BACKGROUND: Needle pricking, the act of being intentionally pricked by an assailant, and needle spiking, the covert injection of substances using a needle, have historical precedents and recently resurfaced in Europe in 2022. This resurgence presented a challenge for emergency and forensic medicine departments.
METHODS: We conducted a retrospective study in the forensic medicine department of Paris, France, including all patients who consulted for suspected needle pricking/spiking in 2022, following a police report. The study aimed to provide epidemiological data on victims, circumstances, and the results of toxicologic and serological analyses.
RESULTS: Of all assault victims in 2022, patients reporting or suspecting needle pricking/spiking represented 1.2 % of the total (171 cases). Most cases involved women (81.9 %) with a median age of 21.75 years. Incidents often occurred in festive contexts (84.8 %). Over a third of the patients didn\'t report any symptoms (37.5 %). Amnesia, nausea, and dizziness were common symptoms among those who did. Patients reporting alcohol consumption were more likely to experience symptoms (p < 0.05). Over half of the patients displayed physical examinations consistent with needle pricking, with pricks mostly on their arms. Not all patients underwent toxicologic analyses (30.6 %), but all results were negative. Despite most patients not providing follow-up serology results, all received results were negative.
CONCLUSIONS: Overall, our data are more suggestive of needle pricking than spiking. Although women were overrepresented, there was no evidence of sexual motivation on the part of the perpetrators. It\'s possible that the perpetrators wanted to instill fear in the population without a specific goal. This form of violence necessitates preventive measures in festive venues and enhanced efforts to detect psychoactive substance.

This Special Report aims to outline the development process of the first National Clinical and Policy guidelines on Intimate Partner Violence and Sexual Violence in Trinidad and Tobago and to support the implementation of quality standards for survivors. The study used an implementation science approach to identify key evidence-based practice recommendations from guidance documents on health care for women who are subjected to violence and from relevant national legislation, policy, and practices. The process engaged stakeholders in discussions on the appropriateness, implementation, and use of these recommendations in the context of local health care delivery. Multidisciplinary teams of frontline health workers were consulted in groups in each of the five Regional Health Authorities. Interviews were held with senior government stakeholders responsible for health policy and with representatives of four civil society agencies. Participants provided recommendations to integrate quality standards into routine practice. These were incorporated into the guidelines, which include human rights principles and pathways of care for identifying violence, providing psychosocial and clinical care, safety planning, referrals, care during emergencies, and prevention of intimate partner violence and sexual violence. The guidelines were approved by the Ministry of Health of Trinidad and Tobago on 15 August 2022. Training of trainers has been undertaken to support implementation.
El objetivo de este informe especial es describir el proceso de elaboración de las primeras directrices políticas y clínicas nacionales sobre violencia de pareja y violencia sexual en Trinidad y Tabago, así como brindar apoyo para la aplicación de normas de calidad dirigidas a las personas supervivientes. El estudio utilizó un enfoque de ciencia de implementación para hallar recomendaciones prácticas clave basadas en la evidencia a partir de documentos de orientación sobre atención de salud para mujeres víctimas de violencia, así como de las leyes, políticas y prácticas nacionales pertinentes. El proceso involucró a las partes interesadas en las deliberaciones sobre la idoneidad, la puesta en práctica y el uso de estas recomendaciones en el contexto de la prestación de servicios de salud locales. Se realizaron consultas grupales a equipos multidisciplinarios de trabajadores de salud de primera línea de cada una de las cinco autoridades regionales de salud. Se mantuvieron entrevistas con funcionarios gubernamentales con cargos de responsabilidad en materia de políticas de salud y con representantes de cuatro organizaciones de la sociedad civil. Los participantes proporcionaron recomendaciones para integrar las normas de calidad en la práctica habitual. Estas recomendaciones se incorporaron a las directrices, que incluyen principios de derechos humanos y protocolos asistenciales para detectar la violencia, prestación de atención psicosocial y clínica, diseño de planes de seguridad, derivación de los casos, atención durante emergencias y prevención de la violencia de pareja y la violencia sexual. Las directrices fueron aprobadas por el Ministerio de Salud de Trinidad y Tabago el 15 de agosto del 2022. Se ha llevado a cabo la capacitación de formadores a fin de brindar apoyo para su puesta en práctica.
O objetivo deste relatório especial é resumir o processo de elaboração das primeiras diretrizes clínicas e orientações sobre políticas de âmbito nacional para violência por parceiro íntimo e violência sexual de Trinidad e Tobago, bem como apoiar a implementação de padrões de qualidade para sobreviventes. O estudo utilizou uma abordagem científica de implementação para identificar as principais recomendações de práticas baseadas em evidências, derivadas de documentos de orientação sobre atenção à saúde para mulheres vítimas de violência e de leis, políticas e práticas nacionais pertinentes. O processo envolveu as partes interessadas em discussões sobre adequação, implementação e uso dessas recomendações no contexto da prestação de serviços de saúde em nível local. Em cada uma das cinco autoridades regionais de saúde, equipes multidisciplinares de profissionais de saúde na linha de frente foram consultadas em grupo. Foram entrevistadas partes interessadas da alta administração do governo que eram responsáveis pela política de saúde e representantes de quatro organizações da sociedade civil. Os participantes fizeram recomendações para integrar padrões de qualidade à prática de rotina. Tais recomendações foram incorporadas às diretrizes, que incluem princípios de direitos humanos e percursos assistenciais para identificação de violência, oferta de atenção psicossocial e clínica, planejamento da segurança, encaminhamentos, cuidados durante emergências e prevenção de violência por parceiro íntimo e violência sexual. As diretrizes foram aprovadas pelo Ministério da Saúde de Trinidad e Tobago em 15 de agosto de 2022. Realizou-se capacitação de instrutores para apoiar a implementação.

Intimate partner violence (IPV) is a public health problem. In Spain, although the prevalence of IPV is greater in immigrant women than in Spanish-born women, immigrant women seem to access services to a lesser extent. This study aimed to explore and compare perceptions of barriers to and strategies for seeking formal help among Spanish-born and immigrant women IPV survivors. A qualitative study was conducted based on three focus groups with women of Spanish (n = 9), Romanian (n = 4), and Latin American (n = 4) origin. The thematic analysis was supported by Atlas.ti. Three categories and 12 subcategories were identified: general characteristics of help-seeking behavior (e.g., children as the main motivating factor), barriers (e.g., immigrant status, fear of the perpetrator), and strategies for accessing services (e.g., increasing education). Differences in help-seeking behavior were found between groups. Relevant information for professionals to improve women\'s access to IPV support services is provided.

Background: Little is known about how young men who have committed sexual assault might acknowledge wrongdoing and eventually change and make amends. There are practical barriers to seeking the real redemption stories of perpetrators.Objective: To explore hypothetical pathways to young men\'s accountability-taking and amends (i.e. redemption) after perpetration of sexual assault.Method: In a pre-registered, qualitative story completion study, we presented heterosexual, cisgender college men (N = 54) with a date-based sexual assault story written by a fictional male perpetrator. Participants were prompted to complete the story so that the protagonist, who initially denies wrongdoing, eventually changes and becomes a violence prevention advocate.Results: A thematic analysis of the redemption stories revealed that this study\'s speculative task was a challenging one. Half of the stories did not provide an explanation for how the perpetrator was able to acknowledge wrongdoing. Overall, individualistic themes (e.g. he introspected) were more common than relational, community, or societal facilitators of redemption.Conclusions: Without infrastructure for accountability-taking and repair, or narrative exemplars to draw from in public life, it is difficult to envision redemption from violence. Rare gender-based, structurally attuned analyses of sexual violence in the stories point the way towards a more transformative vision of redemption.
In this qualitative story completion study, college men wrote the redemption story of a fictional sexual assault perpetrator.Men had difficulty explaining how the perpetrator would acknowledge wrongdoing.Redemption themes tended to be individualistic versus rooted in community.

The ubiquity of public-space sexual harassment (PSH) of women in the global South, particularly in South Asia, is both a public health and gender equity issue. This study examined men\'s experiences with and perspectives on PSH of women in three countries with shared cultural norms and considerable gender inequalities - Bangladesh, India, and Pakistan. The three-country survey in 2021-2022 was completed by 237 men who were generally young, urban, single, well-educated, and middle-/high-income. Among the 53.3% who witnessed PSH, 80% reported intervening to stop it or help the victim. A substantial share of men worried about PSH, and bore emotional, time, and financial costs as they took precautionary or restorative measures to help women in their families avoid PSH or deal with its consequences. Most respondents articulated potential gains for men, women, and society if PSH no longer existed. However, a non-negligible share of participants held patriarchal gender attitudes that are often used to justify harassment, and a small share did not favour legal and community sanctions. Many called for stricter legal sanctions and enforcement, culture change, and education. Men\'s perspectives offer insights for prevention of harassment and mitigation of its consequences.

OBJECTIVE: Staff at violence against women (VAW) organizations provide essential services for survivors of violence. The increase in VAW during the COVID-19 pandemic placed additional pressures on VAW staff. We investigated the impacts of the pandemic on the mental health of VAW staff in the Greater Toronto Area to inform recommendations for policy and practice.
METHODS: We conducted a community-based, mixed-methods study on the processes, experiences, and outcomes of adapting VAW programming during the pandemic using a sequential explanatory approach. Throughout 2021, we conducted a survey of direct support and leadership staff who worked on VAW services (\"VAW staff\") followed by semi-structured interviews with VAW staff purposively sampled from the survey. We descriptively analyzed quantitative survey data on the mental health of 127 VAW staff. We then applied thematic analysis to qualitative data from 18 interviews with VAW staff. We used the qualitative data to support interpretation and enrich the quantitative findings regarding staff mental health.
RESULTS: In the survey, 81% of leadership and 61% of direct support staff indicated that their work was more distressing during the pandemic. Participants reported moderate symptoms of vicarious trauma and mild symptoms of anxiety and depression. We generated three themes from the qualitative data to help explain these findings: (1) challenges related to changing work environments; (2) distress over not meeting client needs; and (3) difficulties in adapting self-care strategies in response to pandemic stressors.
CONCLUSIONS: VAW organizations require increased resources and flexible funding to hire and retain more staff to respond to higher and more complex caseloads during public health emergencies. With more structural supports in place, VAW organizations could create more time and space to develop their trauma-informed organizational practices: for example, establishing a culture of connection and learning among staff virtually and in-person and facilitating a range of self-care opportunities.
RéSUMé: OBJECTIFS: Le personnel des organisations de lutte contre la violence envers les femmes (VEF) fournit des services essentiels aux survivantes de la violence. L’augmentation de la VEF pendant la pandémie de COVID-19 a exercé des pressions supplémentaires sur le personnel de la VEF. Nous avons étudié les impacts de la pandémie sur la santé mentale du personnel de la VEF dans la région du Grand Toronto afin de formuler des recommandations pour les politiques et les pratiques. MéTHODES: Nous avons mené une étude communautaire basée sur des méthodes mixtes sur les processus, les expériences et les résultats de l’adaptation des programmes de VEF pendant la pandémie, en utilisant une approche explicative séquentielle. Tout au long de l’année 2021, nous avons mené une enquête auprès personnel de première ligne et des cadres travaillant sur les services de VEF (personnel de VEF), suivie d’entretiens semi-structurés avec un échantillon intentionnel de ce personnel tiré de l’enquête. Nous avons analysé de manière descriptive les données quantitatives de l’enquête sur la santé mentale de 127 membres du personnel de VEF. Nous avons ensuite appliqué une analyse thématique aux données qualitatives provenant de 18 entretiens avec le personnel de VEF. Nous avons utilisé les données qualitatives pour soutenir l’interprétation et enrichir les résultats quantitatifs concernant la santé mentale du personnel. RéSULTATS: Dans l’enquête, 81 % des cadres et 61 % du personnel de première ligne ont indiqué que leur travail était plus stressant pendant la pandémie. Les participants ont signalé des symptômes modérés de traumatisme indirect et des symptômes légers d’anxiété et de dépression. Nous avons dégagé trois thèmes à partir des données qualitatives pour aider à expliquer ces résultats : (1) défis liés aux environnements de travail changeants; (2) détresse liée à l’incapacité de répondre aux besoins des clients; et (3) difficultés à adapter les stratégies de soins personnels en réponse aux facteurs de stress de la pandémie. CONCLUSION: Les organisations de VEF ont besoin de ressources accrues et de financements flexibles pour recruter et retenir plus de personnel afin de répondre à des charges de travail plus élevées et plus complexes pendant les urgences de santé publique. Avec davantage de soutiens structurels en place, les organisations de VEF pourraient dégager plus de temps et d’espace pour développer leurs pratiques organisationnelles tenant compte des traumatismes. Par exemple, établir une culture de connexion et d’apprentissage entre le personnel, à la fois virtuellement et en personne, et faciliter une gamme d’opportunités de soins personnels.

OBJECTIVE: Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID-19 pandemic in a Brazilian city.
METHODS: This is a cross-sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women\'s Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher\'s exact tests were used to compare groups; the significance level was 5%.
RESULTS: Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months.
CONCLUSIONS: The COVID-19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic.

In the field of violence against women (VAW) prevention, one of the current questions at stake is how to address men\'s role and masculinities, but it is still an emerging field in Spain. The aim of this study was to analyze the up-to-date discourses on masculinity among stakeholders in the field of VAW prevention and gender equity in Spain. We used a qualitative methodology with semi-structured interviews, conducted between October 2019 and February 2020 in Madrid and Alicante (Spain), with 23 key stakeholders from different areas: in governmental (public health and VAW prevention/intervention, and institutional and policy positioning) and nongovernmental organizations (anti-violence masculinities workers, youth education workers, and feminist and LGBT associations). A discourse analysis was performed with the data collected. Our findings showed that discourses around masculinities among Spanish stakeholders in VAW prevention and gender equity were diverse and presented different layers of critique. Despite a general agreement on the importance of transforming sexist men\'s practices toward more gender equitable relations, three main interpretive repertoires were identified: \"Constructing positive/new masculinities\" discourse, focused on promoting men\'s engagement and egalitarian practices; \"Deconstructing hegemonic masculinity\" discourse, intended to critically identify and question harmful masculinities norms; and \"Abolishing gender\" discourse, which aims at dismantling masculinity, and gender in general, as a social structure that generates oppression in itself, advocating for its abolition. Those interpretive repertoires were not mutually exclusive and sometimes stakeholders incorporate in their work more than one approach. The study findings shed light on this current emerging and urgent debate and contributes more broadly to the critical assessment of the concepts used and their implications for VAW prevention.

Gender-based violence (GBV) and, more specifically, violence against women (VAW) are commonly considered a consequence of a patriarchal structure-a social system granting the senior male absolute authority over the family and the community as a whole. Anthropologists have documented that human male dominance is rooted in evolution, with male violent behavior observed among the great apes. Given that evolution is a continuous process, human progress over millennia has modified pre-existing behavior, demonstrating that humans can move beyond ancestral ways of life over time. Precisely because of the imperative to change and improve, at the global international level as well as in individual countries, strong movements are in action to eliminate GBV/VAW. FIGO has been and continues to be at the forefront of the battle for equality, with initiatives that cover many aspects of this, including the imperative to involve men, who-in the majority of cases-are the perpetrators. Since men are often the root of the problem, they must also be at the forefront of the battle to eradicate it. GBV/VAW comprises many facets, including selective female abortion, infanticide, femicide, honor killing, female genital mutilation, and child marriage. These deeply rooted forms of violence continue to perpetuate gender inequalities, remain major obstacles to health and societal progress, and violate the most basic human rights.

Violence against women is a global public health problem. CDC data shows 41% of US women have experienced intimate partner violence. Burn-related violence against women is an extremely confronting form of physical violence. The aim of this study was to describe the frequency, demographics, injury characteristics and outcomes of women admitted to US burn centers who have experienced burn violence compared to those with accidental burn injuries. 2008-2018 data was queried from the ABA Burn Quality Care Platform registry for patients that were women and ≥18 years old. Women who experienced an assault or accidental burn injury were included. Women who experienced self-harm were excluded. Descriptive/simple comparative statistics were used to describe/compare groups. 54,523 women met study inclusion criteria. 956 (2%) experienced burn violence. Women who experienced burn violence had a younger median [IQR] age (36 [27,48] vs 47 [32,61],p<0.0001), were Black/African American (44.5% vs. 22.4%,p< 0.0001), were covered by Medicaid (38.8% vs. 21.6%,p< 0.0001), had a higher median [IQR] %TBSA extent (6.0% [3,15.2] vs. 3.0% [1,7.3],p< 0.0001), a higher proportion with 3rd degree burns (35.4% vs. 28.9%,p<0.0001), and a higher proportion with TBSA >20% (18.2% vs. 6.7%,p<0.0001). Scald/flame injuries were the most frequent mechanism of injury. Women who experienced violence had a higher median [IQR] length of hospital stay (7.0 [2,18] vs. 4.0 [1,11] days, p< 0.0001), ICU stay (8.5 [2,27] vs. 4 [2,13] days,p< 0.0001), and mortality rate (5.7% vs 4.3%,p<0.04). The frequency of women who sustained burn violence appears small yet experience worse outcomes. Clinicians should be aware of these demographic/clinical characteristics to provide optimal care to this vulnerable population.