Sexual Assault Awareness Sexual Assault Awareness
National Center for Injury Prevention and Control

OCCURANCES.
Sexual violence is a serious problem that affects millions of people every year. Its victims are at increased risk of being abused again (Elliott, Mok, and Briere 2004; Jewkes, Sen, and Garcia-Moreno 2002; Rickert et al. 2004). Sexual violence perpetrators are also at increased risk of perpetrating again (Lisak and Miller 2002).
Statistics about sexual violence vary due to differences in how it is defined and how data is collected. Sexual violence data usually come from police, clinical settings, nongovernmental organizations, and survey research.

Available data greatly underestimate the true magnitude of the problem. Rape is one of the most underreported crimes. Reporting rates for rape vary across studies. The National Violence Against Women Survey (NVAWS) found that only 1 in 5 adult women (19%) reported their rapes to police (Tjaden and Thoennes 2006). Estimates of rapes reported to the police from the National Crime Victimization Study (NCVS), conducted by the Department of Justice (DOJ), vary widely from year to year, from 39% in 2002 to 54% in 2003 (DOJ 2002, DOJ 2003). The difference between the NCVS and NVAWS rates is most likely due to different survey methods used in these two studies, so these differing results should not be directly compared.

While not an exhaustive list, here are some statistics on the occurrence of sexual violence.

Consequences
Sexual violence can have very harmful and lasting consequences for victims, families, and communities. The following list describes just some of them.

Physical

Women who experience both sexual and physical abuse are significantly more likely to have sexually transmitted diseases (Wingood et al. 2000).
Over 32,000 pregnancies result from rape every year (Holmes et al. 1996)
There are long-term consequences such as:
Chronic pelvic pain
Premenstrual syndrome
Gastrointestinal disorders
Gynecological and pregnancy complications
Migraines and other frequent headaches
Back pain
Facial pain
Disability preventing work (Jewkes, Sen, and Garcia-Moreno 2002)
Psychological

Victims of sexual violence face both immediate and long-term psychological consequences (Ackard and Neumark-Sztainer 2002; Faravelli et al. 2004; Felitti et al. 1998; Krakow et al. 2002; Ystgaard et al. 2004).

Immediate psychological consequences include:

Shock
Denial
Fear
Confusion
Anxiety
Withdrawal
Guilt
Nervousness
Distrust of others
Symptoms of Post-traumatic stress disorder
Emotional detachment
Sleep disturbances
Flashbacks
Mental replay of assault

Mental chronic psychological consequences include:

Depression
Attempted or completed suicide
Alienation
Post-traumatic stress disorder
Unhealthy diet-related behaviors
Fasting
Vomiting
Abusing diet pills
Overeating
Social

Strained relationships with the victim’s family, friends, and intimate partners
Less emotional support from friends and family
Less frequent contact with friends and relatives
Lower likelihood of marriage (Clements at al. 2004; Golding, Wilsnack, and Cooper 2002)
Health Behaviors

Some researchers view the following health behaviors as both consequences of sexual violence and factors that increase a person’s vulnerability to being victimized again in the future (Brener et al. 1999; Lang et al. 2003).

Engaging in high-risk sexual behavior including:
Unprotected sex
Early sexual initiation
Choosing unhealthy sexual partners
Having multiple sex partners
Trading sex for food, money, or other items
Using or abusing harmful substances, including:
Smoking cigarettes
Drinking alcohol
Driving after drinking alcohol
Taking drugs (Champion et al. 2004; Jewkes, Sen, and Garcia-Moreno 2002; Raj, Silverman, and Amaro 2000)
Groups at Risk

Certain groups are at risk for IPV victimization or perpetration.

Victimization

Women are more likely to be victims of sexual violence than men: 78% of the victims of rape and sexual assault are women and 22% are men (Tjaden and Thoennes 2000).
Sexual violence starts very early in life. More than half of all rapes of women (54%) occur before age 18; 22% of these rapes occur before age 12. For men, 75% of all rapes occur before age 18, and 48% occur before age 12 (Tjaden and Thoennes 2000).
Prevalence of IPV varies among race. American Indian and Alaskan Native women are significantly more likely (34%) to report being raped than African American women (19%) or White women (18%) (Tjaden and Thoennes 2000).
Women in college who use drugs, attend a university with high drinking rates, belong in a sorority, and drank heavily in high school are at greater risk for rape while intoxicated (Mohler-Kuo et al. 2004).
Perpetration

Most perpetrators of sexual violence are men. Among acts of SV committed against women since the age of 18, 100% of rapes, 92% of physical assaults, and 97% of stalking acts were perpetrated by men. SV against men is also mainly male violence: 70% of rapes, 86% of physical assaults, and 65% of stalking acts were perpetrated by men (Tjaden and Thoennes 2000).

Relationship between Victim and Perpetrator

In 8 out of 10 rape cases, the victim knows the perpetrator (Tjaden and Thoennes 2000).
A national survey found that 10% of women were victims of rape or attempted rape by a husband or intimate partner in their lifetime (Basile 2002).
Of people who report sexual violence, 64% of women and 16% of men were raped, physically assaulted, or stalked by an intimate partner. This includes a current or former spouse, cohabitating partner, boyfriend/girlfriend, or date (Tjaden and Thoennes 2000).

Vulnerability Factors for Victimization and Risk Factors for Perpetration

As discussed in the Occurrence section above, statistics on sexual violence are biased by underreporting, and emphasis on more overtly violent sexual assaults by medical and legal services, among other factors. Underreporting is due to victims’ embarrassment, shame, fear, feelings of discomfort and mistrust about the official(s) to whom an assault is reported.

Despite the underestimation of the true magnitude of the problem, research has increased understanding of factors that make some populations more vulnerable to sexual violence victimization and more at risk for sexual violence perpetration.

Vulnerability factors increase the likelihood that a person will suffer harm. Risk factors increase the likelihood that a person will cause harm. However, neither vulnerability nor risk factors are direct causes of sexual violence — they are contributing factors to sexual violence (Jewkes, Sen, and Garcia-Moreno 2002; Malamuth 1998). Vulnerability factors for victimization and risk factors for perpetration comprise a combination of individual, relational, community and societal factors.

Populations vulnerable to victimization and those at risk for perpetration can share these factors. Shared individual-level factors are noted below with an asterisk (*). All community- and social-level factors listed under Risk Factors for Perpetration increase victims’ vulnerability to sexual violence. Some vulnerability and risk factors are correlated with one another; for example, childhood physical and/or sexual victimization is a risk factor for future perpetration of sexual violence.

The public health approach aims to moderate and mediate those contributing factors that are preventable, and to increase protective factors that reduce vulnerability to victimization and risk for perpetration.

Vulnerability Factors for Victimization

Prior history of sexual violence. Women who are raped before the age of 18 are twice as likely to be raped as adults, compared to those without a history of sexual abuse (Tjaden and Thoennes 2000).
Gender. Women are more likely to be victims of sexual violence than men: 78% of the victims of rape and sexual assault are women and 22% are men (Tjaden and Thoennes 2000). These findings may be influenced by the reluctance of men to report sexual violence.
Young age. Sexual violence victimization starts very early in life. More than half of all rapes of women (54%) occur before age 18; 22% of these rapes occur before age 12. For men, 75% of all rapes occur before age 18, and 48% occur before age 12 (Tjaden and Thoennes 2000). Young women are at higher risk of being raped than older women (Acierno et al. 1999).
Drug or alcohol use.* Binge drinking and drug use are related to increased rates of victimization (Champion et al. 2004).
High-risk sexual behavior. As with drug/alcohol use, researchers are trying to understand the complex relationships between sexuality and sexual violence — their causality, directionality, and other etiologic factors that increase vulnerability for victimization are not well understood. Some researchers believe that engaging in high-risk sexual behavior is both a vulnerability factor and a consequence of childhood sexual abuse. Youth with many sexual partners are at increased risk of experiencing sexual abuse (Howard and Wang 2003; Valois et al. 1999).
Poverty.* Poverty may make the daily lives of women and children more dangerous (e.g. walking alone at night, less parental supervision). It may also make them more dependent on men for survival and therefore less able to control their own sexuality, consent to sex, recognize their own victimization or to seek help when victimized. These issues increase their vulnerability to sexual victimization (Jewkes, Sen, and Garcia-Moreno 2002). In addition, poor women may be at risk for sexual violence because their economic (and, often, educational) status necessitates that they engage in high-risk survival activities, for example trading sex for food, money, or other items (Wenzel et al. 2004). Poverty also puts women at increased risk of intimate partner violence, of which sexual violence is often one aspect.
Ethnicity/culture. American Indian and Alaskan Native women are more likely (34%) to report being raped than African American women (19%), White women (18%) or Hispanic women (15%) (Tjaden and Thoennes 2000).

Risk Factors for Perpetration

Individual Factors

Alcohol and drug use*
Coercive sexual fantasies
Impulsive and antisocial tendencies
Preference for impersonal sex
Hostility towards women
Hypermasculinity
Childhood history of sexual and physical abuse*
Witnessed family violence as a child
Relationship Factors

Association with sexually aggressive and delinquent peers
Family environment characterized by physical violence and few resources
Strong patriarchal relationship or familial environment
Emotionally unsupportive familial environment
Community Factors

Lack of employment opportunities
Lack of institutional support from police and judicial system
General tolerance of sexual assault within the community
Settings that support sexual violence
Weak community sanctions against sexual violence perpetrators
Societal Factors

Poverty
Societal norms that support sexual violence
Societal norms that support male superiority and sexual entitlement
Societal norms that maintain women’s inferiority and sexual submissiveness
Weak laws and policies related to gender equity
High tolerance levels of crime and other forms of violence

Protective Factors

Protective factors may lessen the likelihood of sexual violence victimization or perpetration, and exist at individual, relational, community, and societal levels. Although less is known about protective factors, the literature suggests measures to prevent potential perpetrators. Some examples for youth are connectedness with school, friends and adults in the community, and emotional health (Borowsky et al 1997).