Negative consequences of conflict-related sexual violence on survivors: a systematic review of qualitative evidence.
Conflict
Conflict-related sexual violence (CRSV)
Consequences
Gender-based violence (GBV)
Sexual and Reproductive Health and Rights (SRHR)
Sexual violence
Survivor
Journal
International journal for equity in health
ISSN: 1475-9276
Titre abrégé: Int J Equity Health
Pays: England
ID NLM: 101147692
Informations de publication
Date de publication:
27 10 2023
27 10 2023
Historique:
received:
21
08
2023
accepted:
12
10
2023
medline:
30
10
2023
pubmed:
28
10
2023
entrez:
27
10
2023
Statut:
epublish
Résumé
Conflicts exacerbate dynamics of power and inequalities through violence normalization, which acts as a facilitator for conflict-related sexual violence. Literature addressing its negative outcomes on survivors is scant. The aim of this systematic review was to analyze the qualitative evidence reported in scientific literature and focusing on the negative consequences of conflict-related sexual violence on victims' physical, psychological, and social dimensions of health in a gender-inclusive and disaggregated form. A literature search was conducted on January 13, 2023 on Pubmed, Scopus, and PsychArticles. The search strings combined two blocks of terms related to sexual violence and conflict. A time filter was applied, limiting the search to studies published in the last ten years. Information regarding the main characteristics and design of the study, survivors and their experience, and about conflict-related sexual violence was collected. The negative consequences of conflict-related sexual violence on the physical, psychological, and social dimension of victims were extracted according to the Biopsychosocial model of health. The review followed the Joanna Briggs Institute methodology for systematic reviews and relied on the Preferred Reporting Items for Systematic reviews and Meta-Analyses. After full text review, 23 articles met the inclusion criteria, with 18 of them reporting negative repercussions on physical health, all of them highlighting adverse psychological outcomes, and 21 disclosing unfavorable social consequences. The negative outcomes described in multiple studies were sexual and reproductive health issues, the most mentioned being pregnancy, manifestations of symptoms attributable to post-traumatic stress disorder, and stigma. A number of barriers to access to care were presented as emerging findings. This review provided an analysis of the negative consequences of conflict-related sexual violence on survivors, thus highlighting the importance of qualitative evidence in understanding these outcomes and addressing barriers to access to care. Conflict-related sexual violence is a sexual and reproductive health issue. Sexuality education is needed at individual, community, and provider level, challenging gender norms and roles and encompassing gender-based violence. Gender-inclusive protocols and services need to be implemented to address the specific needs of all victims. Governments should advocate for SRHRs and translate health policies into services targeting survivors of CRSV.
Sections du résumé
BACKGROUND
Conflicts exacerbate dynamics of power and inequalities through violence normalization, which acts as a facilitator for conflict-related sexual violence. Literature addressing its negative outcomes on survivors is scant. The aim of this systematic review was to analyze the qualitative evidence reported in scientific literature and focusing on the negative consequences of conflict-related sexual violence on victims' physical, psychological, and social dimensions of health in a gender-inclusive and disaggregated form.
METHODS
A literature search was conducted on January 13, 2023 on Pubmed, Scopus, and PsychArticles. The search strings combined two blocks of terms related to sexual violence and conflict. A time filter was applied, limiting the search to studies published in the last ten years. Information regarding the main characteristics and design of the study, survivors and their experience, and about conflict-related sexual violence was collected. The negative consequences of conflict-related sexual violence on the physical, psychological, and social dimension of victims were extracted according to the Biopsychosocial model of health. The review followed the Joanna Briggs Institute methodology for systematic reviews and relied on the Preferred Reporting Items for Systematic reviews and Meta-Analyses.
RESULTS
After full text review, 23 articles met the inclusion criteria, with 18 of them reporting negative repercussions on physical health, all of them highlighting adverse psychological outcomes, and 21 disclosing unfavorable social consequences. The negative outcomes described in multiple studies were sexual and reproductive health issues, the most mentioned being pregnancy, manifestations of symptoms attributable to post-traumatic stress disorder, and stigma. A number of barriers to access to care were presented as emerging findings.
CONCLUSIONS
This review provided an analysis of the negative consequences of conflict-related sexual violence on survivors, thus highlighting the importance of qualitative evidence in understanding these outcomes and addressing barriers to access to care. Conflict-related sexual violence is a sexual and reproductive health issue. Sexuality education is needed at individual, community, and provider level, challenging gender norms and roles and encompassing gender-based violence. Gender-inclusive protocols and services need to be implemented to address the specific needs of all victims. Governments should advocate for SRHRs and translate health policies into services targeting survivors of CRSV.
Identifiants
pubmed: 37891663
doi: 10.1186/s12939-023-02038-7
pii: 10.1186/s12939-023-02038-7
pmc: PMC10612192
doi:
Types de publication
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
227Informations de copyright
© 2023. The Author(s).
Références
Confl Health. 2020 Jul 08;14:43
pubmed: 32670397
Trauma Violence Abuse. 2011 Jul;12(3):127-34
pubmed: 21511685
Global Health. 2014 May 08;10:32
pubmed: 24885537
Sex Reprod Health Matters. 2019 Dec;27(3):1-5
pubmed: 31880504
Isr Med Assoc J. 2014 Mar;16(3):137-41
pubmed: 24761699
Front Psychol. 2022 Nov 01;13:957327
pubmed: 36389581
Trauma Violence Abuse. 2009 Apr;10(2):125-42
pubmed: 19383630
BMC Public Health. 2022 Apr 9;22(1):700
pubmed: 35397528
Arch Sex Behav. 2019 Feb;48(2):631-644
pubmed: 30062603
Confl Health. 2021 Nov 24;15(1):86
pubmed: 34819111
BMC Public Health. 2020 May 24;20(1):753
pubmed: 32448199
Confl Health. 2016 Dec 21;10:30
pubmed: 28031743
Confl Health. 2022 Jun 28;16(1):37
pubmed: 35765013
Int J Legal Med. 2018 Jul;132(4):1197-1204
pubmed: 29308532
Child Abuse Negl. 2023 Aug;142(Pt 2):105854
pubmed: 36031438
Disasters. 2018 Jan;42 Suppl 1:S61-S78
pubmed: 29281138
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Lancet. 2018 Jun 30;391(10140):2642-2692
pubmed: 29753597
BMC Public Health. 2014 Aug 30;14:892
pubmed: 25174960
Violence Against Women. 2022 Jul;28(9):2204-2230
pubmed: 34533382
Arch Sex Behav. 2017 May;46(4):869-884
pubmed: 27178171
Health Care Women Int. 2013;34(9):736-56
pubmed: 23489119
PLoS One. 2022 Dec 12;17(12):e0278859
pubmed: 36508404
Confl Health. 2014 Jul 11;8:10
pubmed: 25076981
PLoS One. 2016 Oct 14;11(10):e0164631
pubmed: 27741262
Reprod Health Matters. 2015 Nov;23(46):71-84
pubmed: 26718999
BMJ Mil Health. 2020 Jun;166(3):183-186
pubmed: 32447303
Confl Health. 2013 Jun 12;7(1):13
pubmed: 23758886
Cult Health Sex. 2023 Feb;25(2):241-255
pubmed: 35167778
Confl Health. 2022 Apr 11;16(1):16
pubmed: 35410235
Disasters. 2018 Jan;42 Suppl 1:S99-S118
pubmed: 29281141
Kathmandu Univ Med J (KUMJ). 2013 Apr-Jun;11(42):179-84
pubmed: 24096231
Lancet. 2006 Oct 7;368(9543):1260-9
pubmed: 17027732
JAMA. 2012 Aug 15;308(7):677-8
pubmed: 22893163
J Epidemiol Community Health. 2010 Dec;64(12):1056-61
pubmed: 19934172
Int J Equity Health. 2023 Jul 22;22(1):135
pubmed: 37481546
Health (London). 2013 Sep;17(5):441-59
pubmed: 23117592
Confl Health. 2019 Sep 16;13:42
pubmed: 31534473
Int J Equity Health. 2013 Mar 11;12:18
pubmed: 23496984
Science. 1977 Apr 8;196(4286):129-36
pubmed: 847460
Front Psychol. 2018 Sep 26;9:1777
pubmed: 30319489
BMC Pregnancy Childbirth. 2018 Aug 8;18(1):322
pubmed: 30089448
Confl Health. 2013 Aug 05;7(1):16
pubmed: 23915821
Public Health. 2017 Jan;142:121-135
pubmed: 27622295
Arch Sex Behav. 2022 Jan;51(1):391-415
pubmed: 34426898
PLOS Glob Public Health. 2022 Jun 15;2(6):e0000582
pubmed: 36962453
Cult Health Sex. 2023 Jan 2;:1-16
pubmed: 36592099
Confl Health. 2020 Feb 26;14:11
pubmed: 32127913
Leg Med (Tokyo). 2023 Feb;60:102170
pubmed: 36347083