Non-consensual sex experienced by men who have sex with men: prevalence and association with mental health

Ratner, Pamela A.; Johnson, Joy L.; Shoveller, Jean; Chan, Keith; Martindale, Steve; Schilder, Arn J.; Botnick, Michael R.; Hogg, Robert S.

doi:10.1016/s0738-3991(02)00055-1

Cited by 93 publications

(90 citation statements)

References 20 publications

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“…Other authors have reported high levels of non-consensual sex in the latter group. [3][4][5] The findings of rape as the most commonly reported sexual assault and the majority reporting a single male assailant are consistent with other larger case series. 6 7 Violence has a role with just under half having evidence of non-genital injuries.…”

Section: Discussionsupporting

confidence: 85%

Risk of undiagnosed infection in men attending a sexual assault referral centre

Reeves

Jawad²,

Welch³

2004

Sexually Transmitted Infections

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Objectives: To investigate men undergoing forensic examination at the Haven, a specialist centre for the management of sexual assault in south London. Methods: Forensic notes of 92 men attending the Haven from May 2000 to August 2003 were identified and a detailed review performed. Results: Males ranged in age from 12 to 51 years, with 83% within the range 12-35 years. 78% were white. Of those who were sexually active (n = 82) 30% were heterosexual, 34% were homosexual, and the remainder provided no information regarding sexual orientation. Most clients were referred by the police (n = 79) and attended within 3 days of the alleged assault (n = 73). Many of the victims had increased vulnerability to assault-for example, through alcohol or drug consumption or mental health difficulties. One assailant was reported in 61 cases but two or more assailants in 26. Women were reported as assailants in four cases. The sexual assault was frequently accompanied by other physical assault (n = 45). Use/threat of a weapon was reported in 18 cases. Rape or attempted rape was reported in 59 cases and was the most common assault. Non-genital injuries were documented in 37 men (40%). Anal injuries were seen in 31 (34%). The non-attendance rate at follow up was 41%. Post-exposure prophylaxis (PEP) against HIV was commenced in 31 men (34%). 23 of the 54 men (43%) reporting rape and 14 of the 31 (45%) with anal injuries initiated PEP. Conclusions: The number of men presenting after sexual assault is likely to increase but despite significant risk many do not engage with medical care. This carries an unknown risk of HIV and other STI transmission. 1 The Home Office concedes that these trends are ''unlikely to reflect the real experiences of such crimes.'' Although the true prevalence of sexual assault of men in the wider community is not known, one study in a general practice sample reported a 5% lifetime prevalence with 3% in adulthood.2 The Haven is a sexual assault referral centre (SARC) based within the sexual health directorate of a south London teaching hospital, providing forensic and medical services to victims of sexual assault. The aim of this study was to describe male clients attending the Haven for forensic examination and to investigate their subsequent medical follow up, as this patient population is poorly represented in the medical literature. Forensic examination occurs within 7 days of the assault in order to collect DNA evidence and to document injuries accurately. Clients may be referred by the police or by other medical services; they may also self refer. METHODSThe forensic notes of male clients aged 12 years or more attending the Haven from May 2000 to August 2003 were reviewed, focusing on their demographic characteristics, alleged assault, examination findings, and further management-data are missing where clients were unable to give this information. Where possible, comparisons have been made with unpublished data for women clients, using x 2 as a test of significance. RESULTS ClientsBetween May 2000 and Aug...

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Section: Discussionsupporting

confidence: 85%

Risk of undiagnosed infection in men attending a sexual assault referral centre

Reeves

Jawad²,

Welch³

2004

Sexually Transmitted Infections

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“…Each condition represents another epidemic, with a unique set of risk factors. For example, while sexual abuse is associated with HIV infection [1], it is independently associated with various other mental and psychosocial health conditions [18–20]. Traditional mental and psychosocial health conditions as described by Stall and colleagues [21] included substance abuse, depression, intimate partner violence, and sexual risk behaviors.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Health Conditions and HIV Prevalence and Incidence in a Cohort of Men Who have Sex with Men in Bangkok, Thailand: Evidence of a Syndemic Effect

et al. 2014

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Men who have sex with men (MSM) in Bangkok may experience multiple psychosocial health conditions, such as substance use, suicidality, and a history of sexual abuse. These factors may contribute to HIV vulnerability in a syndemic way. A syndemic is defined as a number of synergistically interacting health conditions producing excess disease in a population. The objective of this study is to examine whether psychosocial health conditions among MSM have a syndemic association with HIV prevalence and HIV incidence. To do this, we evaluated psychosocial health conditions and their associations with unprotected sex, HIV prevalence and HIV incidence in a cohort of Thai MSM (N = 1,292). There was a positive and significant association between the number of psychosocial health conditions and increased levels of unprotected sex and HIV prevalence at study baseline. The number of psychosocial health conditions at baseline was also associated with increased HIV incidence during follow-up (no conditions, HIV incidence = 15.3 %; one to three conditions, 23.7 %; four to five conditions, 33.2 %). The number of psychosocial health conditions was positively associated with HIV risk behavior and HIV prevalence and incidence. Prevention efforts among MSM need to address the existence of multiple psychosocial health conditions and their synergy to effectively decrease the spread of HIV infection.

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“…Over the past two decades, relatively few studies have focused on female to male and same-gender sexual violence compared to male to female sexual violence, limiting our knowledge of these issues (e.g., Davies, 2002;Ratner et al, 2003). Further, despite the importance of theory in moving research forward in the area of sexual violence, most studies have been largely a theoretical (Weis, 2002).…”

mentioning

confidence: 99%

An Examination of the Gender Inclusiveness of Current Theories of Sexual Violence in Adulthood

Turchik

Hebenstreit

Judson

2015

Trauma, Violence, & Abuse

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Although the majority of adulthood sexual violence involves a male perpetrator and a female victim, there is also substantial evidence that members of both genders can be victims and perpetrators of sexual violence. As an alternative to viewing sexual violence within gender-specific terms, we advocate for the use of a gender inclusive conceptualization of sexual aggression that takes into account the factors that contribute to sexual victimization of, and victimization by, both men and women. The goal of the current review is to examine the need and importance of a gender inclusive conceptualization of sexual violence and to discuss how compatible our current theories are with this conceptualization. First, we examine evidence of how a gender-specific conceptualization of sexual violence aids in obscuring assault experiences that are not male to female and how this impacts victims of such violence. We specifically discuss this impact regarding research, law, public awareness, advocacy, and available victim treatment and resources. Next, we provide an overview of a number of major sexual violence theories that are relevant for adult perpetrators and adult victims, including neurobiological and integrated biological theories, evolutionary psychology theory, routine activity theory, feminist theory, social learning and related theories, typology approaches, and integrated theories. We critically examine these theories' applicability to thinking about sexual violence through a gender inclusive lens. Finally, we discuss further directions for research, clinical interventions, and advocacy in this area. Specifically, we encourage sexual violence researchers and clinicians to identify and utilize appropriate theoretical frameworks and to apply these frameworks in ways that incorporate a full range of sexual violence.

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Non-consensual sex experienced by men who have sex with men: prevalence and association with mental health

Cited by 93 publications

References 20 publications

Risk of undiagnosed infection in men attending a sexual assault referral centre

Risk of undiagnosed infection in men attending a sexual assault referral centre

Psychosocial Health Conditions and HIV Prevalence and Incidence in a Cohort of Men Who have Sex with Men in Bangkok, Thailand: Evidence of a Syndemic Effect

An Examination of the Gender Inclusiveness of Current Theories of Sexual Violence in Adulthood

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