Factors associated with being a victim of sexual violence

One of the most common forms of sexual violence around the world is that which is perpetrated by an intimate partner, leading to the conclusion that one of the most important risk factors for people in terms of their vulnerability to sexual assault is being married or cohabiting with a partner. Other factors influencing the risk of sexual violence include:
*being young;
*consuming alcohol or drugs;
*having previously been raped or sexually abused;
*having many sexual partners;
*involvement in sex work;
*becoming more educated and economically empowered, at least where sexual violence perpetrated by an intimate partner is concerned;
*poverty.

Age

Young women are usually found to be more at risk of rape than older women. [Acierno R et al. Risk factors for rape, physicalassault, and post-traumatic stress disorder in women: examination of differential multivariate relationships. Journal of Anxiety Disorders, 1999, 13:541–563.] [Greenfeld LA. Sex offenses and offenders: an analysis of data on rape and sexual assault .Washington, DC, United States Department of Justice, Office of Justice Programs, Bureau of Justice Statistics (NCJ 163392).] [Heise L, Pitanguy J, Germain A. Violence against women: the hidden health burden. Washington, DC, World Bank, 1994 (Discussion Paper No. 255).] According to data from justice systems and rape crisis centres in Chile, Malaysia, Mexico, PapuaNew Guinea, Peru and the United States, between one-third and two-thirds of all victims of sexual assault are aged 15 years or less. [Heise L, Pitanguy J, Germain A. Violence against women: the hidden health burden. Washington, DC, World Bank, 1994 (Discussion Paper No. 255).] [Greenfeld LA. Sex offenses and offenders: an analysis of data on rape and sexual assault . Washington, DC, United States Department of Justice, Office of Justice Programs, Bureau of Justice Statistics (NCJ 163392).] Certain forms of sexual violence, for instance, are very closely associated with a young age, in particular violence taking place in schools and colleges, and trafficking in women for sexual exploitation.

Alcohol and drug consumption

Increased vulnerability to sexual violence also stems from the use of alcohol and other drugs. Consuming alcohol or drugs makes it more difficult for people to protect themselves by interpreting and effectively acting on warning signs. Drinking alcohol may also place women in settings where their chances of encountering a potential offender are greater. [Crowell NA, Burgess AW, eds. Understanding violence against women. Washington, DC, National Academy Press, 1996.]

Having previously been raped or sexually abused

There is some evidence linking experiences of sexual abuse in childhood or adolescence with patterns of victimization during adulthood. [Acierno R et al. Risk factors for rape, physical assault, and post-traumatic stress disorder inwomen: examination of differential multivariate relationships. Journal of Anxiety Disorders, 1999, 13:541–563.] [Tjaden P, Thoennes N. Full report of the prevalence, incidence and consequences of violence against women: findings from the National Violence Against Women Survey. Washington, DC, National Institute of Justice, Office of Justice Programs, United States Department of Justice and Centers for Disease Control and Prevention, 2000 (NCJ 183781).] [Crowell NA, Burgess AW, eds. Understanding violence against women. Washington, DC, National Academy Press, 1996.] [Fleming J et al. The long-term impact of childhood sexual abuse in Australian women. Child Abuse & Neglect, 1999, 23:145–159.] A national study of violence against women in the United States found that women who were raped before the age of 18 years were twice as likely to be raped as adults, compared with those who were not raped as children or adolescents (18.3% and 8.7%, respectively). [Tjaden P, Thoennes N. Full report of the prevalence, incidence and consequences of violence against women: findings from the National Violence Against Women Survey. Washington, DC, National Institute of Justice, Office of Justice Programs, United States Department of Justice and Centers for Disease Controland Prevention, 2000 (NCJ 183781).]

The effects of early sexual abuse may also extend to other forms of victimization and problems in adulthood. For instance, a case control study in Australia on the long-term impact of abuse reported significant associations between child sexual abuse andexperiencing rape, sexual and mental health problems, domestic violence and other problems in intimate relationships even after accounting for various family background characteristics. [Fleming J et al. The long-term impact of childhood sexual abuse in Australian women. Child Abuse & Neglect, 1999, 23:145–159.] Those who had experienced abuse involving intercourse had more negative outcomes than those suffering other types of coercion.

Having many sexual partners

Young women who have many sexual partners are at increased risk of sexual violence. [Fergusson DM, Horwood LJ, Lynskey MT. Childhood sexual abuse, adolescent sexual behaviours and sexual revictimization. Child Abuse & Neglect, 1997, 1:789–803.] [Pederson W, Skrondal A. Alcohol and sexual victimization: a longitudinal study of Norwegian girls. Addiction, 1996, 91:565–581.] [Crowell NA, Burgess AW, eds. Understanding violence against women. Washington, DC, National Academy Press, 1996.] It is not clear, though, if having more sexual partners is a cause or consequence of abuse, including childhood sexual abuse. For example, findings from a representative sample of men and women in León, Nicaragua, found that womenwho had experienced attempted or completed rape during childhood or adolescence were more likely to have a higher number of sexual partners in adulthood, compared with non-abused or moderately abused women. [Olsson A et al. Sexual abuse during childhood andadolescence among Nicaraguan men and women: a population-based survey. Child Abuse & Neglect,2000, 24:1579–1589.] Similar findings have been reported in longitudinal studies of young women in New Zealand and Norway. [Fergusson DM, Horwood LJ, Lynskey MT. Childhood sexual abuse, adolescent sexual behaviours and sexual revictimization. Child Abuse & Neglect, 1997, 1:789–803.] [Pederson W, Skrondal A. Alcohol and sexual victimization: a longitudinal study of Norwegian girls. Addiction, 1996, 91:565–581.]

Educational level

Women are at increased risk of sexual violence, as they are of physical violence by an intimate partner, when they become more educated and thus more empowered. Women with no education were found in a national survey in South Africa to be much less likely to experience sexual violence than those with higher levels of education. [Jewkes R, Abrahams N. The epidemiology of rapeand sexual coercion in South Africa: an overview. Social Science and Medicine (in press).] In Zimbabwe,women who were working were much more likely to report forced sex by a spouse than those who were not. [Watts C et al. Withholding sex and forced sex: dimensions of violence against Zimbabwean women. Reproductive Health Matters, 1998, 6:57–65.] The likely explanation is that greater empowerment brings with it more resistance from women to patriarchal norms [Jewkes R, Penn-Kekana L, Levin J. Risk factors for domestic violence: findings from a South African cross-sectional study. Social Science and Medicine (in press).] , so that men may resort to violence in an attempt to regain control. The relationship between empowerment and physical violence is an inverted U-shape with greater empowerment conferring greater risk up to a certain level, beyond which it starts to become protective. [Crowell NA, Burgess AW, eds. Understanding violence against women. Washington, DC, National Academy Press, 1996.] [Jewkes R. Intimate partner violence: causes and prevention. Lancet, 2002, 359:1423–1429.] It is not known, though, whether this is also the case for sexual violence.

Poverty

Poor women and girls may be more at risk of rape in the course of their daily tasks than those who are better off, for example when they walk home on their own from work late at night, or work in the fields or collect firewood alone. Children of poor women may have less parental supervision when not in school, since their mothers may be at work and unable to afford child care. The childrenthemselves may, in fact, be working and thus vulnerable to sexual exploitation. Poverty forces many women and girls intooccupations that carry a relatively high risk of sexual violence [Omorodion FI, Olusanya O. The social context of reported rape in Benin City, Nigeria. African Journal of Reproductive Health, 1998, 2:37–43.] , particularly sex work [Faune MA. Centroamerica: los costos de la guerra y la paz. [Central America: the costs of war and of peace.] Perspectivas, 1997, 8:14–15.] . It also creates enormous pressures for them to find or maintain jobs, to pursue trading activities and, if studying, to obtain good grades all of which render them vulnerable to sexual coercion from those who can promise these things [Omaar R, de Waal A. Crimes without punishment: sexual harassment and violence against female students in schools and universities in Africa. African Rights, July 1994 (Discussion Paper No. 4).] . Poorer women are also more at risk of intimate partner violence, of which sexual violence is often a manifestation. [Martin SL et al. Sexual behaviour and reproductive health outcomes: associations with wife abuse inIndia. Journal of the American Medical Association, 1999, 282:1967–1972.] [International Clinical Epidemiologists Network.Domestic violence in India: a summary report of a multi-site household survey. Washington, DC, International Center for Research on Women, 2000.]

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