US and Chinese preschoolers normalize household labor inequality.

Across many cultural contexts, the majority of women conduct the majority of their household labor. This gendered distribution of labor is often unequal, and thus represents one of the most frequently experienced forms of daily inequality because it occurs within one's own home. Young children are often passive observers of their family's distribution of labor, and yet little is known about the developmental onset of their perceptions of it. By the preschool age, children also show strong normative feelings about both equal resource distribution and gender stereotypes. To investigate the developmental onset of children's recognition of the (in)equality of household labor, we interviewed 3 to 10-y-old children in two distinct cultural contexts (US and China) and surveyed their caregivers about who does more household labor across a variety of tasks. Even at the youngest ages and in both cultural contexts, children's reports largely matched their parents', with both populations reporting that mothers do the majority of household labor. Both children and parents judged this to be generally fair, suggesting that children are observant of the gendered distribution of labor within their households, and show normalization of inequality from a young age. Our results point to preschool age as a critical developmental time period during which it is important to have parent-child discussions about structural constraints surrounding gender norms and household labor.

Racial social norms among Brazilian students: Academic performance, popularity, and racial identification.

Studies in the United States have shown that minority students might face a trade-off between better academic performance and peer acceptance, which has been termed "acting White." This paper investigates racial differences in the relationship between grades and popularity in five Brazilian schools. Popularity is measured using friendship ties among students, assigning a higher value to students more central in the network. The racial composition of friendship ties is generally diverse, although they tend to favor racial peers, especially among Black students. We find a positive correlation between grades and popularity of non-White students that is driven by their friendships with their White classmates. This contrasts with patterns associated with acting White, where a negative correlation between minorities' grades and their popularity among racial peers is not compensated by their status among White students. We also investigate how academic performance is associated with racial identity choice conditional on skin color, finding a weak negative relationship between higher grades and the odds of classification as mixed race.

Ethnic differences in meat consumption attitudes, norms and behaviors: A survey of White, South Asian and Black ethnic groups in the UK.

A reduction in meat consumption is necessary to mitigate negative impacts of climate change and adverse health outcomes. The UK has an increasingly multi-ethnic population, yet there is little research on meat consumption habits and attitudes among ethnic groups in the UK. We ran a survey (N = 1014) with quota samples for ethnic groups and analyzed attitudes, behaviors and norm perceptions of White, South Asian and Black British respondents. Most respondents believe overconsumption of red and processed meat has negative impacts on health (73.3%) and the environment (64.3%).South Asian respondents were statistically significantly less likely to be meat eaters than White respondents (OR = 0.44, 95% CIs: 0.30-0.65, t = -4.15, p = 0.000), while there was no significant difference between White and Black respondents (OR = 1.06, 95% CIs: 0.63-1.76, t = 0.21, p = 0.834). Both South Asian (OR = 2.76, 95% CIs: 1.89-4.03 t = 5.25, p = 0.000) and Black respondents (OR = 2.09, 95% CIs: 0.1.30-3.35, t = 3.06, p = 0.002) were significantly more likely to express being influenced by friends and family in their food choices than White respondents. South Asian (OR = 3.24,95% CIs: 2.17-4.84, t = 5.74, p = 0.000) and Black (OR = 2.02,95% CIs: 1.21-3.39, t = 2.69, p = 0.007) respondents were also both significantly more likely to report they would want to eat similarly to their friends and family than White respondents. Statistical analyses suggested some gender and socioeconomic differences across and among ethnic groups, which are reported and discussed. The differences in meat consumption behaviors and norm conformity between ethnic groups raises the prospect that interventions that leverage social norms may be more effective in South Asian groups than Black and White groups in the UK.

Predicting social tipping and norm change in controlled experiments.

The ability to predict when societies will replace one social norm for another can have significant implications for welfare, especially when norms are detrimental. A popular theory poses that the pressure to conform to social norms creates tipping thresholds which, once passed, propel societies toward an alternative state. Predicting when societies will reach a tipping threshold, however, has been a major challenge because of the lack of experimental data for evaluating competing models. We present evidence from a large-scale laboratory experiment designed to test the theoretical predictions of a threshold model for social tipping and norm change. In our setting, societal preferences change gradually, forcing individuals to weigh the benefit from deviating from the norm against the cost from not conforming to the behavior of others. We show that the model correctly predicts in 96% of instances when a society will succeed or fail to abandon a detrimental norm. Strikingly, we observe widespread persistence of detrimental norms even when individuals determine the cost for nonconformity themselves as they set the latter too high. Interventions that facilitate a common understanding of the benefits from change help most societies abandon detrimental norms. We also show that instigators of change tend to be more risk tolerant and to dislike conformity more. Our findings demonstrate the value of threshold models for understanding social tipping in a broad range of social settings and for designing policies to promote welfare.

The fear of social stigma experienced by men: a barrier to male involvement in antenatal care in Misungwi District, rural Tanzania.

BACKGROUND: Evidence has shown that male involvement is associated with improved maternal health outcomes. In rural Tanzania, men are the main decision makers and may determine women's access to health services and ultimately their health outcomes. Despite efforts geared towards enhancing male participation in maternal health care, their involvement in antenatal care (ANC) remains low. One barrier that impacts men's participation is the fear and experience of social stigma. This study, builds on previous findings about men's perspectives in attending antenatal care appointments in Misungwi district in Tanzania, examining more closely the fear of social stigma amongst men attending ANC together with their partners. METHODS: Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers and expectant fathers. In-depth interviews were conducted with health providers, volunteer community health workers and village leaders. Interviews were audiotaped, and transcripts were transcribed and translated to English. Transcripts were organized in NVivo V.12 then analyzed using thematic approach. RESULTS: Three main themes were found to create fear of social stigma for men: 1. Fear of HIV testing; 2. Traditional Gender Norms and 3. Insecurity about family social and economic status. CONCLUSION: Respondent's experiences reveal that fear of social stigma is a major barrier to attend ANC services with their partners. Attention must be given to the complex sociocultural norms and social context that underly this issue at the community level. Strategies to address fear of social stigma require an understanding of the real reasons some men do not attend ANC and require community engagement of community health workers (CHWs), government officials and other stakeholders who understand the local context.

Social norm enforcement in ethnically diverse communities.

Recent waves of immigration to Western nations have fueled a debate over the consequences of ethnic diversity for social cohesion. One prominent argument in this debate holds that diversity is detrimental to trust and cooperation because individuals in heterogeneous communities face difficulties in enforcing social norms across ethnic lines. We examine this proposition in a field experiment involving real-life interactions among residents of multiethnic German neighborhoods. We find significant ethnic asymmetries in the pattern of norm enforcement: Members of the majority "native" German population are more active in sanctioning norm violations, while ethnic minorities are more likely to find themselves the target of sanctions. We interpret these results in light of prevailing status inequalities between ethnic minorities and the native majority. We further calculate that, as a result of ethnic discrimination, social control is likely to rise in communities with moderate minority population shares.

Considerations for stakeholder engagement and COVID-19 related clinical trials' conduct in sub-Saharan Africa.

The aim of this study is to determine how stakeholder engagement can be adapted for the conduct of COVID-19-related clinical trials in sub-Saharan Africa. Nine essential stakeholder engagement practices were reviewed: formative research; stakeholder engagement plan; communications and issues management plan; protocol development; informed consent process; standard of prevention for vaccine research and standard of care for treatment research; policies on trial-related physical, psychological, financial, and/or social harms; trial accrual, follow-up, exit trial closure and results dissemination; and post-trial access to trial products or procedures. The norms, values, and practices of collectivist societies in Sub-Saharan Africa and the low research literacy pose challenges to the conduct of clinical trials. Civil-society organizations, members of community advisory boards and ethics committees, young persons, COVID-19 survivors, researchers, government, and the private sector are assets for the implementation and translation of COVID-19 related clinical trials. Adapting ethics guidelines to the socio-cultural context of the region can facilitate achieving the aim of stakeholder engagement.

Experiences, views and needs of first-time fathers in pregnancy-related care: a qualitative study in south-East Nigeria.

BACKGROUND: Given the relevance of paternal involvement in maternal care, there is a need to prepare first-time fathers to participate in pregnancy and childbirth actively. This study explores the experiences and needs of first-time fathers; and how these influences their involvement during pregnancy and childbirth in Nigeria. METHODS: A descriptive qualitative study was conducted. Semi-structured interviews with 50 men recruited from rural and urban workplaces, hospitals, and markets, generated data used to explore the experiences, views and needs of first-time fathers' in pregnancy-related care in south-east Nigeria. All data were transcribed and analysed using thematic analysis. RESULTS: Six major themes were identified: gender roles, antenatal involvement, care costs and delivery choices, need to be informed, dealing with emotions, and dealing with the delivery day. The key finding reveals that inexperience and perceptions of gender roles greatly influenced the support provided by first-time fathers to their spouses and the support they received from their social support networks. Two primary needs were identified: need to be informed and the need to know about the cost of care in health settings. First-time fathers acknowledged the role of information on their decision making and final choices. CONCLUSION: Findings reveal the influence of gender norms, beliefs, and social support on first-time fathers' involvement in pregnancy and childbirth. This study also highlights the urgent need to provide informational support for first-time fathers and presents insights into what hospitals can do to achieve this need.

Barriers to husbands' involvement in maternal health care in Sidama zone, Southern Ethiopia: a qualitative study.

BACKGROUND: Husbands' involvement in maternal care is considered as a crucial step in scaling up women's utilization of the services. However, the factors related with how husband's involvement in maternal health care have hardly been studied to date in the study areas. Therefore, this study aimed to explore barriers to husbands' involvement in maternal health care, in Sidama zone, Southern Ethiopia. METHODS: The study employed a qualitative method. A pre-tested interview guide questions that prepared in English and translated in to Amharic language were used for data collection. The data were collected using focus group discussions, in-depth interviews and key-informants' interview in April and May 2015. The data were analyzed thematically. RESULTS: The study identified a range of factors that-deterred husbands to involve in their female partners' maternal health care. These are childbirth is a natural process, pregnancy and childbirth are women's business, preference for TBAs' care and husband's involvement in pregnancy and birth care is a new idea were identified as barriers for husbands' involvement in maternal health care, in this study. CONCLUSIONS: A range of factors related with clients' and service delivery factors' were identified as barriers to husbands' involvement in maternal health care. Based on the study findings we recommend a contextual based awareness creation programs about husbands' involvement in maternal health care need to be established.

Transforming social norms to end FGM in the EU: an evaluation of the REPLACE Approach.

BACKGROUND: Despite numerous campaigns and interventions to end female genital mutilation (FGM), the practice persists across the world, including the European Union (EU). Previous interventions have focused mainly on awareness raising and legislation aimed at criminalizing the practice. Limited evidence exists on the effectiveness of interventions due in part to the lack of systematic evaluation of projects. This paper presents an evaluation of the REPLACE Approach, which is a new methodology for tackling FGM based on community-based behaviour change and intervention evaluation. METHODS: We developed, trialed and evaluated the REPLACE Approach through extensive engagement with eight FGM affected African diaspora communities in five EU countries. We employed qualitative and quantitative tools to obtain data to inform the development, implementation and evaluation of the Approach. These included community-based participatory action research, questionnaires and community readiness assessments. The research took place between 2010 and 2016. RESULTS: Findings suggested that the Approach has the capability for building the capacities of FGM affected communities to overturn social norms that perpetuate the practice. We observed that community-based action research is a useful methodology for collecting data in FGM intervention settings as it allows for effective community engagement to identify, educate and motivate influential community members to challenge the practice, as well as obtaining useful information on the beliefs and norms that shape the practice. We also found that community readiness assessments, pre and post intervention, were useful for tailoring interventions appropriately and for evaluating changes in attitudes and behaviour that may have resulted from the interventions. CONCLUSION: This evaluation has demonstrated that the REPLACE Approach has the potential, over time, to bring about changes in norms and attitudes associated with FGM. Its strengths lay in the engagement with influential community members, in building the capacity and motivation of community members to undertake change, in recognising contextual differences in the barriers and enablers of FGM practice and in tailoring interventions to local community readiness to change, and then evaluating interventions to re-inform implementation. The next steps would therefore be to implement the Approach over a longer time frame to assess if it results in measurable change in behaviour.

Resilience, Trauma, and Cultural Norms Regarding Disclosure of Mental Health Problems among Foreign-Born and US-Born Filipino American Women.

Resilience refers to a set of personal qualities and abilities that allow an individual to confront challenges, risks, or traumatic experiences in an integrated manner and to thrive in the face of significant adversities. This cross-sectional study explores resilience, posttraumatic stress disorder (PTSD), and family norms with disclosure of mental health problems (FNAD) in a sample of 182 Filipino American women (FAW). Participants completed survey measures of resilience, PTSD, and FNAD and open-ended questions about beliefs and reasons for (not) disclosing mental health problems outside the family. Previous research found that the rates of psychological trauma and depression among FAW are higher than those in other Asian ethnic groups, which makes it necessary to investigate the protective characteristic of resilience among FAW. According to our results, foreign-born FAW had a significantly lower PTSD and greater resilience as compared to their US-born counterparts. A significant negative relationship between PTSD and resilience was observed only among foreign-born FAW. We also found a conditional moderating effect of FNAD on the negative relationship between resilience and PTSD. The results of our qualitative analysis of the participants' responses to the open-ended questions of the survey showed that FAW's family norms of nondisclosure are related to the cultural value of "saving face," a salient cultural construct among Asian family members. Results suggest that protective properties of resilience against PTSD are influenced by cultural factors, such as FNAD. Taken together, our findings underscore the importance of considering the impact of collectivistic cultural values (e.g., FNAD) in future research on resilience among Asian Americans.

Body image among Muslim women in Israel: exploring religion and sociocultural pressures.

The study aimed to investigate the association of the Muslim religion, as a multidimensional factor, with social pressures related to body image concerns, among Muslim women in Israel. Four hundred and Seventy-five Israeli Muslim women ages between 18 and 30 years completed questionnaire measures of strength of religious faith, wearing a traditional head cover (the Hijab), positive and negative body image, media exposure, societal pressures to conform to Western body ideals and its internalization, from 2016 to 2018. Strength of religious faith and wearing the Hijab were positively associated with positive aspects of body image, while only strength of religious faith negatively correlated with body dissatisfaction. Further, mediation analyses revealed that the relationship between the strength of religious faith and both positive body image and body dissatisfaction was mediated by media pressures. Notably, reduced peer pressures had more influence on positive body image, while reduced family pressures were more influential for negative body image. These results are discussed with regard to promoting a more intricate and multicultural understanding of body image concepts.

Explaining the Asian American Youth Paradox: Universal Factors versus Asian American Family Process Among Filipino and Korean American Youth.

This study used longitudinal survey data of Filipino American and Korean American youth to examine ways in which universal factors (e.g., peer antisocial behaviors and parent-child conflict) and Asian American (AA) family process variables (e.g., gendered norms) independently and collectively predict grade point average (GPA), externalizing, and internalizing problems. We aimed to explain the "Asian American youth paradox" in which low externalizing problems and high GPA coexist with high internalizing problems. We found that universal factors were extensively predictive of youth problems and remained robust when AA family process was accounted for. AA family process also independently explained youth development and, in part, the AA youth paradox. For example, gendered norms increased mental distress. Academic controls did the opposite of what it is intended, that is, had a negative impact on GPA as well as other developmental domains. Family obligation, assessed by family-centered activities and helping out, was beneficial to both externalizing and internalizing youth outcomes. Parental implicit affection, one of the distinct traits of AA parenting, was beneficial, particularly for GPA. This study provided important empirical evidence that can guide cross-cultural parenting and meaningfully inform intervention programs for AA youth.

Este estudio utilizó datos de una encuesta longitudinal de jóvenes filipinoamericanos y coreanoamericanos para analizar las maneras en las que los factores universales (p. ej.:las conductas antisociales entre pares y el conflicto entre padres e hijos) y las variables de los procesos familiares asiáticoamericanos (p. ej.: las normas de género) predicen independientemente y colectivamente el promedio de calificaciones y los problemas interiorizados y exteriorizados. Nos propusimos explicar la "paradoja de los jóvenes asiáticoamericanos" en la cual un bajo grado de problemas exteriorizados y un alto promedio de calificaciones coexisten con un alto grado de problemas interiorizados. Descubrimos que los factores universales fueron en gran parte predictivos de los problemas de los jóvenes y se mantuvieron firmes cuando se tuvo en cuenta el proceso familiar asiáticoamericano. El proceso familiar asiáticoamericano también explicó independientemente el desarrollo de los jóvenes y, en parte, la paradoja de los jóvenes asiáticoamericanos. Por ejemplo, las normas de género aumentaron el distrés mental. Los controles académicos hicieron lo opuesto a lo deseado, por ejemplo, tuvieron un efecto negativo en el promedio de calificaciones así como en otras áreas del desarrollo. La obligación familiar, evaluada por actividades centradas en la familia y por la colaboración, fue beneficiosa tanto para los resultados exteriorizados como interiorizados de los jóvenes. El afecto implícito de los padres, uno de los rasgos distintivos de la crianza de los asiáticoamericanos, fue beneficioso, particularmente para el promedio de calificaciones. Este estudio ofreció importante conocimiento empírico que puede guiar la crianza intercultural y respaldar de manera significativa programas de intervención para jóvenes asiáticoamericanos.

Heteronormative gatekeeping when enacting queer research in elementary schools: an autoethnographic perspective.

Using authoethnography, the authors analyze how queerphobia and cis/heterosexism shape their research process regarding (LGBTQ)-inclusive empirical work in elementary school spaces. With examples from their own experiences, they show how queerphobic gatekeeping affects site access, negotiations required during data collection, and dissemination of the results to others. The authors argue that, taken together, these forces complicate - if not outright prevent - empirical, school-based research with young children, thereby artificially constraining the knowledge base of the field related to LGBTQ-inclusive education. They offer these analyses as affirmations to those facing similar challenges and as education to those in positions of power to change perceptions of, support of, and responses to queer, school-based educational research.

The development of children's preferences for equality and equity across 13 individualistic and collectivist cultures.

A concern for fairness is a fundamental and universal element of morality. To examine the extent to which cultural norms are integrated into fairness cognitions and influence social preferences regarding equality and equity, a large sample of children (N 2,163) aged 4-11 were tested in 13 diverse countries. Children participated in three versions of a third-party, contextualized distributive justice game between two hypothetical recipients differing in terms of wealth, merit, and empathy. Social decision-making in these games revealed universal age-related shifts from equality-based to equity-based distribution motivations across cultures. However, differences in levels of individualism and collectivism between the 13 countries predicted the age and extent to which children favor equity in each condition. Children from the most individualistic cultures endorsed equitable distributions to a greater degree than children from more collectivist cultures when recipients differed in regards to wealth and merit. However, in an empathy context where recipients differed in injury, children from the most collectivist cultures exhibited greater preferences to distribute resource equitably compared to children from more individualistic cultures. Children from the more individualistic cultures also favored equitable distributions at an earlier age than children from more collectivist cultures overall. These results demonstrate aspects of both cross-cultural similarity and divergence in the development of fairness preferences.

Reasoning About the Scope of Religious Norms: Evidence From Hindu and Muslim Children in India.

Conflicts arise when members of one religion apply their norms to members of another religion. Two studies explored how one hundred 9- to 15-year-old Hindu and Muslim children from India reason about the scope of religious norms. Both Hindus and Muslims from a diverse Hindu-Muslim school (Study 1) and Hindus from a homogeneous Hindu school (Study 2) more often judged it wrong for Hindus to violate Hindu norms, compared to Muslim norms, and said the opposite for Muslims. In contrast, children judged it wrong for both Hindus and Muslims to harm others. Thus, even in a setting marred by religious conflict, children can restrict the scope of a religion's norms to members of that religion, providing a basis for peaceful coexistence.

Moving beyond orientations: a multiple case study of the residency experiences of Canadian-born and immigrant international medical graduates.

Many international medical graduates (IMGs) enter North American residency programs every year. The Canadian IMG physician pool increasingly includes Canadian-born IMGs (C-IMGs) along with Immigrant-IMGs (I-IMGs). Similar trends exist in the United States. Our objective was to understand the similarities and differences in the challenges faced by both I-IMGs and C-IMGs during residency to identify actionable recommendations to support them during this critical time. We performed a multiple case study of IMGs' experiences at a large Canadian university. Within our two descriptive cases (I-IMGs, C-IMGs) we iteratively conducted twenty-two semi-structured interviews; we thematically analyzed our data within, between, and across both cases to understand challenges to IMGs' integration and opportunities for curricular innovations to facilitate their adaptation process. Research team members with different perspectives contributed reflexively to the thematic analysis. Participants identified key differences between medical culture and knowledge expected in Canada and the health systems and curricula in which they originally trained. I-IMG and C-IMG participants perceived two major challenges: discrimination because of negative labelling as IMGs and difficulties navigating their initial residency months. C-IMGs described a third challenge: frustration around the focus on the needs of I-IMGs. Participants from both groups identified two major opportunities: their desire to help other IMGs and a need for mentorship. I-IMGs and C-IMGs face diverse challenges during their training, including disorientation and discrimination. We identified specific objectives to inform the design of curriculum and support services that residency programs can offer trainees as well as important targets for resident education and faculty development.

Extending the Theory of Normative Social Behavior to Predict Hand-Washing among Koreans.

The current study tests the predictions of the theory of normative social behavior (TNSB) in a hand-washing context in a Korean sample and extends the theory to examine the role of perceived publicness, a variable believed to activate face concerns, as a moderator of the norm-behavior relationship. The findings show substantial main effects for all of the study variables on behavior. In addition, the descriptive norm-behavior relationship is moderated by perceived publicness and outcome expectations, but the nature of the interactions is not consistent with that evidenced in previous literature on US samples. Implications for normative theory and communication campaigns are discussed.

'In the Islands people don't really talk about this stuff, so you go through life on your own': An arts-based study exploring intimate relationships with young people in Samoa.

This study explores conceptualisations and understandings of intimate relationships with young people in Samoa - an at-risk group experiencing high rates of intimate partner violence and alienation from sexual and relationship health promotion. Insights contribute to the immediate need to advance knowledge and practice around prevention with this group. An arts-based approach, which included a two-day interactive drama workshop coupled with follow-up, peer-led focus groups, was used to explore perceptions and understandings related to intimate relationships with 15 tertiary educated young people (nine female and six male) from across Samoa. Intersectionality informed the data collection and thematic analysis, examining participants' lived experiences and the ways multiple and intersecting identities interact within social and cultural systems to influence and inform these experiences. Outcomes highlight important tensions for young people, including the way in which age, gender, religion and sexuality interact with social hierarchies and power structures, socially prescribed gender norms, family structures and globalisation. This research provides insights that can inform the development of prevention strategies to address the root causes of intimate partner violence, building the knowledge and skills required for establishing intimate relationships free from violence with young people.

[Sexual violence against women in Tunisia]. / Violence sexuelle exercée sur les femmes en Tunisie.

BACKGROUND: Sexual violence exists everywhere in the world. It depends mainly on the cultural and religious norms conveyed in the various societies. This is a neglected area of research. Available data are insufficient, especially in Arab-Muslim context. METHODS: In this paper, we comprehensively review the scientific literature in order to clarify the cultural, religious and legal aspects of the concept of sexual violence against women in Tunisia, and ask the question of the urgent need to put in place strategies to counter this problem. RESULTS: The National Office for Family and Population published in 2011 the results of the national survey on violence against women in Tunisia, including data on sexual violence and its impact on women's health and well-being. According to this survey, 14.2% of women reported having been sexually abused by an intimate partner during their lifetime and 9.0% reported having experienced it during the last 12 months. One out of every six Tunisian women has been the victim of a sexual violence in a conjugal setting. More men than women legitimized violence against women in contexts where family control, especially conjugal control, is exercised over them. In a study examining the impact of culture and religion on experiences and sexual practice of women in Tunisian society, the majority of respondents thought that sexuality in women was a religious duty and that they do not have the right to refuse their husbands or to rebel. Thus, women would be doubly sanctioned having neither the right to express their desire nor not to respond to their husband's desire. A survey of a representative sample of Tunisian women found that 56.9% of the participants reported being victims of domestic violence, particularly sexual violence (10.7%) consisting mainly of rape and sodomy, at least once in their lifetime. This survey showed that those victims expressed dissatisfaction with overall quality of life. Moreover, contrary to Western literature, sexual violence was the least reported form of violence by teenage girls in Tunisian schools. Indeed, cultural values of modesty, virginity and honor are socially much more demanded for girls, in Arab countries in general, reinforcing staggering silence and inaction around violence experienced by school-aged adolescents. In Tunisian society, the cultural "solution" to rape wants the woman to marry her rapist which safeguards her family's integrity by legitimizing the union. CONCLUSION: Sexual violence has detrimental effects on female victims' physical and mental health. Even if the information on this form of violence is not easy to obtain in our environment, and that rates of subjects reporting sexual violence in their lifetimes are not important, the problem of sexual violence must be considered as a public health problem requiring urgent interventions and a greater institutional will.