Exploring Problems with Sexual Violence Data and the Potential to Impact Reform

Erin Bowers


There has been an abundance of worldwide research into sexual violence (SV). However, problems exist with data collection that include cross-cultural considerations, perceptions of rape and victimization, and study methodology issues. These problems affect the ability for the research to lead to meaningful and lasting reform. This paper discusses worldwide SV trends, prevalence rates, impacts for females, and the effects of creating change. Issues explored include cultural norms, legal practices, perceptions of SV, study design, and age of research. Recommendations for research, programming, and policy are discussed with a focus on study methodology, program design, program evaluation, and using human rights to advocate for change.

Keywords: females, human rights, policy, prevalence statistics, programming, research, sexual violence, worldwide trends

Sexual violence (SV) is a violation of human rights that has been experienced by over 33% of females globally (Burn, 2011; DeGue et al., 2014; World Health Organization [WHO], 2017). The Declaration on the Elimination of Violence Against Women defined gender-based violence as any act that results in harm or suffering to females in physical, emotional, sexual, and psychological ways (United Nations [UN] General Assembly, 1993). SV is not limited to rape. It also includes sexual assault or abusive acts that force females that may be derogatory or cause injury, such as kissing, groping, prostitution, and sex trafficking (Burn, 2011; Sev’er, 2015; Watts & Zimmerman, 2002). SV intrudes upon an individual’s rights to bodily integrity and freedom to live without fear of cruel, degrading, and inhumane treatment (Johnson & Colpitts, 2013). SV is an important issue that deserves further research to help understand its scope and impact on females around the world.

Many academic and government studies have been conducted to understand the causes and scope of SV. However, it is important to note there are several issues with SV statistics that impact the ability for meaningful and lasting reform by government and legal agencies, as well as the development of programming that assists survivors (Abrahams et al., 2014; Clay-Warner & Burt, 2005; McLean-Riggs, 2015). This paper will discuss SV prevalence rates and identify problems with data collection, such as a lack of cross-cultural considerations, perceptions of rape and victimization, and study methodology issues. Implications for future research and SV programming, including adopting a human rights perspective, will also be explored as options that could improve practice processes and empirical research. The issues with prevalence statistics for SV require discussion because they may hinder the ability to create programming to assist females who want help, as well as negatively impact legal reforms that can prevent future instances of SV (DeGue et al., 2014). Exploring problems with SV prevalence statistics can help improve future research as well as program design and policy development for professionals who work with victims around the world.

Types of Sexual Violence and Prevalence

In order to understand the scope of SV and identify how data collection impacts meaningful policy and programmatic change, it is essential to examine trends and prevalence rates. An analysis of female-based violence from figures reported in over 80 nations showed that 35% of females have experienced SV (WHO, 2017). SV is a major public health issue at every corner of the globe (Burn, 2011; DeGue et al., 2014; Viki, Chiroro, & Abrams, 2006). The UN (2015) noted that in the Asia Pacific alone, upwards of 80% of males reported using some type of violence, including sexual, against females at least once. Though prevalence statistics paint a grave picture, they are not fully representative of the gravitas of the topic.

Non-Stranger Rape

Intimate partner rape is a pervasive problem around the world. The majority of rape perpetrators are known to females (Abrahams et al., 2014; Gross, Winslett, Roberts, & Gohm, 2006; UN, 2015; Watts & Zimmerman, 2002). In fact, over 60% of females in the continents of Africa, Asia, and Oceania who reported rape were in a relationship with the offender at the time of the incident (UN, 2015). Bergen (2004) approximated that 14% of females in San Francisco experienced intimate partner rape. A report on violent victimization by the United States Bureau of Justice Statistics noted that between 1995 and 2002, 74% of rapes on American college campuses involved known assailants (Gross et al., 2006). Gross et al. (2006) also noted that studies have yielded different prevalence statistics, ranging from 74% to upwards of 95%, which stem from the separation between forceful assaults and those that involve psychological or emotional pressure. Gross et al. (2006) indicated many researchers do not include non-forceful assaults in study definitions, which impacts prevalence rates. There is clearly a wide variance, and prevalence statistics should be interpreted with a degree of caution. Differing methodologies used in studies, such as questionnaire design, perceptions of what constitutes non-stranger rape, and levels of cultural acceptance may impact global figures and data veracity.

Stranger Rape

Even though stranger rape transpires worldwide, there is less research about it than for non-stranger rape, which results in definitions and measuring tools receiving less attention (Abrahams et al., 2014; UN, 2015). Gross et al. (2006) reported a 2% prevalence in stranger rape on American college campuses, though they also noted that several participants chose not to identify their perpetrator. Worldwide, just over 7% of females reported stranger SV during their lifetimes, though there is a substantial variation in prevalence across regions, ranging from 21% in Africa to 8% in Asia (Abrahams et al., 2014; UN, 2015). Abrahams et al. (2014) also indicated there was a lack of reliable data in the Middle East, parts of Europe, and Asia Pacific due to an absence of quality studies, undependable reporting methods, and cultural attitudes. The lack of reliable data affects the ability to accurately report prevalence rates of stranger rape worldwide. Moreover, the tendency of studies to concentrate on non-stranger rape and omit stranger rape has the circular effect of contributing to undermining the experiences of women, which then leads to under-reporting.

War or Conflict Rape

War or conflict rape occurs during times of violence and unrest, and millions of females around the world have been victimized throughout history (Burn, 2011). War brings instability and a lack of policing, which increases risk of rape for females (Burn, 2011; UN, 2015). During World War II, Nazi soldiers raped an estimated 130,000 females as they invaded the Soviet Union (Messerschmidt, 2006). In fact, Messerschmidt (2006) argued that the actual number is much higher because of instances of repeated gang rapes and difficulties in obtaining data during times of conflict. In the 1990s, approximately 20,000 to 50,000 Muslim women were raped during conflicts in the Middle East, and between 250,000 to 500,000 women were raped during the Rwandan civil war (Burn, 2011; Watts & Zimmerman, 2002). Data from the Republic of Congo, which has experienced a lengthy period of civil unrest, suggests that nearly half of the men have perpetrated, or attempted to perpetrate, SV against females (UN, 2015). Despite these alarming numbers, prevalence rates for war and conflict SV are sparse, and there are no truly accurate data sets that measure the scope of rape during wartime (UN, 2015; Watts & Zimmerman, 2002). The absence of definitive prevalence rates may have impacted the development of solutions to address the problems on a global scale because the estimates are perceived as lacking validity. The large variances in figures may also signal issues with study design.

Coerced Sexual Assault

Sexual coercion involves psychological and verbal pressure to engage in sexual activity and is typically not physically forceful (Burn, 2011). Watts and Zimmerman (2002) noted that sexual coercion is tolerated and condoned in many countries. Therefore, it is difficult to secure accurate statistical information regarding trends and prevalence. Gross et al. (2006) indicated that many SV investigations group victims together to obtain outcome measures, and that rape is usually separated from sex acts involving verbal and emotional pressure. Gross et al. reported that up to 50% of females do not report coercion as SV, even if sexual intercourse is involved, because they did not experience physical force. Sexual coercion is under-represented in prevalence statistics, as public tolerance and private condonation may impact the likelihood of women coming forward to report an assault. The perception that physical force is required for an incident to be labelled as SV also hinders the reliability of statistics and the ease of data collection.

Sex Trafficking/Prostitution

Prostitution involves selling sexual activity, while sex trafficking refers to the transport and sale of humans to perform sex acts that typically earn money for underground factions around the world (Burn, 2011). There is a growing trend that involves trafficking females for sex and exploitation of labour (Watts & Zimmerman, 2002). Burn (2011) stated that sex trafficking is popular in Asian countries such as Thailand, Korea, and the Philippines. Although Watts and Zimmerman (2002) reported there are no reliable statistics on sex trafficking, estimates state between 700,000 to 2 million females are involved. Watts and Zimmerman note that roughly 250,000 Asian females are sold per year. Russia accounts for nearly 100,000 females in the sex trafficking industry while Central and Eastern Europe account for about 175,000. Latin American and Caribbean females make up approximately 150,000 sex workers involved in trafficking (Watts & Zimmerman, 2002). Since global statistics are undependable and sex trafficking is seen as acceptable behaviour in some nations, SV in these circumstances is under-reported, thus minimizing the actual impacts of females trapped in sex trafficking schemes.

Burn (2011) suggested that most females working in prostitution are exploited sexually and often marginalized, making it difficult to escape their situations. Many of the women involved in prostitution live in poverty, have mental health or substance abuse issues, and subjected to violent and controlling situations with their pimps (Burn, 2011). Watts and Zimmerman (2002) stated that SV against prostitutes has not been a focus of academic study or of public interest, yet women who work in prostitution experience a high rate of SV. Worldwide trends show that 81% of prostitutes experience violence (Watts & Zimmerman, 2002). Though statistics show a high amount of SV in prostitution, it is not an area that garners much attention. The global lack of academic and public interest could indicate that the statistical representation for violence in prostitution is lower than in actuality, resulting in less of an understanding of how seriously SV affects women.

Impacts of Sexual Violence on Women

SV has serious impacts on women around the world. Not only are there increased costs to health care systems worldwide, there are also economic impacts on legal systems, housing, and social support services that aim to assist women that have experienced SV (UN, 2015; WHO, 2017). In addition to extensive economic factors, many females suffer from emotional and physical health issues resulting from SV. These issues include sexually transmitted infections, mental health issues, and substance abuse (Gerassi, 2015; UN, 2015; WHO, 2017). SV impacts the lives of women globally, and studies that measure levels of violence may not always take these impacts into consideration (UN, 2015). Therefore, in addition to collecting data, it is imperative to consider the ways SV affects women’s lives in order to create meaningful change to legal systems, survivor assistance programs, and government policies.

Impacts to Emotional Health

When SV is experienced, it can have serious impacts on emotional health (Gerassi, 2015; UN, 2015). Post-traumatic stress disorder, eating disorders, sexual dysfunction, depression, anxiety, suicide attempts, and dissociation befall many who are forced or coerced into performing unwanted sexual acts (Gerassi, 2015; Johnson & Colpitts, 2013; WHO, 2017). Moreover, there are regularly increased levels of alcohol and drug use as a result of how SV impacts mental health (Johnson & Colpitts, 2013; UN, 2015; WHO, 2017). Sinha (2015) noted that Canadian females who experience SV use higher levels of medication, to the point of misuse, as a way to cope with stress from the trauma they experienced and to aid with sleep. Since emotional health is important to the healing process, it is vital that programs and legal reforms consider mental health as part of their policy.

Impacts to Physical Health

In addition to emotional impacts, there are also deleterious physical health consequences from SV (Gerassi, 2015; Johnson & Colpitts, 2013; WHO, 2017). Cohen and Maclean (2004) suggested that increased rates of pelvic diseases as well as urinary and bladder infections occur in women who experience SV. In many regions, SV results in an amplified risk of sexually transmitted infections, including HIV (UN, 2015; WHO, 2017). SV can result in broken bones, head trauma, unintended pregnancies, infertility, and gynecological issues (Gerassi, 2015; WHO, 2017). Gerassi (2015) reported that health care costs are up to 19% higher for females who experience SV than for their general population counterparts due to sexual infections and gynecological issues. Prevalence statistics may not fully represent the physical and emotional toll on women, and this is a potential issue when considering reform laws, reporting procedures, and program policies. Screening for SV at hospitals when females present for physical injury may help lead to more complete statistics.

Problems with Data Collection and Statistics

Though many studies speak to trends of SV against females, they do not demonstrate the full extent of the issue. Casey and Nurius (2006) indicated that experts view prevalence rates as controversial because studies vary widely in their design, since some researchers focus on quantitative data while others gather qualitative data. It is widely acknowledged that SV is under-reported worldwide, and this impacts the statistics that are represented in studies (Abrahams et al., 2014; Gross et al., 2006; Lee, Pomeroy, Yoo & Rheinboldt, 2005; Viki et al., 2006; Watts & Zimmerman, 2002). Therefore, prevalence statistics should be regarded with caution. There are many reasons why problems with data collection and subsequent statistical reporting issues occur, including a lack of cross-cultural considerations, perceptions of rape and victimization, and the various methodologies used by researchers to gather and analyze data.

Cross-Cultural Considerations

Cultural attitudes toward SV play a role in statistical discrepancies. Sex trafficking is considered socially acceptable in many areas of the world, especially in Asian nations (Burn, 2011; Watts & Zimmerman, 2002). Lee et al. (2005) suggested that Asian students are more likely to believe that SV prevention lies primarily with females than non-Asian students, and that victims themselves contribute to SV because they are not acting in a chaste manner. Moreover, marital rape is frequently condoned as punishment towards a wife in several Middle Eastern and African countries (Burn, 2011; UN, 2015). In this sense, SV is perceived as an action that does not transgress value systems or violate accepted social norms. The acceptance regarding SV against females could preclude a substantial number of reports to authorities because of underlying cultural beliefs that it is justifiable.

In part, the cultural aspects that impact how often females report their experiences are due to variations in laws that mitigate instances of SV. Viki et al. (2006) reported that African males have higher proclivity for rape in situations where there is the assurance that they will not be held criminally responsible. Burn (2011) noted that globally, rape laws are generally weak, with only about 50 nations enforcing SV laws. In addition to a lack of enforceable laws, many females around the world have a deep distrust of law enforcement. This distrust is due to corruption within agencies, leniency towards the culturally-based practices of wife-beating, genital mutilation, marital rape in many nations in Africa, the Middle East, Asia, and Oceania (Lee et al., 2005; UN, 2015). If a nation’s authority figures do not have proclivity to investigate or punish SV, it weaves a narrative that says the issues of women are not important enough to address, and that women are less worthy of protecting.

Furthermore, there is a lack of female law enforcement officers worldwide. Globally, women make up less than 35% of the available police force because many nations refuse to place women in positions of power (UN, 2015). The lack of women in law enforcement impacts the comfort level of females who wish to report SV (UN, 2015). If a woman feels uncomfortable or unsupported after experiencing SV, she may be disinclined to report it to authorities for fear of her own safety and lack of recourse. Moreover, it suggests that there are cultural pressures to keep silent because of the belief that interviewers cannot be trusted with highly personal and private information. Since many men in Africa, the Middle East, and Asia view females as subjects or property, cultural practices limit speaking out for fear of reprisal from spouses if information is shared by police (Burn, 2011; Lee et al., 2005; UN, 2015). If females in these nations report to mostly male law enforcement, it potentially creates further danger for victims from their perpetrators.

Perceptions of Sexual Violence and Victimization

Gross et al. (2006) indicated a lack of consistency in the definition of SV, particularly rape, and sexual victimization. Many believe that rape is committed by unknown assailants, even though there is evidence that suggests otherwise (Abrahams et al., 2014; Gross at al., 2006; UN, 2015; Watts & Zimmerman, 2002). As a result of this perception, many rapes are not reported because there is a belief that intimate partner rape does not qualify as forced sex or as a crime (Abrahams et al., 2014). In addition, coerced sexual acts may not be reported because females perceive physical force as associated with SV (Gross et al., 2006). If this is indeed the case, many females may not report to police, or participate in studies, because they do not fully understand that SV does not rely on force as an absolute measure of incidence.

Study questionnaires may not take the stigma created by disparate cultural perceptions of SV in account. Part of this stigmatization revolves around gender norms and perceptions of what constitutes SV. For females, this impacts disclosure rates because they fear being blamed (Abrahams et al., 2014; UN, 2015). In many Asian, African, and Middle Eastern countries, reporting SV is not supported because it is deemed shameful to families to do so (Burn, 2011; UN, 2015). There are many reasons for this, including an uphill battle in changing the perceptions of what constitutes rape and if it needs to violate social norms to be considered a crime (Burn, 2011). In addition, attitudes of privacy and family values also influence reporting (Sev’er, 2015; UN, 2015). Cultural stigma surrounding SV clearly contributes to women’s hesitance to identify themselves as victims, and SV research would benefit from careful consideration of cultural perceptions into study definitions and interview approaches.

Methodology Issues

Globally, most studies focus on instances of SV perpetrated by known assailants, which means that non-stranger assaults are neglected (Abrahams et al., 2014). Gross et al. (2006) noted that date rape is under-reported, and that many studies view SV by known assailants differently than unknown ones. As a result, some interviewers will fail to draw parallels between sexual coercion by known and unknown males, which results in inconsistent data collection (Gross et al., 2006). Moreover, many studies are based on very specific questions about non-stranger SV and typically use broadly-worded questions to gather data on stranger incidences (Abrahams et al., 2014). Moreover, Abrahams et al. suggested that data collection measures for stranger SV may be less vigorous. Data collected is frequently separated into two groups, impacting statistical reliability. Therefore, quality is hampered due to decreased levels of disclosure regarding stranger-perpetrated SV. The singular focus of many SV studies severely limits data collection and results in statistics that are lower than what exists in actuality.

In addition to singular focus, many studies are localized to certain regions and may not fully reflect the number of occurrences nationwide (Abrahams et al., 2014; Clay-Warner & Burt, 2005). This localization limits the generalizability of the data collected on a global level. Additionally, study designs impact the level of responses provided because they are either deemed not to fit the study definition, or the participants fall outside the study location (Casey & Nurius, 2006; Clay-Warner & Burt, 2005). These narrow study designs contribute greatly to under-reporting. Casey and Nurius (2006) reported that there has traditionally been a lack of longitudinal studies regarding SV, and almost no study compares prevalence among comparable samples, which means that broader trends are difficult to truly assess. Due to the discrepancies in definitions and methodological concerns, it is highly likely that prevalence statistics and trends are inaccurately capturing SV worldwide (UN, 2015). The narrow focus of most studies on one aspect of SV does a disservice in providing a complete statistical picture of scope of the problem and caution should be used in interpreting figures and trends, which may be outdated.

Though data measuring SV has increased over time, many countries have only conducted a single survey since 1995 (UN, 2015). Therefore, many prevalence trends tend to focus on studies that are older because nations have not conducted follow-up studies in order to capture the current state of the issue. This is true not only in under-developed nations; it is also the case in North America. In Canada, a detailed survey measuring SV has not been conducted since 1993 (McInturff, 2013). In America, the National Violence Against Women Survey was last conducted in 2000 (Clay-Warner & Burt, 2005). Abrahams et al. (2014) noted that nations have not engaged in regular data collection regarding SV because empirical research is deemed unimportant. The belief that SV research lacks importance means that prevalence rates are not current and that worldwide trend data is outdated. In fact, the UN (2015) noted that since the Declaration on the Elimination of Violence Against Women was passed in 1993, only small-scale, ad hoc studies were conducted until the early 2000s. Clearly the age of many of these studies has an impact on global data trends and may not be a reliable portrayal of the scope of SV. The age of prevalence statistics and lack of continued study may have a direct impact on creating meaningful and lasting change.

Impact of Studies on Change

In addition to discussing the problems with data collection regarding SV prevalence rates, it is important to examine how engaging in research has impacted reform. Due to many of the issues with empirical studies focusing on SV, including a lack of cross-cultural considerations, perceptions of rape, and differing methodologies, reforms to law, social norms, and programming may be negatively affected. Globally, speed of progress in the legal realm, ease of reporting SV, program effectiveness, and evaluation of programs due to lack of funding have all seen issues stemming from the quality and sparseness of SV research (Burn, 2011; Casey & Nurius, 2014; Clay-Warner & Burt, 2005; DeGue et al., 2014; Mclean-Riggs, 2015; UN, 2015). These issues increase the difficulty in addressing SV and how it affects females worldwide.

Pace of Progress and Ease of Reporting

Despite the massive number of females experiencing SV, movement to create laws that protect rights has been slow. It took until 2002 for 60 nations to ratify the International Criminal Court’s draft treaty to declare war rape as a crime, with the first prosecutions not occurring until 2009 (Burn, 2011). Moreover, only 52 nations have laws regarding marital rape (UN, 2015). This small number may be due to many nations’ tolerant attitudes regarding female-based violence (UN, 2015). SV laws aren’t just lacking in third-world nations, first-world nations that pride themselves on their attempts at SV reform also lack meaningful laws and have questionable investigation practices once an instance of SV is reported. In America, Mclean-Riggs (2015) reported 11,000 rape kits that had been completed, but never tested, were discovered in an abandoned police warehouse. Mclean-Riggs further noted that despite American laws aimed at mitigating SV, the fact that these kits were abandoned without proper investigation is not unusual and speaks to the inherent failure of legal reform. Clearly, the progress for international legal recognition of SV as a serious crime has been slow at best.

Not only has legal reform stalled, research around help-seeking and community perceptions is generally scarce (Casey & Nurius, 2006). Only a fraction of females who experience SV report it to police or seek assistance in other ways, such as from family or community support programs (UN, 2015). When they do access legal recourse, females regularly report their experiences with law enforcement, the courts, and other figures of authority as hurtful and stigmatizing (Casey & Nurius, 2006). Clay-Warner and Burt (2005) stated that even if females were to report every instance of SV, more than 90% of their perpetrators would not be taken to court. Though rape laws were widely implemented in America, there is inconclusive evidence as to whether the number of reports to police has increased (Clay-Warner & Burt, 2005). This lack of clarity is due to factors discussed earlier, such as narrow definitions, stigma, and public perception of what violates social norms. The lack of commitment on an international level to label SV as a serious crime shows that much still needs to be done to change public perception and increase reporting safety.

Ineffectiveness of Programs and Lack of Evaluation

Despite increased data collection, SV reforms have been somewhat unsuccessful in effecting change, which has impacted community programming (Clay-Warner & Burt, 2005; DeGue et al., 2014). Mclean-Riggs (2015) stated that crisis centres have not been as progressive and creative as they could be in providing assistance due to underfunding and state-led victim referral processes. Naturally, this lack of funding and creativity have led to ineffectiveness in assisting females who have experienced SV and in preventing further assaults. SV prevention evaluation literature has not increased over time even though research around SV has increased (DeGue et al., 2014). DeGue et al. found that many American SV victim support programs are ineffective in dealing with trauma or educating men, despite an abundance of statistical information, because evaluation methods have been lacking in both quality and quantity. Moreover, the authors’ evaluation of SV prevention programs peaked in the late 1990s and did not pick back up until around 2010. In order to develop effective prevention and support programs and policies, continued evaluation is important to identify which methods are effective and where changes need to occur (DeGue et al., 2014; Mclean-Riggs, 2015). Regardless of education, it seems that numerous American programs dedicated to mitigating instances of SV lack of creativity in programming, and spotty evaluation methods for tracking level of information transfer. The chronic under-reporting of SV, stigma faced by victims, and issues with evaluation impact state interest levels and funding, prohibiting effective victim support program planning.

Implications for Future Research and Programming

Clearly, SV research has several issues that impact programming, policy, and reform. If female safety is to be successfully addressed worldwide, a change to the way research is conducted is imperative. Furthermore, it is vital to alter legal policies, reporting procedures, and programming that provides support for women who have experienced SV to increase access to assistance and prevent future occurrences. Human rights perspectives can help create policies and SV prevention and victim support programs that empower women and help destigmatize SV.

Recommendations for Research

Further research regarding SV needs to be undertaken on a global scale to update prevalence rates. Rather than focusing on localized areas, national studies should be conducted to better represent the diverse populations of women who are impacted by SV (Bergen, 2004). To help address this issue, WHO (2017) is collaborating with partners around the world to build upon the existing evidence base by encouraging qualitative studies across different settings and supporting nations to conduct further research on the documentation of violence and its consequences to females, legal and healthcare response rates, program interventions to address SV, and improving study methodologies used in order to update prevalence rates.

Additionally, research that employs rigorous methodologies and includes all forms of SV must continue to more fully capture the scope of the problem globally (UN, 2015). Studies that compare similar populations over a specific time should also be a future focus. Since dedicated surveys can be costly, inserting a breadth of questions regarding SV experiences into questionnaires that capture a wide range of issues regarding women’s well-being may be helpful in increasing data collection, provided that careful consideration is given to definitions (UN, 2015). Carefully constructed interviews that include specific definitions of SV, as well as specificities around instances of occurrence may increase the veracity of data collected. For example, researchers may ask participants to provide their own definitions of SV to capture different perspectives and account for cultural considerations. Questions around ease of reporting as well as effectiveness of support crisis and prevention programs should be incorporated into study designs. This may be beneficial to policy and law makers who are searching for ways to empower women to report SV and seek redress. Combining both quantitative and qualitative research methods in studies can support prevalence rates as well as identify gaps in real world settings.

Updating research methodologies can have direct implications for professionals working with females who have experienced SV (Abrahams et al, 2014; DeGue et al, 2014). Social workers, as well as other professionals, can advocate for research that involves seeking information about human rights and social justice in order to bring reform that is resiliency-based and empowering. Furthermore, members of multi-disciplinary teams can engage in research to help inform crisis and victim support programming and policies that are more inclusive to diverse populations, as well as gauge interest and effectiveness of treatment modalities. Medical professionals can use research to provide trauma-informed care and include SV screening as a part of assessing female health. DeGue et al. (2014) noted that gathering experiences helps provide a humanizing approach that can be useful for building more effective prevention programs and lessening stigma. Since these females may have unique needs based on their experiences, it is important to provide an avenue to have their voices heard.

Recommendations for Programming and Policy

DeGue et al. (2014) indicated that for SV prevention and intervention programs to be effective, they should be comprehensive, lengthy, and sensitive to the needs of females by employing professionals who have specific training in female trauma. Prevention and intervention program designs and policies should address multiple components (education, policy, social norm campaigns, and skill-building) across a variety of settings, be available to adolescents, foster positive relationships, have socio-cultural relevance to the population, and be based in theory (DeGue et al., 2014; UN, 2015). It is important that programs aiming to provide both short and long-term support recognize cultural differences and involve females in creating policy (Lee et al., 2005; UN, 2015). SV victim support programs must recognize all forms of SV to help educate females, as well as members of the public, and they need to be continuously evaluated (UN, 2015, WHO, 2017). Components that empower females, such as skills training and financial planning, should be provided so that women have the economic independence and employment skills required to leave potentially harmful situations (WHO, 2017). It is imperative that men be included in prevention programming so that they can better understand the inequalities in gender and power that contribute to social norms regarding SV (UN, 2015; WHO, 2017). Furthermore, it is vital that programs aim to reduce the stigma associated with SV and rape to encourage participation in healing and continued reporting.

In addition to SV programming, a human rights perspective can be used to advocate for stronger legal support and policy change. Implementing reforms that are rights-based can help change not only law, they can also assist in reconstruction of social norms (Burn, 2011; DeGue et al., 2014). To achieve this, policy and lawmakers, as well as community organizations, must adopt a human rights lens to advocate for change. Laws should address the seriousness of SV as a crime, while empowering females to report their experiences and seek social support, without creating barriers and furthering stigma (UN, 2015; WHO, 2017). Adopting a human rights lens means that police investigations and court proceedings should be reviewed to ensure that females have proper access to legal services and mental health supports when seeking redress. Policies must be racially sensitive, take cultural values into consideration, and aim to eliminate discrimination by empowering females (UN, 2015; WHO, 2017). Any strategy that is considered by law and policy makers should ideally be implemented nationally, as well as at the community level. Adopting this approach means coalitions and partnerships can be formed that recognize individual community needs and the unique issues that females living within them face.


SV is the subject of many studies that detail prevalence and worldwide trends regarding non-stranger rape, stranger rape, war or conflict rape, coerced sexual assault, sex trafficking, and prostitution. However, there are problems with statistics due to cross-cultural considerations, perceptions of rape and victimization, and study methodology issues. Societies shame females who experience SV and law enforcement is lacking in areas of the world, contributing to under-reporting. Many studies focus on narrow definitions of forceful sexual acts by intimate partners and do not discuss encounters with strangers or acts of coercion, which influences resulting data. These issues with data collection impact the ability for reform and meaningful intervention and prevention programs. Therefore, prevalence statistics should be interpreted with caution when addressing SV. There is potential for program improvement by taking cultural perceptions, stigma, and inclusivity for all types of SV into consideration. Future research should include all forms of SV in larger settings, and with comparable sample populations. Moreover, human rights perspectives are imperative in creating policy and programming that minimizes stigma and empowers survivors. These considerations may result in more meaningful change and a more accurate representation of a massive issue that affects the human rights and safety of females globally.


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