Session
SRH - Sexual Assault and Intimate Partner Violence
APHA 2022 Annual Meeting and Expo
Abstract
Sexual Coercion among Black and Latinx Women at High Risk for HIV
APHA 2022 Annual Meeting and Expo
Sexual coercion is unwanted sexual activity that occurs when a person is pressured, tricked, threatened or forced in a nonphysical way by another person (i.e. partners, friends, bosses, landlords), often who holds power over you. There are multiple forms of sexual coercion including making one feel obligated to have sex in order to maintain their current situation. Some women feel obligated to engage in survival sex which is having sex for money to afford bills, shelter or provide for their children. This obligation may lead to increased forced risky sexual behavior which research suggests increases their likelihood of HIV/sexual transmitted diseases (STD) acquisition. Research also indicates that experiencing sexual coercion, particularly if it leads to sexual activity, can impact a women’s mental and physical health. The current study conducted a qualitative review of two larger studies that explored pre-exposure prophylaxis awareness, interest, and adoption among women at high risk for HIV. Study 1 included 30 cisgender Black/African American women (M age = 32.2) who were interviewed at baseline, one, three and six months using audio-recorded, in-depth semi-structured interviews. Study 2 included 18 cisgender Black/African American women (M age = 31.3) who were interviewed three times across a 3 month-span using in-depth, semi-structured interviews. All interviews from both Study 1 and Study 2 were coded and analyzed in NVivo. Data was analyzed using descriptive thematic analysis. All authors reanalyzed data to explore sexual coercion and systematically analyzed interview line by line to identify primary themes. Analyses demonstrated that a majority of participants reported sexual coercion by a partner. Participants who reported sexual coercion were more likely to report serious physical, psychological and sexual IPV, substance misuse and low HIV/STD risk perception. Future work should focus on increasing social support and structural interventions (i.e. accessible housing) in order to reduce perceptions of sexual obligations and experiences of sexual coercion.
Abstract
Attitudes towards intimate partner violence education among Baltimore City high school students
APHA 2022 Annual Meeting and Expo
Introduction: Early education and intervention in intimate partner violence (IPV) during high school has been identified as a prevention tactic in adolescents and young adults (AYA). People experiencing IPV at any point in their lifetime have been shown to have immediate and lifelong adverse psychosocial health outcomes. However, there are few statistics on rates and quality of IPV education provided to AYAs in the US, and limited research on AYA preferences for IPV education. Our objective was to understand access, attitudes, and barriers towards IPV education for AYAs in Baltimore City.
Methods: Four focus group discussions (FGD, 60 minutes) were conducted with 4-6 youth each from 5 high schools in Baltimore City. The FGD utilized a conceptual framework to understand access, attitudes, and barriers towards IPV education. Notes from the focus group were transcribed and thematic analysis was conducted in NVivo. Memos were written to further synthesize themes and to identify representative quotes.
Results: Participants (mean age 16 years, SD 1.1 years, ranging in age 14-19) were 16 female and 2 non-binary, and self-identified as 67% Black/African-American, 22% Asian-American, and 11% White and Hispanic/Latino. Lack of IPV education, especially on which resources to use to address IPV, emerged as a pertinent finding, with many participants stating that they did not have a health education class and had never learned about concepts such as consent and assault in a school setting. AYAs identified interpersonal (e.g., nonchalant peer attitudes), institutional (e.g., no IPV curriculum), and societal barriers (e.g., stigma against discussing IPV) to IPV education. Participants also supported discussion of IPV in both schools and healthcare settings, citing peer education and access to follow-up resources as facilitators respectively.
Conclusion: AYAs have identified a need for high school IPV education that addresses various levels of barriers to IPV education. Understanding limitations to IPV education from the AYA perspective can help improve IPV education as a preventative measure for IPV in adolescence.
Abstract
Communication self-efficacy with male partners and health outcomes among young African American women
APHA 2022 Annual Meeting and Expo
Background: Women’s low communication self-efficacy with sex partners may be associated with poor physical and mental health outcomes. The study assesses the association between low self-efficacy for communicating with sex partners and physical and mental health.
Methods: This study comprised 560 African American women, 18-24 years, recruited from community settings in Atlanta, Georgia. Communication self-efficacy is assessed by a 6-item scale; scores range from 6 to 28. Scale scores were dichotomized such that scores ≥19 reflect high communication self-efficacy, and scores <19 low communication self-efficacy. Multivariable logistic regression models were used to calculate the adjusted odds ratios (AORs) and 95% confidence intervals (95% CI).
Results: Relative to women with high communication self-efficacy, controlling for age, education, and employment, women with low communication self-efficacy were more likely to have problematic alcohol (AOR=2.22; 95% CI=1.51, 3.26; p<0.001) and marijuana use (AOR=1.54; 95% CI=1.03, 2.29; p<0.05). With respect to sexual health behaviors and outcomes, women with lower self-efficacy of communication scores were more likely to report multiple sex partners (AOR=1.55; 95% CI=1.10, 2.18; p<0.05), to have lower intentions to use condoms (AOR=1.86; 95% CI=1.31, 2.64; p<0.001), to perceive greater barriers to using condoms (AOR=2.87; 95% CI=2.01, 4.09; p<0.001), to report less frequent communication with a partner about sex (AOR=2.14; 95% CI=1.51, 3.03; p<0.001), to report lower self-efficacy for refusing sex (AOR=3.82; 95% CI=2.67, 5.46; p<0.001), and more likely to report less relationship control (AOR=3.66; 95% CI=2.56, 5.23; p<0.001). In terms of mental health, women with lower communication self-efficacy scores were more likely to report greater depressive symptomatology (AOR=1.72; 95% CI=1.17, 2.54; p<0.01), to report high overall stress (AOR=2.00; 95% CI=1.42, 2.82; p<0.001), to have poorer coping skills (AOR=1.85; 95% CI=1.31, 2.62; p<0.001), and more likely to have poor emotional regulation (AOR=1.80; 95% CI=1.27, 2.56; p<0.01).
Conclusions: Findings suggest low communication self-efficacy may be associated with diverse sexual health and substance use behaviors. Assessing communication self-efficacy and intervening to enhance women’s communication self-efficacy through role play and other behavior change strategies may be valuable.
Abstract
Do current efforts at rape prevention reach straight men? Findings from a college survey on rape and consent
APHA 2022 Annual Meeting and Expo
Sexual minority and female college students are at higher risk for being sexually assaulted than heterosexual males, while the latter make up the majority of offenders. As part of a campus-wide study investigating sexual assault climate and student experiences at a large state university, respondents (n=1335) were asked about their definitions of consent and rape. Using a previously published Rape Beliefs Scale, factor analysis yielded four sub-scales. Heterosexual men differed from women and sexual minority students on three of the four sub-scales (P< 0.001). Specifically, they were more likely to believe that women report rape after regretting having sex, that women can bear responsibility for their own rape, and that rape is often the result of men’s overpowering sex drive. In addition, on a validated Consent Scale, heterosexual men interpreted a wider range of sexual situations as consensual than either women or sexual minority students (P<0.01). The data suggest that current efforts at sexual assault prevention may not be reaching those most likely to be perpetrators, namely heterosexual men, and specifically, that they are not having an impact on straight men’s well-subscribed rape myths. These findings are consistent with prior research stressing the need for more comprehensive sexual assault prevention including consent education as a critical part of K-12 curricula for all young people and for interventions specially designed to reach those who are most likely to commit sexual assault, rather than its potential victims. Implications for K-12, college campuses and beyond will be discussed.
Abstract
Implications for Sexual Assaults and Ride-sharing
APHA 2022 Annual Meeting and Expo
Background: Sexual assault rates are increasing with ride-shares. Sexual violence data is often underestimated due to sexual violence cases going unreported. Sexual violence can lead to negative health issues for the victim. There is no research on the phenomenon of sexual assaults among ride-share users. This study looks at data of sexual assaults from two predominate ride-share companies and the policies/procedures in place to prevent sexual assaults.
Methods: The data from two ride-share companies’ previous Safety Reports were compared to see if there is an increase of sexual assaults. These companies categorize sexual assaults into five categories and record the number of incidence reports in each category. Also, the researchers looked at the policies and regulations that these ride-share companies have in place to prevent sexual assault.
Results: Almost all five categories show an increase in sexual assaults with an alarming increase in non-consensual touching of a sexual body part for users. The data suggests that most sexual assaults identify the driver as the aggressor. Both ride-shares have similarities in procedures and policies to prevent sexual assaults, but there are procedures that endanger the rider.
Conclusion: This study reveals that there is an increase in sexual assaults among the five categories in both ride-share companies. Procedures and policies that are in place, at both ride-share companies, could potentially endanger riders. Ride-share companies have the responsibility to remove barriers that prevent riders from seeking emergency services. The researchers discuss the implementation of policies and procedures to prevent sexual assaults in ride-shares.