be violated and they are on the increase, especially in the indigenous regional regions of the country. As we see in the annual report of the Public Ministry of Panama for the year 2021, a total of 2,257 cases of "sexual access with a person over fourteen (14) years of age and under eighteen (18)" were registered (article 176 of the penal code ) which represented an increase of 18% compared to the 1,913 cases in 2020.

Etiological factors related to the nursing diagnosis "post-trauma syndrome" in women victims of violence: A systematic review and meta-analysis.

OBJECTIVE: Identify etiological factors related to the determination of the nursing diagnosis post-trauma syndrome in women victims of violence DATA SOURCE: : Five databases were searched: SciVerse Scopus, PubMed, Latin American and Caribbean Health Sciences Literature, CINAHL with Full Text, and PsycINFO DATA SYNTHESIS: : A total of nine etiological factors related to post-trauma syndrome were identified: physical assault, sexual assault, psychological violence, childhood trauma, low education level, low socioeconomic status, lack of employment, age under 40 years, and depression severity. Such factors were associated with the nursing diagnosis of post-trauma syndrome, according to the synthesis CONCLUSION: : We believe that identifying the nursing diagnosis post-trauma syndrome in its current form shown in the NANDA-I taxonomy is limited as the determination of nursing interventions is based on the etiological factors identified during the diagnostic reasoning step IMPLICATIONS FOR NURSING PRACTICE: : This study brings the need to implement knowledge about nursing diagnoses related to violence against women, highlighting the lack of literature that can exemplify the practice of nurses with regard to care relevant to the public in question.

Fear of Crime Among Caribbean Women in University: A Qualitative Exploration Using the Free Association Narrative Method.

Women attending university are generally at a heightened risk of victimization. As such, there is an emerging body of literature exploring fear of crime among them. Although several studies have explored this phenomenon quantitatively, relatively few have investigated fear of crime among this group of women in their own words. Using a sample of women at the University of the West Indies, this study seeks to address this gap. The study reveals strong support for the shadow of sexual assault theory as the women interviewed overwhelmingly describe their fear of crime against the background of their perceived vulnerability to rape.