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Sexual Violence Within the Context of Intimate Partner Violence

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Sexual Violence Within the Context of Intimate Partner Violence Sexual Violence within the Context of Intimate Partner Violence April 16, 2010 Portland, Oregon Nancy Glass, PhD, MPH, RN, FAAN Associate Professor Johns Hopkins University School of Nursing PRESENTATIONPRESENTATION (morning)(morning) SexualSexual andand gender-basedgender-based violenviolencece (SGBV)(SGBV) asas aa humanhuman rightsrights violationviolation (global(global perspective),perspective), DefinitionDefinition ofof sexualsexual violenceviolence inin abusiveabusive intimateintimate relationshipsrelationships (including(including same-sexsame-sex relationships),relationships), PrevalencePrevalence ofof sexualsexual violenceviolence inin abusiveabusive intimateintimate relationshipsrelationships –– NationalNational andand OregonOregon specificspecific informationinformation IdentifyingIdentifying riskrisk factorsfactors forfor sexualsexual violenceviolence inin abusiveabusive intimateintimate relationshipsrelationships Health,Health, EconomicEconomic andand SocialSocial ImpactImpact ofof SexualSexual ViolenceViolence onon IPVIPV SurvivorsSurvivors HIV/STIsHIV/STIs ReproductiveReproductive controlcontrol andand coercioncoercion PsychologicalPsychological CulturalCultural considerationsconsiderations PRESENTATIONPRESENTATION (afternoon)(afternoon) AssessmentAssessment forfor sexualsexual violenceviolence inin thethe contextcontext ofof intimateintimate partnerpartner violenceviolence ConsentConsent ConfidentialityConfidentiality AssessmentAssessment questionsquestions andand toolstools Resources/ReferralsResources/Referrals (including(including forensicforensic exam,exam, post-exposurepost-exposure prophylaxis)prophylaxis) UsingUsing assessmentassessment informationinformation toto collaborativelycollaboratively developdevelop aa tailoredtailored action/safetyaction/safety planplan withwith survivorssurvivors andand childrenchildren FramingFraming SexualSexual andand GenderGender BasedBased ViolenceViolence (SGBV)(SGBV) asas aa HumanHuman RightsRights ViolationViolation TheThe UnitedUnited NationsNations UniversalUniversal DeclarationDeclaration ofof HumanHuman RightsRights (UDHR,(UDHR, 1945)1945) declaresdeclares thatthat humanhuman rightsrights applyapply toto allall humanhuman beingsbeings withoutwithout distinctiondistinction ofof gender,gender, althoughalthough itit doesdoes notnot specificallyspecifically addressaddress issuesissues relatedrelated toto womenwomen oror violenceviolence againstagainst women.women. ConventionConvention onon EliminationElimination ofof AllAll FormsForms ofof Discrimination Against Women (CEDAW, 1979). Discrimination Against Women (CEDAW, 1979). CEDAWCEDAW addressesaddresses thethe rightright ofof womenwomen toto bebe freefree fromfrom traffickingtrafficking andand prostitution,prostitution, butbut doesdoes notnot explicitlyexplicitly addressaddress IPV,IPV, sexualsexual abuse,abuse, incest,incest, oror raperape (UN,(UN, 1979).1979). FramingFraming SexualSexual andand GenderGender BasedBased ViolenceViolence (SGBV)(SGBV) asas aa HumanHuman RightsRights ViolationViolation DeclarationDeclaration onon thethe EliminationElimination ofof ViolenceViolence AgainstAgainst WomenWomen (DEVAW,(DEVAW, 1993),1993), ViennaVienna DeclarationDeclaration (UN(UN WorldWorld ConferenceConference onon HumanHuman Rights,Rights, 1993),1993), thethe BeijingBeijing DeclarationDeclaration andand PlatformPlatform forfor ActionAction (UN(UN FourthFourth WorldWorld ConferenceConference onon Women,Women, 1995).1995). AllAll threethree declarationsdeclarations definedefine violenceviolence againstagainst women,women, includingincluding violenceviolence withinwithin thethe family,family, asas aa humanhuman rightsrights issue.issue. Definition Intimate Partner Violence REPEATED PHYSICAL AND/OR SEXUAL ASSAULT WITHIN A CONTEXT OF COERCIVE CONTROL (Campbell & Humphreys, ’93; Humphreys & Campbell ‘04) Conceptualized as a risk factor for many health or social issues rather than a disease or syndrome or diagnosis FramingFraming SexualSexual andand GenderGender BasedBased ViolenceViolence (SGBV)(SGBV) asas aa HumanHuman RightsRights ViolationViolation IntimateIntimate partnerpartner violenceviolence isis clearlyclearly aa violationviolation ofof thethe rightsrights articulatedarticulated inin UDHRUDHR ArticleArticle 33 (the(the rightright toto personalpersonal security)security) and,and, inin moremore severesevere cases,cases, maymay alsoalso violateviolate ArticlesArticles 44 (slavery)(slavery) andand 55 (torture).(torture). OngoingOngoing patternspatterns ofof physicalphysical andand sexualsexual violence,violence, thethe abusiveabusive partnerpartner assumesassumes rightsrights andand privilegesprivileges thatthat belongbelong toto thethe survivorsurvivor andand thus,thus, lowerslowers thethe statusstatus ofof thethe womanwoman toto lessless thanthan thatthat ofof aa humanhuman beingbeing (Young,(Young, 2003).2003). FramingFraming SexualSexual andand GenderGender BasedBased ViolenceViolence (SGBV)(SGBV) asas aa HumanHuman RightsRights ViolationViolation AbusiveAbusive partnerpartner oror ex-partnerex-partner inflictinflict physicalphysical violence,violence, sexualsexual violence,violence, andand emotionalemotional abuse,abuse, butbut alsoalso coercivelycoercively controlscontrols thethe woman’swoman’s environment,environment, includingincluding income,income, housing,housing, accessaccess toto friendsfriends andand families,families, work,work, food,food, children,children, culture,culture, andand sexuality.sexuality. InsufficientInsufficient governmentalgovernmental andand institutionalinstitutional responseresponse fromfrom thethe criminalcriminal justice,justice, healthhealth care,care, andand socialsocial servicesservices systemssystems areare violationsviolations ofof women’swomen’s humanhuman rightsrights andand denydeny survivorssurvivors attemptingattempting toto leaveleave abusiveabusive situationssituations ofof basicbasic needsneeds andand livingliving support.support. Global Perspective: Intimate Partner Violence Globally, the vast majority of women experience violence at the hands of an intimate or ex-intimate partner or someone known to them as compared to men who most often experience violence from strangers. One out of every three women worldwide will be physically and/or sexually violated or psychologically abused during her lifetime by an intimate or ex-intimate partner, with rates reaching 70 percent of women in some countries (WHO Multi- Country Study, 2005). Multi-Country Study on Women’s Health and Domestic Violence WHO Multi-Country Study: 15 sites and 10 countries: Bangladesh, Brazil, Ethiopia, Japan, Peru, Namibia, Samoa, Serbia and Montenegro, Thailand and the United Republic of Tanzania. Methodology: Population-based stratified sampling one urban & one province (rural) site in each country 24,000 women completed in home interviews by skilled interviewers (except Japan & Serbia -survey research firm completed interviews) Results comparable across countries Final Report: http://www.who.int/gender/violence/who_multicou ntry study/en/ Women Lifetime Experience of Physical and/or Sexual Partner Violence Global Prevalence of Forced First Sex GlobalGlobal ForumForum Definition:Definition: SexualSexual ViolenceViolence “any“any sexualsexual act,act, attemptattempt toto obtainobtain aa sexualsexual act,act, unwantedunwanted sexualsexual commentscomments oror advances,advances, oror actsacts toto traffic,traffic, oror otherwiseotherwise directeddirected againstagainst aa person'sperson's sexualitysexuality usingusing coercion,coercion, byby anyany personperson regardlessregardless ofof theirtheir relationshiprelationship toto thethe survivors/victims,survivors/victims, inin anyany setting,setting, includingincluding butbut notnot limitedlimited toto homehome andand work”work” --SexualSexual ViolenceViolence ResearchResearch InitiativeInitiative (www.svri.org)(www.svri.org) ofof thethe GlobalGlobal ForumForum forfor HealthHealth ResearchResearch GlobalGlobal PrevalencePrevalence ofof SexualSexual ViolenceViolence SexualSexual violenceviolence rangesranges fromfrom unwantedunwanted sexualsexual contactcontact toto raperape CulturalCultural ritualsrituals andand practicespractices arrangedarranged marriagesmarriages ofof youngyoung girlsgirls GenitalGenital cuttingcutting ForcedForced prostitution,prostitution, sexualsexual slavery,slavery, survivalsurvival sexsex RapeRape ofof internallyinternally displaceddisplaced persons/refugeespersons/refugees RapeRape asas aa weaponweapon ofof warwar “Marital”“Marital” raperape RapeRape asas aa WeaponWeapon WarWar DestabilizationDestabilization ofof familyfamily andand destructiondestruction ofof communitycommunity DestroyingDestroying adversary’sadversary’s cultureculture AA part part ofof thethe "rules"rules ofof war,”war,” aa rightright ofof thethe victorsvictors HumiliationHumiliation ofof thethe malemale “enemy”“enemy” Retaliation/maintainRetaliation/maintain fearfear amongamong civilianscivilians ImpunityImpunity forfor perpetratorsperpetrators RapeRape ofof virginvirgin providesprovides protectionprotection fromfrom diseases and bullets – can not be killed in war diseases and bullets – can not be killed in war CongoleseCongolese femalefemale leader’sleader’s strategystrategy toto endend raperape andand violenceviolence againstagainst womenwomen byby male/boymale/boy childchild soldierssoldiers Democratic Republic of Congo - Mass Rape, Torture and Slavery - “Done to Destroy Women” Challenges of Forced Sex
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