After a sexual assault, survivors have the option of seeking a medical forensic exam, which includes medical evaluation and treatment, as well as forensic evidence collection. Forensic evidence is collected in a sexual assault evidence kit (SAEK) and typically released to police to aid in the investigation and potential prosecution of the assault. However, 20% to 25% of survivors who have a SAEK collected do not report their assault to police at that time and choose instead to have their SAEK stored for possible future use. This study sought to understand the reasons for not reporting among this group of survivors. We examined medical records of 296 individuals aged 18 and older who had documented their reasons for not reporting to police in their medical record and used a non-theory-driven coding framework to conduct a reflexive thematic analysis based on that data. We identified four themes: Reporting Won\'t Help, Reporting Will Harm, Not Now, and Not What I\'m Here For. These data illustrate that survivors are making an active choice which, for many, was based on concerns that reporting would not meaningfully help their situation or may even make their situations worse. For some survivors, the decision to have forensic evidence collected without a police report was based on their needs at that moment, whereas for other survivors it was based on their desire to move on from the assault more permanently. Practice and policy recommendations are discussed, including the importance of providing survivors information about what police reporting would look like in specific circumstances as well as ensuring that financial concerns are not a barrier to survivors receiving post-assault medical care without forensic evidence collection.

Sexual violence (SV) against women is common in higher education settings, causing serious harm to the health, well-being, and academic outcomes of victim/survivors. There have been numerous systematic reviews of the quantitative evidence on this topic, highlighting the prevalence, health impacts, and barriers and facilitators to help-seeking after SV. To date, however, qualitative research exploring the lived experience of women higher education students has not been synthesized. This scoping review and thematic synthesis of qualitative studies aims to map the global evidence on women higher education students\' experiences of SV and explore how they understand and make sense of their experiences. We searched five databases (CinAHL, Academic Search Complete, Medline, PsychInfo, and SocIndex) in January 2023 for relevant articles. Eligible articles needed to be published in English and describe qualitative or mixed-methods primary research on the lived experiences of women higher education students who were victim/survivors of SV. In all, 34 articles describing 32 studies met these inclusion criteria. Thematic analysis of data extracted from the included studies suggests that, for women higher education students, the experience of SV is characterized by profound shame, with often-irreversible impacts on hopes and plans for the future. Yet, at the same time, SV is normalized and expected as a part of the \"student experience.\" Furthermore, an imagined \"specter\" of \"real violence\" is held up as a constant comparison that serves to minimize and trivialize their experiences. These findings have important implications for higher education providers seeking to improve programs to address SV.

Reports of sexual offences have increased in recent years, with many cases involving allegations against high-status individuals (e.g., Harvey Weinstein, Bill Cosby). In addition, many of these cases have involved allegations against the defendant from multiple victims, with long delays in reporting of the alleged assault. The purpose of this study was to examine the influence of defendant occupational status (low vs. high), defendant race (White, Black), number of allegations (one vs. five victims), and the length of reporting delay (5, 20, or 35 years) on mock-juror decision-making. Mock-jurors (N = 752) read a mock-trial transcript describing a sexual assault case. After reading the trial transcript, mock-jurors were asked to provide dichotomous and continuous guilt ratings, as well as ratings regarding their perceptions of the defendant and victim. Results revealed that mock-jurors rendered more guilty verdicts, assigned higher guilt ratings, and perceived the defendant less favorably and the victim more favorably, when the defendant was White (as opposed to Black) and when there were multiple allegations against the defendant. The current findings suggest that defendant race and the number of allegations are highly influential in the context of a sexual assault case.

The recent attention focused on child sexual abuse (CSA) disclosure pathways has highlighted complex psychological processes that influence disclosure both for children and adults. Some authors have suggested that such processes may differ between children and adults yet few studies have examined distinct samples within the same study. This paper addresses this gap by exploring adolescent (n = 20) and adult (n = 10) experiences of disclosure of childhood sexual abuse. Interviews were conducted with both samples, using the same interview schedule and a comparative analysis was conducted of the key themes identified from a grounded theory analysis. Those themes that were found to be common to both samples included pressure cooker effect, telling would make it worse, and self-blame. Themes that were found to be more prevalent in the adolescent sample included police/court involvement, concern for other children, being asked, and peer influence. It is suggested that such potential differences reflect the changing social context over the past few decades which is characterised by increased awareness of sexual abuse as a crime and the risks of recidivism of offenders.

Stranger-perpetrated harassment was identified decades ago to describe the pervasive, unwanted sexual attention women experience in public spaces. This form of harassment, which has evolved in the modern era, targets women as they navigate online spaces, social media, texting, and online gaming. The present research explored university-aged women\'s experiences (n = 381) with online male-perpetrated sexual harassment, including the nature and frequency of the harassment, how women responded to the harassment, and how men reportedly reacted to women\'s strategies. Trends in harassment experiences are explored descriptively and with thematic analysis. Most women reported receiving sexually inappropriate messages (84%, n = 318), sexist remarks or comments (74%, n = 281), seductive behavior or come-ons (70%, n = 265), or unwanted sexual attention (64%, n = 245) in an online platform, social media account, email, or text message. This sexual attention from unknown males often began at a very young age (12-14 years). The harassment took many forms, including inappropriate sexual comments on social media posts, explicit photos of male genitalia, and solicitations for sex. Although most women reported strong negative emotional reactions to the harassment (disgust, fear, anger), they generally adopted non-confrontational strategies to deal with the harassment, electing to ignore/delete the content or blocking the offender. Women reported that some men nevertheless persisted with the harassment, following them across multiple sites online, escalating in intensity and severity, and leading some women to delete their own social media accounts. These results suggest the need for early intervention and education programs and industry response.

Sexual assault and sexual re-assault are common problems on college campuses for women, and experiencing an initial assault dramatically increases risk for experiencing sexual re-assault. Low use of sexual refusal assertiveness and assertive resistance strategy intentions has been found to predict initial victimization, yet few studies to date look collectively at the associations of sexual refusal assertiveness and assertive resistance strategy intentions to sexual re-assault. The current study examined both sexual refusal assertiveness and assertive resistance strategy intentions as potential moderators of sexual re-assault among college women. It was hypothesized that the association between sexual assault severity before college and sexual assault severity since college would be stronger among those with low sexual refusal assertiveness compared to those with high sexual refusal assertiveness (Hypothesis 1). it was also hypothesized that the association between sexual assault severity before college and sexual assault severity since college would be stronger among those who endorsed assertive resistance strategy intentions (Hypothesis 2). Participants (N = 623) included college women at a large, public university within the northwestern region of the United States, who completed a web-based survey. Results revealed that the association between sexual assault severity before college and sexual assault severity since college was significant among those with lower levels of sexual refusal assertiveness (t = 91.42, p < 0 .001). Results also revealed that the association between sexual assault severity before college and sexual assault severity since college was stronger among those who endorsed non-assertive resistance strategy intentions to a potential sexual assault scenario (t = 25.09, p < 0.001). These findings provide insight into risk for sexual re-assault, wherein risk reduction programmatic efforts may be targeted towards women entering college with a sexual assault history to increase their use of sexual refusal assertiveness and assertive resistance strategy intentions.

Sexual assault and intimate partner violence (IPV) are common experiences in women, but few studies have examined correlates of social reactions experienced by victims telling others about assault. This systematic review identified 30 studies through searches of research databases on correlates of social reactions to disclosure of sexual assault or IPV in samples of adult victims or disclosure recipients. Studies showed evidence of greater negative social reactions for Black and Hispanic victims, less educated, and bisexual victims. More extensive trauma histories in victims were related to receipt of greater negative social reactions, whereas assault characteristics (e.g., victim-offender relationship, alcohol use, perpetrator violence during assault) were sometimes associated with negative reactions. In terms of postassault factors, more psychological symptoms, self-blame, avoidance coping, less perceived control, and less posttraumatic growth were related to more negative social reactions. Disclosure characteristics, telling informal sources, and telling more sources were related to more positive reactions, whereas telling both formal and informal sources was related to negative reactions. Demographic, attitudinal, and relational factors were related to disclosure recipients\' intended social reactions. Future research needs to examine how various factors relate to social reactions in the context of theory, and clinical treatment and interventions should use this information to identify and intervene with victims to reduce negative social reactions and their psychological impacts and to increase positive social reactions particularly from informal support sources.

UNASSIGNED: This article reports the findings of a scoping review designed to identify research exploring the losses associated with childhood sexual abuse in women survivors. A systematic search of databases for articles published between 1983 and 2019 were conducted using keywords related to loss and women survivors of childhood sexual abuse.
UNASSIGNED: Twenty studies were selected for review using predefined inclusion criteria: studies that include adult women survivors of childhood sexual abuse, studies that include child/childhood sexual abuse, studies that include stigmatized loss, studies that indicate stigmatized loss in adult women survivors of childhood sexual abuse. Sources were subject to quality appraisal and data were extracted in line with the review question.
UNASSIGNED: Findings acknowledged and extended on Bloom\'s model of stigmatized loss and suggested that female survivors of childhood sexual abuse may experience an overall loss of self-efficacy, presenting as a loss of personal agency, interpersonal agency, and sexual agency. The results of this research suggest that loss be considered in support interventions with women self-reporting childhood sexual abuse. It is recommended that further research be conducted to confirm these findings so that they may advocate for inclusion in childhood sexual abuse treatment interventions.

Rape is associated with myriad negative physical and mental health effects, yet little is known about medical prescribing following rape-related emergency room visits. The goal of this study was to examine factors associated with medications prescribed the same day as a sexual assault medical forensic examination (SAMFE). A total of 939 medical records (93.9% female) of a medical university in the Southeastern United States between July 1, 2014, and May 15, 2019, were paired with Sexual Assault Nurse Exam records. Demographic and assault characteristics were examined as correlates of medications prescribed at the emergency department within the same day of a SAMFE. All individuals were offered medications within the national guidelines. Intimate partner violence (IPV) was negatively associated with antibiotic prescriptions and with emergency contraception prescriptions. Genital injury and male gender of victim were positively associated with antiviral prescriptions. Non-genital injury was positively associated with both over-the-counter and prescription pain medication prescriptions. Report of strangulation was positively associated with accepting over-the-counter but not prescription pain medication. IPV and strangulation were positively associated with psychotropic prescriptions. Although specific medications were offered to individuals during the SAMFE, demographic and assault characteristics were associated with medication acceptability.

Factors affecting prosecutorial decision-making represent one of the most understudied parts of the criminal justice system. Documenting these influences in relation to sexual assault cases is even more rare. The present study analyzed the complete prosecutorial case files of a large, southern district attorney\'s office regarding all adult sexual assault cases received over a three-year period. Logistic regression and continuation ratio modeling were used to determine which factors were related to continued progression through the court system, from charging to sentencing. The findings indicate that cases with older or Latino defendants, as well as cases involving injury to the victim, were significantly more likely to be charged. A continuation ratio model of subsequent case outcomes indicated that factors such as DNA evidence, the use of a weapon, and the inclusion of a victim impact statement increased the likelihood of a case progressing to later stages of the system. The influence of criminal history and the amount of prosecutor contact with the victim, however, varied across outcomes. Namely, criminal history increased the odds of receiving a prison sentence while prosecutor contacts with the victim increased the odds of case indictment. These findings imply potential shifts in the treatment of these cases while also suggesting areas of improvement. Namely, prosecutors should strive to increase the amount of meaningful contacts with victims and encourage their participation in the court process. These findings also support the use of sexual assault packets by law enforcement to improve and standardize reporting practices for these cases.