More research needed, but what next?

More research is needed to create evidence-based policies, programs, and provider practices to prevent and address the widespread problem of nonconsensual sex. Issues that require attention include:

* Gaps in the research.

Limited geographical settings. Programmatic research and studies of interventions from the developed world tend to have been conducted in the United States, while the most extensive research from the developing world comes from Africa and India. Results from these locations may not apply to other countries or cultural settings. (1)

Underreporting. Nonconsensual sex--particularly childhood sexual abuse and male rape--is probably greatly underreported. (2)

Limited attention to certain groups. Experiences of nonconsensual sex have been studied more among girls than boys and more among single women than married women.

Limited understanding of context. The typical sequence of events leading to nonconsensual sex, cultural norms influencing it, motives for it, and how it is perceived and justified require more study. (3)

* Flawed or inconsistent study methodologies that make comparisons difficult. Definitions, measurement tools, study designs, and study populations vary widely. (4) Also, studies tend to focus on people who access health services or are otherwise easy to recruit, such as university students; thus, findings may not be generalizable. (5)

* Lack of clarity about the relationship between nonconsensual sex and adverse health consequences. Studies on this topic are observational in design and thus limited to establishing associations between sexual coercion and adverse health outcomes. They cannot determine cause-effect relationships.

* Few evaluations of interventions and their effectiveness. Available data and expert opinion suggest that promising interventions share several key characteristics, but few efforts to prevent nonconsensual sex have been rigorously evaluated.

Web Resource

http://www.who.int/svri/en

The Sexual Violence Research Initiative, supported by the Global Forum for Health Research (GFHR) and the World Health Organization (WHO), seeks to promote and disseminate research and build research capacity to reduce and respond to sexual violence in developing countries.

References

(1) Bennett LR, Manderson L, Astbury J. Mapping a Global Pandemic: Review of Current Literature on Rape, Sexual Assault and Sexual Harrassment of Women Consultation on Sexual Violence Against Women. Geneva, Switzerland: Global Forum for Health Research, 2000.

(2) Krug EG, Dahlberg LL, Mercy JA, et al., eds. World Report on Violence and Health. Geneva, Switzerland: World Health Organization, 2002.

(3) Jejeebhoy S, Bott S. Non-consensual Sexual Experiences of Young People: A Review of Evidence from Developing Countries. New Delhi, India: Population Council, 2003.

(4) Population Council. The Adverse Health and Social Outcomes of Sexual Coercion: Experiences of Young Women in Developing Countries [working paper]. New Delhi, India: Population Council, 2004.

(5) Bennett.