Communicating sexual health to the incarcerated population: information dissemination in a US sample of inmate handbooks.

Incarcerated individuals frequently enter prison with a history of high-risk lifestyle behaviours likely to contribute to the transmission of infectious disease. Prisons offer a unique setting in which to advance health equity to an underserved population by disseminating information and education. Sexual health education has the potential to mitigate negative health consequences in the incarcerated population and improve sexual health practices upon community re-entry, benefiting both incarcerated individuals and communities. Limited empirical research examines sexual health information and education in US correctional facilities. Handbooks, given to all people upon incarceration, have the potential to provide vital information and education to promote safe sexual practice and prevent disease transmission. This work, guided by 22 critical sexual health education recommendations from the US Centers for Disease Control and Prevention, examines the presence (or absence) of recommended sexual health information and guidance in prison handbooks. Handbooks (n = 74) from 49 of 50 US states were qualitatively analysed with results revealing limited information, education or guidance about sexual health/safe sexual practice during incarceration or afterwards. Utilising handbooks for comprehensive sexual education could be a critical step towards reaching members of an already at-risk underserved population.

"If I Stay Silent, It Doesn't Help Anyone": Understanding How People Use TikTok to Talk About Sexual Violence.

TikTok is the second most popular social media platform among American teenagers, suggesting it may be a way to reach young people with sexual violence-related messages. This qualitative content analysis focused on what TikTok users share about sexual violence. The content of the videos fell into two primary types of information, people sharing experiences of sexual violence (i.e., what happened, how they responded, impacts of experiences) and people sharing other information related to sexual violence (i.e., education, raising awareness). The study results demonstrate that people use TikTok as a platform to share their messages about sexual violence-related topics, underscoring the potential of this platform for prevention and recovery messages targeted toward individuals who directly or indirectly experience sexual violence.

The dawn of a sexual assault relief center: A 12-year fact-finding survey of victims of sexual assault conducted since 2010 by SACHICO, Japan's first rape crisis center.

OBJECTIVE: In Japan, amidst insufficient legal provisions and governmental support, in 2010, the first rape crisis center, the Sexual Assault Crisis Healing Intervention Center Osaka (SACHICO) was established. We compared SACHICO visitor data from 2010 to 2021 with National Police Agency statistics to clarify the current situation of sexual assault victims in Japan and considered future issues for Japan to address. METHODS: This study was a cross-sectional study that analyzed the data described below. All visitations to SACHICO between April 2010 and December 2021 were considered targets for data totaling. Data on crime statistics were gathered from the official governmental statistics portal site. RESULTS: A total of 12 036 visitations occurred, of which 3189 were first-time consultations; 3100 initial medical examinations were conducted, and no medical examination was conducted in the remaining 89 cases (2.7%). The number of initial medical examinations increased 3.7 times from 2010 to 2021. Victims under the age of 19 comprised 60% of the total number of initial medical examinations (1863/3100). The reporting rate for all 3100 initial medical examinations was only 31.3% (969/3100) of the cases. The proportion of forcible sexual intercourse versus forcible indecency were the converse of those observed among acknowledged cases nationwide and in Osaka Prefecture. For several years, the number of initial medical consultations at SACHICO has exceeded that of acknowledged cases in Osaka Prefecture. CONCLUSION: Support for victims of sexual assault in Japan is still insufficient. It is necessary to strengthen the system of rape crisis centers system to realize an unbroken chain of support for victims.

Considerations on expanding criminal offender DNA databases with Y-STR profiles.

Although national criminal offender DNA databases (NCODDs) including autosomal short tandem repeats (STRs) have been a successful tool to identify criminals for decades in many countries, yet there are many criminal cases they cannot solve. In cases with mixed male-female samples, particularly sexual assault, expanding NCODDs with Y-chromosomal STR (Y-STR) profiles allows database matching in the absence of autosomal STR profiles. Although Y-STR matches are not individual-specific, this can be largely overcome with rapidly mutating Y-STRs (RM Y-STR) allowing separation of paternally related men. Expanding NCODDs with Y-STR profiles is also beneficial for law enforcement in cases without known suspects via familial searching. Expanding NCODDs with Y-STR profiles may raise concerns about genetic privacy and fundamental human rights. A legal analysis of the European Convention on Human Rights revealed that when primarily for reidentifying convicted sex offenders, it would be in line with the case law of the European Court of Human Rights, while a generalized approach primarily for familial searching and involving all types of offenders may not. This paper aims to stimulate a debate among various stakeholders regarding the benefits and risks of expanding NCODDs with Y-STR profiles that in some countries has already been practically implemented.

The Confluence Model of Sexual Aggression in the Context of Acute Intoxication and State Emotion Regulation.

Understanding the mechanisms underlying sexual aggression perpetration is critical for the development of targeted, evidence-based prevention. The current study evaluates the effects of state emotion regulation (ER), acute alcohol intoxication, and Confluence Model constructs on sexual aggression perpetration intentions. Single, male social drinkers, aged 21-30 years, with a history of sexual risk-taking (N = 90) were randomly assigned to an alcohol (BrAC = 0.1%) or sober control condition and completed measures of hypothetical sexual aggression intentions, state ER, and Confluence Model constructs. Logistic regression demonstrated men high in hostile masculinity expressed significantly greater sexual aggression intentions. In addition, men with poor state ER endorsed significantly greater sexual aggression intentions, although this relationship only held for the men in the sober condition. Results suggest that interventions targeting state ER may be beneficial to sexual aggression perpetration prevention programming.

Who Is Considered a Potential Victim, Perpetrator, or Bystander? A Systematic Review and Meta-Analysis of Research Evaluating Gender-Specific Campus Sexual Assault Prevention Programs Implemented in the United States.

Campus sexual assault is a problem that overwhelmingly affects cisgender women and transgender, genderqueer/questioning, and nonbinary (TGQN) students. Yet, students of any gender may be perpetrators or victims of assault. Thus, it is important that prevention programs incorporate a range of scenarios that depict different genders as both perpetrators and victims, while also acknowledging the differential risk between gender groups. Gender-specific programming is one way of achieving this goal. In this systematic review and meta-analysis, we synthesized studies evaluating campus sexual assault prevention programs implemented with specified gender groups in the United States. Through a comprehensive literature search, we identified 38 studies that met eligibility criteria and were disseminated through 2021 (N = 22 women's studies; N = 16 men's studies; N = 0 TGQN studies). Programs overwhelmingly portrayed women as victims and men as perpetrators or bystanders while largely ignoring experiences of TGQN students. A greater proportion of women's programs included risk reduction content that relayed tactics participants may use to avoid victimization. A greater proportion of men's programs included bystander content that emphasized ways participants may stop others from committing sexual assault. Women's programs had a small but significant and favorable effect on victimization, but studies evaluating these programs did not measure perpetration outcomes. Men's programs had a non-significant effect on perpetration but victimization outcomes were not measured. Gender-specific prevention programming should begin to reflect the differential risks of perpetration and victimization across gender identities, and the effects of this program content should be rigorously evaluated.

Sexual Assault Nurse Examiner Knowledge and Confidence in Providing Care for Transgender Patients Following Sexual Assault.

The transgender population experiences disproportionate rates of sexual assault (SA) compared with the cisgender population. Sexual assault nurse examiners (SANEs) have specialized education to provide care to victims of SA across the lifespan; however, training related to the care of transgender individuals following sexual assault is not always represented in SANE education. This leads to a lack of knowledge and confidence in providing care to transgender victims and can result in inequitable care and poor outcomes. To explore forensic nurses' knowledge and confidence in the care of the transgender population following SA, a descriptive, cross-sectional survey design was employed and distributed to two professional forensic nursing organizations. A total of 240 survey responses were received. The majority of participants reported that content related to transgender sexual assault (TGSA) was not part of their SA education. Nearly 60% perceived their knowledge and confidence in providing TGSA care as "beginner" or "developing" and almost all "agree" or "strongly agree" that additional TGSA education would be beneficial to them. As over half of participants have provided care to a TGSA patient and more than 80% expect to provide care in the future, it is imperative include standardized content related to TGSA care as part of core SANE curriculum and to offer continuing education to address the gap in current SANE TGSA knowledge and practice.

Rethinking Lifetime Abuse in Old Age.

Research on abuse is often piecemeal and focused on specific forms, populations, and social situations. As a result, these studies tend to ignore the web of abuse resulting from the interactive effects of various forms of abuse over the life course, together referred to as "lifetime abuse." An examination of abuse from the point of view of older adults is likely to provide a lifetime perspective based on linking child abuse to elder abuse over the life course and an assessment of its consequences. Despite the growing awareness and resulting body of knowledge regarding this phenomenon, proposed theoretical formulations about it remain limited. The present article aimed to conceptualize the multifaceted phenomenon of lifetime abuse and to gain a deeper perspective of the topic by understanding its dimensions, meanings, and experiences in older age, based on a critical review of empirical studies. A model is suggested, which can be useful for future exploration and understanding of lifetime abuse. Based on a critical review of previous studies, we suggest a theoretical framework of lifetime abuse from the perspective of older adults, identifying three key domains: (a) perception of time and life review in old age; (b) cumulative and interactive abusive life events; and (c) resilience versus vulnerability over the life course. We propose a heuristic model to explore and understand lifetime abuse. We believe our proposed model is open to reflection and elaboration and is intended to raise questions that could enhance the need for our understanding of lifetime abuse in old age.

Intimate Partner Violence Predicts Child Marriage and Pregnancy Among Adolescents in Malawi.

A sizeable literature has shown that child marriage is associated with an increased risk for intimate partner violence (IPV). However, this research has been cross-sectional, and the temporality of the association has not been investigated. Specifically, no study has yet examined whether IPV is a predictor of child marriage and adolescent pregnancy. This study uses prospective longitudinal data on a cohort of adolescent girls from the Malawi Longitudinal Study of Families and Health to evaluate whether IPV victimization predicts child marriage or adolescent pregnancy. Using survival models, we find that adolescent girls who experienced physical IPV (measured at survey baseline, in 2017-2018) are more likely to enter child marriages (measured at survey follow-up, in 2021) (hazard ratio [HR] = 2.7 [1.44, 5.08]). Experiencing sexual IPV is also significantly associated with adolescent pregnancy (HR = 1.97 [1.16, 3.33]). These findings indicate the need for greater intervention to ensure healthy adolescent relationships, as well as further research to understand how abusive relationships shape early transitions to adulthood.

Overcoming Rape: A Mixed-Methods Approach to Understanding Psychological and Physical Health Functioning of Male Survivors.

When examining sexual assault, men are often hidden from the literature. The current study employed a mixed-methods, convergent parallel design to examine the experiences of 22 male survivors of sexual assault (mean age = 44.19, SD = 13.28, range 18-65; 91% European American; 50% heterosexual). Survivors were administered an online survey using quantitative and qualitative questions to assess rape myths, gender roles, self-esteem, self-efficacy, resiliency, coping, overall mental and physical health, and diagnostic criteria for alcohol abuse, post traumatic stress disorder (PTSD), and sexual dysfunction. Three key themes emerged from the integration of quantitative and qualitative data: (a) Help is Elusive, (b) Internal Struggles and External Strengths, and (c) Living with Clinical Diagnoses. This study adds to an important area of the literature that increases understanding of men's experiences with sexual violence and honors the voices of these survivors.

Identifying as a Survivor Versus a Victim After Sexual Violence Predicts Divergent Posttrauma Pathways.

The present study investigated social identification with "survivors" versus "victims" following sexual violence and the degree to which this predicted posttraumatic growth versus posttraumatic stress. Participants (N = 290) were adult women who had experienced sexual violence. As predicted, cumulative sexual trauma was positively associated with symptoms of both posttraumatic stress and posttraumatic growth. Further, people who had experienced more cumulative sexual trauma were more likely to identify with victims, which in turn predicted posttraumatic stress. Similarly, people who had experienced more cumulative sexual trauma were also more likely to identify with survivors, and this in turn predicted posttraumatic growth.

Association of Victimization by Sex among Public Facing Bus and Subway Transit Workers, New York City.

Federal data indicate that assaults on transit workers resulting in fatalities or hospitalizations tripled between 2008 and 2022. The data indicated a peri-pandemic surge of assault-related fatalities and hospitalizations, but assaults with less dire outcomes were not recorded. In collaboration with the Transport Workers Union, Local 100, we conducted an online survey in late 2023 through early 2024 of New York City public-facing bus and subway workers that focused on their work experiences during the 2020-2023 period of the COVID-19 pandemic. Items for this analysis on victimization included measures of physical and sexual assault/harassment, verbal harassment/intimidation, theft, and demographic characteristics (e.g., sex, race, work division). We estimated separate modified Poisson models for each of the four outcomes, yielding prevalence ratios (PRs) and 95% confidence intervals (CIs). Potential interactions between variables with strong main effects in the adjusted model were further examined using product terms. Among 1297 respondents, 89.0% reported any victimization; respondents also reported physical assault (48.6%), sexual assault/harassment (6.3%), verbal harassment/intimidation (48.7%), and theft on the transit system (20.6%). Physical assault was significantly more common among women in the bus division compared to female subway workers, male bus workers, and male subway workers (adjusted PR (aPR) = 3.54; reference = male subway workers; Wald test p < .001). With the same reference group, sexual assault/harassment was more frequently reported among female subway workers (aPR = 5.15; Wald test, p < .001), but verbal assault/intimidation and experiencing theft were least common among women in the bus division (aPR = 0.22 and 0.13, respectively; Wald tests, p < .001). These data point to the need for greater attention to record and report on victimization against workers in both buses and subway.

The Landscape of Sexual Harm in the Video Game, Streaming, and Esports Community.

While sexual harm has been studied across a range of contexts, it has not yet been considered within the video game, streaming, and esports community. This study aimed to explore the landscape of sexual harm in this community, specifically, where it has been committed by esports professionals and video game live streamers. Fifty-five victim statements were extracted from online sources (such as Twitter/X and Reddit) and coded into variables relating to offender and victim demographics, offense characteristics, the offense process, and platform(s) used. Descriptive statistics were generated for each variable and Fisher's exact tests were conducted to examine the differences between adult-on-adult and adult-on-child cases. The findings reveal diverse offense outcomes across the sample, ranging from rape to sexual communication with a child. Some offense patterns can be seen in wider sexual offending literature, such as pre-offense alcohol consumption, offending against incapacitated victims (e.g., sleeping), and offending within an established romantic relationship. However, several offense process characteristics unique to the video gaming community were identified. These included offenders using their position of fame within the community to access victims and bypass the need for other coercive behaviors. Online offenses were more common with children and offenders demonstrated a preference for "live" methods, such as voice chat and video calling, rather than instant messaging or sharing images of themselves. This limits the digital evidence left behind and indicates the offenders' greater technological literacy. The study's findings shed light on the sexual harm that exists within this previously unexplored context and highlight areas where esports organizations, live-streaming platforms, and educational providers can do more to safeguard players, fans, and viewers in this community.

Social Connections as a Protective Factor for Sexual Violence-Related Attitudes.

Endorsing problematic sexual violence-related attitudes including rape myth acceptance (RMA), hostile sexism, and disapproval of sexual consent is associated with negative outcomes, including the perpetration of sexual violence. This study examined social connections as a protective factor for sexual violence-related attitudes among a sample of 770 participants. Results indicate that in the full sample, connections to a workplace were protective for RMA and hostile sexism while family connections were protective for disapproval of sexual consent, RMA, and hostile sexism. Patterns of other social connections differed in separate models for men and women. Unexpected findings indicating that connections to a religious social group are a risk, not a protective, factor are discussed.

Experiences of women sexual assault survivors with police in the early aftermath of assault: Results from a large-scale prospective study.

Over 100,000 women present for emergency care after sexual assault (SA) annually in the United States. To our knowledge, no large prospective studies have assessed SA survivor experiences with police. Women SA survivors enrolled at 13 sites (n = 706), and 630 survivors reported on their police interactions. Most women were interested in speaking with police, spoke with police, and reported positive experiences. Latinas and women with lower education and income were less likely to speak with police. Trauma and posttraumatic stress symptoms were associated with more negative experiences. Qualitative comments provide key points for police to consider when speaking with survivors.

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.

Incorporation of suvorexant and lemborexant into hair and their distributions after a single intake.

PURPOSE: This study examined the applicability of hair analysis as an approach to identify suvorexant (SUV) and lemborexant (LEM) intake by analyzing black hair specimens collected from study participants after a single oral administration. METHODS: Hair specimens were collected form participants who took a single dose of 10 mg SUV or 5 mg LEM. Identification of the dual orexin receptor antagonists (DORAs) and their metabolites was performed by liquid chromatography-tandem mass spectrometry. Reference standards of S-M9 and L-M4, the metabolites of SUV and LEM, respectively, were synthesized in our laboratory. Sectional analysis of 1-mm segments of the single-hair strands was also performed to investigate the incorporation behavior of the drugs into hair. RESULTS: Unchanged SUV and LEM, and their metabolites S-M9 and L-M4 were detected even in the single-hair specimens. Results of the segmental hair analysis showed predominant incorporation of the drugs into hair through the hair bulb region rather than through the upper dermis zone of the hair root. The drug concentrations in the hair specimens, collected about 1 month after intake, were 0.033-0.037 pg/hair strand (0.17-0.19 pg/mg) for SUV and 0.054-0.28 pg/hair strand (0.28-1.5 pg/mg) for LEM. The calculated distribution ratios of the DORAs into hair to the oral doses were much lower than those of benzodiazepines and zolpidem reported in a previous study. CONCLUSIONS: This is the first report of the detection of the DORAs in hair. The incorporation behavior of the DORAs into hair revealed herein are crucial for proper interpretation of hair test results.

The prevalence of selected licit and illicit drugs in drug facilitated sexual assaults.

Little is known about the prevalence of incapacitating substances present in drug facilitated sexual assaults (DFSA). Presented here is a literature review conducted to provide background information, such as symptoms, exacerbations, and drug interactions, on drugs typically implicated in DFSA, namely gamma-hydroxybutyrate (GHB), gamma-butyrolactone (GBL), 1,4-butanediol (1,4-BD), ketamine, diazepam, oxycodone, methamphetamine, and alcohol. Literature found through Scopus and Pubmed was reviewed to determine the current prevalence of these substances in DFSA with a focus on Australian data. The global literature revealed that there is a wide variety of substances used in DFSA and the prevalence varied by country. For example, it was found that in Northern Ireland, opioids were most prevalent whereas in France, benzodiazepines were most prevalent. In Australia the review revealed a lack of contemporary data with the most recent report in Victoria using data collected during 2011-2013. The literature also revealed there can be an important difference between self-reported substance use and substances discovered via toxicological analysis. This can be due to the challenges of biological detection, reliability of self-reporting, and the possibility of a substance being introduced to a person's food or drink without their knowledge. This review highlights the need for the collection and analysis of current data pertaining to DFSA reports and the drugs detected, and due to the constantly evolving picture of both licit and illicit drug use an assessment of the role of prescription medications in DFSA due to drug-drug interactions as well as potential to incapacitate is warranted.

Myths of trauma memory: on the oversimplification of effects of attention narrowing under stress.

The present article addresses claims commonly made by prosecution witnesses in sexual assault trials: that attention narrows under stress, and that these attended aspects of the event are encoded in a way that ensures accuracy and resistance to fading and distortion. We provide evidence to contradict such claims. Given that what is encoded is largely the gist of one's interpretation of experience, we discuss the way in which attention and emotion can bias the interpretation of experience. We illustrate with issues of memory reports in cases of acquaintance rape, where the primary issue is the presence or absence of consent. We provide some specific illustrations concerning effects of emotion on interpretation of sexual consent. Finally, based on what is known regarding priming effects on memory retrieval and judgment, we conclude with discussion of the potential of some "trauma-informed" interviewing strategies to promote false memories (such as FETI: Forensic Experiential Trauma Interview).

"I'll Try and Make Myself as Small as Possible": Women and Gender-Diverse People's Safety Work on Public Transport.

Public transport is a known hotspot for sexual violence and harassment. Through 41 interviews with women and gender-diverse people who have experienced sexual violence and harassment on public transport, we found that women and gender-diverse people engage in extensive "safety work," such as changing their behavior, strategizing, and planning. Safety work takes considerable time and effort, often leaving participants feeling stressed. However, participants advocated for changes to public transport to reduce the work they do to stay safe. We argue that significant changes, including primary prevention of gender-based violence, are needed to reduce their safety work.