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This is a qualitative investigation into women’s awareness of sexual violence during emerging adulthood. Sexual violence refers to any sexual act that is experienced as a threat or violation and takes away an individual’s ability to control intimate contact (Adams, 2005). Current estimates suggest that one in six adult women in the United States has been the victim of rape or attempted rape in her life (Department of Justice, 2015). Women in emerging adulthood (18-28 years old) are three to four times more likely than all women to experience sexual assault, and sexual violence is more prevalent than other crimes on college campuses (Cantor, Fisher, Chinball, Townsend, Lee, 2015). Given the ubiquity of sexual violence, some researchers (e.g., Brison, 2002; Adams, 2005) have argued that the threat of sexual violence harms women. There is a growing body of literature, essays, documentaries, and news reports documenting college women’s experiences of sexual assault. However, the dearth of empirical psychological literature on the impact of women’s knowledge of the possibility of sexual violence impacts them has implications for practitioners and researchers working with women affected by sexual violence. Therefore, a phenomenological approach using semi-structured individual interviews was used in this qualitative investigation of how women in emerging adulthood are aware of the possibility of sexual violence. The study was guided by the following questions 1. How do women in emerging adulthood encounter sexual violence in their lives? 2. How are women in emerging adulthood taught to think about, prepare for, and deal with unwanted sexual encounters? 3. What social forces perpetuate rape culture? Six women in emerging adulthood and enrolled in university courses were interviewed for this study. During the interview process, participants described how they learned about sexual violence, how they think about it in the present day, how their awareness impacts their movement in the world, and how sexual violence impacts their relationships with others. The content of the interviews was analyzed using Interpretive Phenomenological Analysis (IPA) as described by Smith, Flowers, and Larkin (2009). Results from the data analysis yielded four superordinate themes: (a) Lack of dialogue about sexual violence, (b) Living with the possibility of sexual assault, (c) Discrepant understandings of sexual violence, and (d) Sexual assault and interpersonal relationships. These themes reflect an awareness of sexual violence that is informed by dominant representations of what sexual assault looks like. Participants’ narratives reflect the struggle of trying to understand their own experiences of sexual violation in a culture that represents narrow depictions of what counts as sexual violence. The participants also expressed hope and optimism for change in the future.

ABSTRACT Introduction The health system is struggling with the implementation of a comprehensive and systematic approach to post rape management and HIV prevention, Post Exposure Prophylaxis (PEP). The main aim of this study was to evaluate the impact of an intervention programme implemented at a rural hospital. Methods The study was conducted in Acornhoek from March 2004 - August 2006. A five-part intervention was introduced, that included centralisation and coordination of post rape care; implementing a hospital rape management policy; a 2 day training workshop for HCW; engaging a broader group of stakeholders and raising community awareness. Three hundred and sixty five of 409 rape survivor patient records were reviewed to assess changes in quality of care of (Voluntary Counselling and Testing) VCT, Post Exposure Prophylaxis (PEP) and Emergency Contraception (EC). One hundred and fifteen clients were followed up to assess clients perceptions of quality of care and their adherence to PEP treatment. Key informant interviews were conducted with 19 service providers to assess whether the intervention had any impact on VCT, PEP and EC services. Results There were improvements in HCW knowledge: when to prescribe EC (22.7% vs. 79.0% OR 12.4 CI 2.5- 60.7); correct prescription of EC (10.3% vs. 61.9%; OR 12.5 CI 2.7-55.8 P<0.001) and use of anti-emetics (17.2% vs. 36.9% P<0.001). VCT services were provided more consistently at the first visit during Phase 2 compared to the Phase 1 (44.1% vs. 59.6% P<0.001). In the Post-Intervention phase 28 day PEP was introduced, thus minimising return visits. Conclusions Improvements in knowledge of the use of EC were greater than improvements in knowledge about the correct use of PEP. There are systematic obstacles to providing VCT and PEP which are difficult to address. One of the repeatedly cited obstacles was the shortage of trained VCT providers. The improvement of sexual assault services hinges on demonstrable commitment from senior management officials to providing good quality post rape care.

Sexual assault has increasingly become a large problem on college and university campuses in the United States. Not only is the frequency of the occurrences problematic, but the lack of reporting, the mishandling of cases, and efforts to stop campus sexual assaults have also garnered a large amount of attention. While many research studies have focused on the effectiveness of educational programs aimed to increase awareness, reporting, and prevention of sexual assault among college students, not many studies have examined if students’ abilities to identify sexual assaults in contextual situations and their attitudes regarding sexual assault are affected by these programs. The purpose of this study was to investigate if students entered college with attitudes that are supportive of sexual assault, the ability of first-semester college freshman to identify sexual assault within contexts, students’ decision to report a perceived sexual assault, the likelihood that students would intervene as a bystander, and demographics related to student attitudes toward, identification of, and decisions to report sexual assaults. Participants in this study were 551 freshmen in their first-semester at Temple University, who were 18 or 19 years of age. Participants completed a survey which consisted of demographic questions, 11 original vignettes depicting potential sexual assault scenarios, the updated Illinois Rape Myth Acceptance (IRMA) scale, and the Type T personality questionnaire. Results revealed that about one-third of students surveyed did not completely disagree with sexual assault-supportive statements on the updated IRMA scale, with the He Didn’t Mean To and She Lied attitudes being the most popularly endorsed. Students who endorsed sexual assault-supportive attitudes were significantly more likely to misidentify an instance of sexual assault and to not report a perceived sexual assault in some scenarios. In regards to demographics, males were more likely than females to endorse sexual assault-supportive attitudes, to misidentify sexual assaults, to not report a perceived sexual assault in some scenarios, and they were less likely than females to intervene as a bystander in a sexual assault scenario. Sexuality and ethnic identification had some effect on attitudes endorsed and ethnic identity had an effect on the decision to report a sexual assault in two specific scenarios. In addition, the type of high school students attended and the types of sexual education topics they were educated on prior to college were significantly linked to attitudes endorsed, and the type of high school students attended was significantly linked to identifying instances of sexual assault. The growing issue of campus sexual assault is represented by the amount of students in this study who cannot correctly identify sexual assault situations, by the attitudes that contribute to the occurrences of sexual assault, and by the reasons why students feel sexual assault scenarios should not be reported. The significant relationship between endorsing attitudes and incorrectly identifying sexual assaults, as well as the decision to not report perceived sexual assaults, supports the potentially harmful effects having an attitude that essentially supports sexual assault can have in society. Prevention efforts need to address the root of a problem, which in this case is a culture where sexual assault, largely against women, is excused, dismissed, and subsequently deemed acceptable. Thus, adolescents should be educated and provided with appropriate messaging on topics related to sexual assault well before they enter college. / School Psychology

Sexual Assault Nurse Examiners (SANE) are nurses that provide forensic examination and crisis intervention to victims of sexual assault. The training required to receive SANE certification ensures that SANE nurses are 1educated to provide thorough examinations and compassionate care to sexual assault victims. A SANE often works on a Sexual Assault Response/Resource Team (SART) which combines the efforts of law enforcement, detectives, victim advocates, and healthcare providers to provide a rapid response to the sexual assault victim. Proper evidence collection and a maintained chain of custody provide support for the conviction and if the evidence is obtained inaccurately the examination may be inadmissible in court. Even though SANEs can provide quality nursing care, many facilities lack trained SANEs to perform sexual assault examinations. Accurate data is crucial to support the need for facilities to implement a SANE program. This review and synthesis of literature examines the quality of forensic examinations performed by SANEs, conviction rates, and psychological well being of victims examined by SANEs. Research studies examined in this review suggest that SANE examinations are more complete and contribute to higher conviction rates then examinations performed by non-SANEs, however a combined SANE and SART intervention results in the highest level of victim participation. The research also suggests that the psychological well being of victims is improved with SANE intervention, however more evidence is needed

Despite the vast body of research on outcomes of sexual violence victimization, little is known about the psychological outcomes of sexual violence perpetration. This omission is significant, due to the fact that preventing recidivism may depend on treatment of identified perpetrators. The purpose of the current thesis is to examine the psychological responses to perpetrating sexual violence with a qualitative analysis of first-hand accounts of sexual violence perpetration, obtained from anonymous posts on Reddit.com. The analysis revealed four primary emotional outcomes to perpetrating sexual violence: shame, remorse, depression, and anger. The four themes appeared independently and were associated with different contextual themes. Remorse, unlike the other themes, co-occurred with reports of self-growth, indicating that remorse may be a more adaptive outcome. The results also indicated that the social context played an important role in perpetrator outcomes. These findings have important clinical implications for the treatment of perpetrators.

Thesis advisor: Ann W. Burgess / Background: There is an opportunity for nurses to integrate HPV education and prevention strategies into the routine care for adolescent and young adult sexual assault patients. Study design: An exploratory, cross-sectional, electronic mail survey was conducted to explore forensic nurses' knowledge, beliefs, and attitudes about HPV, the HPV vaccine, and HPV preventative strategies, as well as identify facilitators and barriers that may influence nurses' level of support regarding incorporating HPV preventative strategies into their care. Eligibility criteria for inclusion were: nurse members of the International Association of Forensic Nurses (IAFN) and stakeholders in the care of sexual assault patients. Results: 541 nurses completed the survey; 98% (n= 508) were supportive of at least providing written educational information regarding HPV and the HPV vaccine during post sexual assault care, 86% (n= 446) were supportive of providing written information plus making changes to the written discharge instructions to incorporate HPV vaccination recommendations, and 53% (n= 273) were supportive of providing written information, making changes to the discharge instructions, and initiation of HPV vaccination at point of care. The strongest predictor of level of support was having positive perceived benefits of HPV and vaccination. A one standard deviation increase in perceived benefit was associated with a 50% increased odds of having the highest level of support (support for vaccination initiation) (OR=1.5, CI= 1.1-1.9). Conclusions: Forensic nurses provide care for many adolescents and young adults who are at risk for acquiring HPV and are within the age range for HPV vaccination. There is an opportunity to update current practice guidelines and recommendations. Nurses in this national sample demonstrated a high level of HPV knowledge, as well as positive attitudes and beliefs. The nurses were overwhelmingly supportive of integrating HPV prevention strategies into their care. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

The current study investigated a model explaining sexual assault victims’ severity of trauma symptoms that incorporated multiple stigma constructs. Integrating the sexual assault literature with the stigma literature, this study sought to better understand trauma-related outcomes of sexual assault by examining three levels of stigma—cultural, social, and self. Results showed self-stigma was significantly and positively related to trauma symptom severity. Thus, results revealed that the internalized aspect of stigma served as a mechanism in the relation between sexual assault severity and increased levels of trauma symptom severity, highlighting the importance of assessing self-stigma in women reporting sexual assault experiences.

The purpose of this thesis was to explore whether the gender of a sexual assault survivor influenced to whom they disclosed the sexual assault. Previous research indicates that barriers to disclosure could differ based both on the gender of a sexual assault survivor and characteristics of the disclosure recipient. Examining how disclosure is influenced by survivor gender could help better identify which groups could benefit most from educational resources. Participants (n = 160) were college students who experienced a sexual assault in adolescence or adulthood. Disclosure to a range of different formal and informal supports was assessed. Findings indicated that male survivors were significantly less likely to disclose to female friends than female survivors. Both male and female survivors reported low rates of disclosure to formal support providers (such police, therapists, medical professionals). These findings suggest that both men and women who experience sexual assault are unlikely to report the incident to police and campus offices, and they are unlikely to disclose the incident to medical and mental health providers. Therefore, it is important that barriers to disclosure to formal support providers be examined in future research.