How Men's Sexual Assault Victimization Experiences Differ Based on Their Sexual History

Emergency Care Utilization for Mental and Sexual Health Concerns Among Adolescents Following Sexual Assault: A Retrospective Cohort Study

PURPOSE

This study aimed to explore the health outcomes of adolescent survivors of sexual assault, as measured by subsequent emergency department (ED) utilization for mental and sexual health concerns.

METHODS

This retrospective cohort study used the Pediatric Health Information System (PHIS) database. We included patients aged 11-18 years seen at a PHIS hospital with a primary diagnosis of sexual assault. The control group included age- and sex-matched patients seen for an injury. Participants were followed in PHIS for 3-10 years; subsequent ED visits for suicidality, sexually transmitted infection, pelvic inflammatory disease (PID), or pregnancy were identified, and likelihoods of each were compared using Cox proportional hazards models.

RESULTS

The study population included 19,706 patients. ED return visit rates in the sexual assault and control groups were 7.9% versus 4.1% for suicidality, 1.8% versus 1.4% for sexually transmitted infection, 2.2% versus 0.8% for PID, and 1.7% versus 1.0% for pregnancy, respectively. Compared to controls, sexual assault patients were significantly more likely to return to the ED for suicidality throughout the follow-up period, with the highest hazard ratio of 6.31 (95% confidence interval 4.46-8.94) during the first 4 months. Sexual assault patients also had higher likelihood of returning for PID (hazard ratio 3.80, 95% confidence interval 3.07-4.71) throughout the follow-up period.

DISCUSSION

Adolescents seen in the ED for sexual assault were significantly more likely to return to the ED for suicidality and sexual health concerns, highlighting the need for increased allocation of research and clinical resources to improve their care.

Socioeconomic inequalities in sexual victimisation in a nationally representative sample of the Swedish population

AIMS

Sexual victimisation is a key public health concern because of its physical, psychological and social consequences. Nationally representative studies exploring sexual victimisation and re-victimisation are still scarce. The aim of the current study was to explore associations of sexual victimisation with sociodemographic factors including sexual orientation in Sweden.

METHODS

We used Swedish data from a national population survey linked to nationwide registers. The sample consisted of 3349 individuals aged 30-44 years, (2021 women and 1328 men). With a latent class analysis we identified groups of individuals with distinctly different experiences of sexual victimisation. Multinomial logistic regression was used to explore how common characteristics could explain latent class membership classes.

RESULTS

Experiences of sexual victimisation were common: 48% of women and 13% of men had experienced sexual harassment, 47% of women and 12% of women sexual assault, 11% of women and 1% of men attempted intercourse and 8% of women and 1% of men rape. Among women four groups were identified who had distinctly different experiences of exposure to sexual victimisation such as low victimisation, sexually harassed and assaulted several times, highly sexually victimised with low re-victimisation and finally high victimisation. Both women and men who were highly sexually victimised had to a higher extent a non-heterosexual sexual identity.

CONCLUSIONS

Non-heterosexual orientation is a robust indicator of a high level of sexual victimisation as well as re-victimisation among both male and female adults.

Do Sexual Minorities Face Greater Risk for Sexual Harassment, Ever and at School, in Adolescence? : Findings From a 2019 Cross-Sectional Study of U.S. Adults

Bullying of sexual minorities in the United States is common and often begins in middle and high school, yet research that examines sexual harassment of sexual minorities is limited. This study examines whether sexual minorities are more likely than straight people to (a) report sexual harassment and (b) report sexual harassment as adolescents at middle or high school. We analyzed survey data from a cross-sectional study of sexual harassment and assault, conducted with nationally representative samples of adults in 2019 (N = 2,205). Sexual harassment was categorized as non-physically aggressive sexual harassment only (NPSH; e.g., verbal or cyber harassment), physically aggressive sexual harassment (PSH; e.g., stalking, rubbing up against you; with or without NPSH), sexual assault (SA; i.e., forced sex; with or without NPSH or PSH), or no sexual harassment (none). In total, 6% of female and male respondents identified as a sexual minority. A history of sexual harassment or assault was reported by 95.0% of sexual minority women and 80.3% of straight women (p = .001), and by 77.3% of sexual minority men and 41.3% of straight men (p = .001). Multivariable multinomial models demonstrate that sexual minorities were more likely than straight individuals to report NPSH (Adjusted Odds Ratio [AOR] = 2.88, 95% [Confidence Interval] CI = [1.33, 6.20]), PSH (AOR = 4.15, 95% CI: [1.77, 9.77]), and SA (AOR = 5.48, 95% CI = [2.56, 11.73]; reference group: no harassment), as well as to report PSH (AOR = 2.67, 95% CI = [1.30, 5.47]) at school in middle or high school. These abuses demonstrate increased risk for sexual harassment among sexual minorities, including increased risk for physically aggressive sexual harassment when in middle and high school.

Does Question Format Matter in Assessing the Prevalence of Sexual Aggression? A Methodological Study

As research on sexual aggression has been growing, methodological issues in assessing prevalence rates have received increased attention. Building on work by Abbey and colleagues about effects of question format, participants in this study (1,253; 621 female; 632 male) were randomly assigned to one of two versions of the Sexual Aggression and Victimization Scale (SAV-S). In Version 1, the coercive tactic (use/threat of physical force, exploitation of the inability to resist, verbal pressure) was presented first, and sexual acts (sexual touch, attempted and completed sexual intercourse, other sexual acts) were presented as subsequent questions. In Version 2, sexual acts were presented first, and coercive tactics as subsequent questions. No version effects emerged for overall perpetration rates reported by men and women. The overall victimization rate across all items was significantly higher in the tactic-first than in the sexual-act-first conditions for women, but not for men. Classifying participants by their most severe experience of sexual victimization showed that fewer women were in the nonvictim category and more men were in the nonconsensual sexual contact category when the coercive tactic was presented first. Sexual experience background did not moderate the findings. The implications for the measurement of self-reported sexual aggression victimization and perpetration are discussed.

The Assessment of Forced Penetration: A Necessary and Further Step Toward Understanding Men's Sexual Victimization and Women's Perpetration

A unique form of sexual victimization that often goes undiscussed and, therefore, underassessed is that of being forced to penetrate another person (i.e., forced penetration). Due to forced penetration being a relatively novel addition to the definition of rape, there is a lack of assessment tools that identify forced penetration cases. Thus, the goal of this study was to assess the utility and validity of new items designed to assess forced penetration. More than 1,000 participants were recruited across three different studies to assess forced penetration victimization and perpetration. The rate of forced penetration victimization ranged from 4.51% to 10.62%. Among men who reported victimization of any type, 33.8% to 58.7% of victimized men reported experiencing forced penetration across the samples, suggesting this experience is common. All new and unique cases of sexual victimization identified by the forced penetration items were those of heterosexual men. These findings suggest that assessing for forced penetration would increase the reported prevalence rates of sexual victimization, particularly in heterosexual men (and correspondingly, rates of perpetration in women).