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War-related sexual violence in Sierra Leone

Lynn L Amowitz, MD, MSPH, MSc1, Chen Reis, JD MPH2, Kristina Hare Lyons, MALDF2, Beth Vann, MSW2, Binta Mansaray, MA3, Adeyinka M Akinsulure-Smith, PhD4, Louise Taylor, MBA, LLM3, and Vincent Iacopino, MD2. (1) Senior Medical Researcher and Director, Initiative in Global Women's Health, Physicians for Human Rights, Harvard Medical School, 100 Boylston St, Suite 702, Boston, MA 02116, (2) Physicians for Human Rights, 100 Boylston St, Suite 702, Boston, MA 02116, 617 695 0041 x208, creis@phrusa.org, (3) UNAMSIL, UNAMSIL HQ, Freetown, Sierra Leone, (4) Physicians for Human Rights / Bellview NYU, 100 Boylston St, Boston, MA 02116

Context: All parties to Sierra Leone's decade-long conflict committed abuses including sexual violence. Objective: To assess the prevalence and impact of war-related sexual violence and other human rights abuses among internally displaced persons in Sierra Leone. Design and Setting: A cross-sectional, randomized survey, using structured interviews and questionnaires, of internally displaced Sierra Leonean women living in 3 IDP camps and 1 town, conducted over a 4-week period in 2001. Participants: 991 women provided information on 9,166 household members. Results: 9% of respondents reported war-related sexual assaults. The lifetime prevalence of non–war-related sexual assault among these respondents was also 9%, which increased to 17% with the addition of war-related sexual assaults. More than 60% of respondents believed a man has a right to beat his wife if she disobeys, and that it is a wife's duty/obligation to have sex with her husband even if she does not want to. 34% of respondents reporting war related sexual violence self-reported an STD as a consequence. Conclusions: Sexual violence committed by combatants in Sierra Leone was widespread. Prevailing social norms also limit women’s ability to control the terms of sexual interactions and place them at increased risk for HIV infection. In post-conflict settings, survivors of sexual violence should be acknowledged as a group at high risk for HIV infection that is not likely to self-identify. Whenever possible, generalizable assessments of war-related sexual violence prevalence should be conducted to inform prevention care and support program planning and priorities.

Learning Objectives:

Keywords: Sexual Assault, War

Related Web page: www.phrusa.org

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

War and Women's Health: Bodies on the Battlefield

The 132nd Annual Meeting (November 6-10, 2004) of APHA