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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2018

Open Access 01-12-2018 | Research

Towards a more integrated and gender-sensitive care delivery for victims of sexual assault: key findings and recommendations from the Belgian sexual assault care centre feasibility study

Authors: Bavo Hendriks, Anke Marie-Josée Aimé Vandenberghe, Laura Peeters, Kristien Roelens, Ines Keygnaert

Published in: International Journal for Equity in Health | Issue 1/2018

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Abstract

Background

Sexual assault remains a major threat to public health, affecting every gender, gender identity and sexual orientation. Following the Belgian ratification of the Istanbul Convention in 2016, the feasibility of a Belgian sexual assault centre model was investigated, aiming to provide more integrated and patient-centred health and judiciary services to victims of sexual assault. By actively involving health professionals, police and judiciary system representatives, as well as victims themselves, this feasibility study eventually fed into the Belgian Sexual Assault Care Centre model. In this process, this paper assessed current Belgian health services and the degree to which the implementation of this model could contribute to both a more integrated and gender-sensitive care delivery. Findings from this study and the subsequent recommendations aim to contribute to similar reforms in other countries that have already taken or are about to take steps towards an integrated, multi-agency support framework for victims of sexual assault.

Methods

A qualitative, descriptive analysis of the survey response of 60 key health professionals (N = 60) representing 15 major Belgian hospitals was first conducted. Comparing their approach with the international guidelines and standards, a Strengths Weaknesses Opportunities and Threats analysis of the current sexual assault health services and their potential transition to the Sexual Assault Care Centre model was then executed.

Results

Despite adequate equipment, the clear fragmentation of health services and limited follow-up hamper an integrated care delivery in most hospitals. Only three hospitals differentiated their sexual assault care protocol based on the victim’s gender, gender identity and sexual orientation. A striking unawareness among health professionals of sexual assault in male victims, as well as in gender and sexual minorities further hampers a gender-sensitive care delivery.

Conclusions

The Sexual Assault Care Centre model aims to counter most of the current sexual assault health services’ weaknesses and threats hampering an integrated care for victims of sexual assault. Further research and training of health professionals are however required in order to tune this integrated form of care to sexuality and gender-based differences in victims’ already multi-faceted healthcare needs.
Literature
1.
World Health Organisation, United Nations Office on Drugs and Crime. Strengthening the medico-legal response to sexual violence. Geneva: World Health Organisation; 2015.
2.
Delbrouck I. Aanranding van de eerbaarheid en verkrachting. [Indecent assault and rape]. Die Keure: Bruges; 2015. [in Dutch]
3.
Herkes G, Bisschop L, Vandeviver C, Delefortrie D. Male victims of sexual violence, a review of the literature. Ghent: Institute for International Research on criminal policy, Ghent University; 2015.
4.
Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R. The world report on violence and health. Geneva: World Health Organisation; 2002.
5.
Buysse A, Caen M, Dewaele A, Enzlin P, Lievens J, T’Sjoen G, et al. Sexpert, seksuele gezondheid in Vlaanderen. [Sexpert, sexual health in Flanders]. Ghent: Academia Press; 2012. [in Dutch]
6.
D'haese L, Dewaele A, Van Houtte M. Geweld tegenover holebi's - II, een online survey over ervaringen met holebigeweld in Vlaanderen en de nasleep ervan (tweede tussentijds rapport - februari 2014). In: Violence against LGBT – II, an online survey on experiences of LGBT violence in Flanders and its consequences. Antwerp: Steunpunt Gelijkekansenbeleid; 2014. [in Dutch].
7.
Krahé B, Berger A, Vanwesenbeeck I, Bianchi G, Chliaoutakis J, Fernández-Fuertes AA, Fuertes A, Gaspar de Matos M, Hadjigeorgiou E, Haller B, Hellemans S, Izdebski Z, Kouta C, Meijnckens D, Murauskiene L, Papadakaki M, Ramiro L, Reis M, Symons K, Tomaszewska P, Vicario-Molina I, Zygadło A. Prevalence and correlates of young people's sexual aggression perpetration and victimisation in 10 European countries: a multi-level analysis. Cult Health Sex. 2015;17(6):682–99.CrossRef
8.
European Union Agency for Fundamental Rights. European Union lesbian, gay, bisexual and transgender survey: main results. Luxemburg: Publication Office of the European Union; 2014.
9.
Jina R, Thomas LS. Health consequences of sexual violence against women. Best Practice Res. 2013;27(1):15–26.CrossRef
10.
White C. Genital injuries in adults. Best Practice Res. 2013;27(1):113–30.CrossRef
11.
Basile KC, Black MC, Simon TR, Arias I, Brener ND, Saltzman LE. The association between self-reported lifetime history of forced sexual intercourse and recent health-risk behaviors: findings from the 2003 National Youth Risk Behavior Survey. J Adolesc Health. 2006;39(752):e1–7.
12.
Mason F, Lodrick Z. Psychological consequences of sexual assault. Best Practice Res. 2013;27(1):27–37.CrossRef
13.
McLean IA. The male victim of sexual assault. Best Practice Res. 2013;27(1):39–46.CrossRef
14.
Sivakumaran S. Male/male rape and the "taint" of homosexuality. Baltimore: The Johns Hopkins University Press; 2005. p. 1274–306.
15.
Gold SD, Marx BP, Lexington JM. Gay male sexual assault survivors: the relations among internalized homophobia, experiential avoidance, and psychological symptom severity. Behav Res Ther. 2007;45(3):549–62.CrossRef
16.
Bullock CM, Beckson M. Male victims of sexual assault: phenomenology, psychology, physiology. J Amer Acad Psychiatry Law. 2011;39(2):197–205.
17.
Christie N. The ideal victim. In: Fattah EA, editor. From crime policy to victim policy: reorienting the justice system. London: Palgrave Macmillan UK; 1986. p. 17–30.CrossRef
18.
Rowbottom S, Brown D, Cachia P. The male gender role and men’s psychological distress: a review. Soc Psychol Rev. 2012;14(1):16–27.
19.
Larsen ML, Hilden M, Lidegaard Ø. Sexual assault: a descriptive study of 2500 female victims over a 10-year period. BJOG. 2015;122(4):577–84.CrossRef
20.
Light D, Monk-Turner E. Circumstances surrounding male sexual assault and rape: findings from the National Violence against Women Survey. J Interpers Violence. 2009;24(11):1849–58.CrossRef
21.
Motmans J, T’Sjoen G, Meier P. Geweldervaringen van transgender personen in België. [Violence experiences among transgender persons in Belgium]. Steunpunt Gelijkekansenbeleid: Antwerp; 2015. [in Dutch]
22.
Ard KL, Makadon HJ. Addressing intimate partner violence in lesbian, gay, bisexual, and transgender patients. J Gen Intern Med. 2011;26(8):930–3.CrossRef
23.
Rutherford K, McIntyre J, Daley A, Le R. Development of expertise in mental health service provision for lesbian, gay, bisexual and transgender communities. Med Educ. 2012;46(9):903–13.CrossRef
24.
Teram E, Stalker C, Hovey A, Schachter C, Lasiuk G. Towards malecentric communication: sensitizing health professionals to the realities of male childhood sexual abuse survivors. Issues Mental Health Nurs. 2006;27(5):499–517.CrossRef
25.
Hovey A, Stalker CA, Schachter CL, Teram E, Lasiuk G. Practical ways psychotherapy can support physical healthcare experiences for male survivors of childhood sexual abuse. J Child Sexual Abuse. 2011;20(1):37–57.CrossRef
26.
Templeton DJ, Williams A, Healey L, Odell L, Wells D. Male forensic physicians have an important role in sexual assault care. 'A response to "Chowdhury-Hawkins et al. preferred choice of gender of staff providing care to victims of sexual assault in sexual assault referral centers (SARCs)" [journal of forensic and legal medicine. 15 (2008) 363-367]'. J Forensic Legal Med. 2010;17(1):50–2.CrossRef
27.
Khosla R, Say L, Temmerman M. Sexual health, human rights, and law. Lancet. 2015;386(9995):725–6.CrossRef
28.
United Nations General Assembly. Transforming our world: the 2030 agenda for sustainable development. New York City: UN doc.A/RES/70/1; 2015.
29.
World Health Organisation. Guidelines for medico-legal care for victims of sexual violence. Geneva: World Health Organisation; 2003.
30.
World Health Organisation. Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines. Geneva: World Health Organisation; 2013.
31.
32.
National Institute for Health and Care Excellence. CG26 post-traumatic stress disorder, the management of PTSD in adults and children in primary and secondary care. Leicester: Gaskell and The Britisch Psychological Society; 2005.
33.
Workowski KA. Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clin Infect Dis. 2015;61(Suppl 8):S759–62.CrossRef
34.
Eogan M, McHugh A, Holohan M. The role of the sexual assault center. Best Pract Res Clin Obstetr Gynaecol. 2013;27(1):47–58.CrossRef
35.
36.
Vandenberhge A. B-SARC Zorgcentra na seksueel geweld: de rol van zorgverleners in een patiëntgerichte opvang [B-SARC Sexual Assault Care Centres: the role of caregivers in a patient-centred approach]. Ghent: Ghent University; 2016. [in Dutch]
37.
Peeters L. B-SARC Zorgcentra na seksueel geweld: het perspectief van slachtoffers op het huidige zorgaanbod in België en de toekomstige zorgcentra [B-SARC Sexual Assault Care Centres: the perspective of victims on current care and the future care centres in Belgium]. Ghent: Ghent University; 2016. [in Dutch]
38.
39.
Department of Health, Home Office, Association of Chief Police Officers. Revised national service guide: a resource for developing sexual assault referral centers. London: DH/HO/ACPO; 2009. [cited 2018 August 11]. Available from http://​www.​sericc.​org.​uk
40.
Bramsen RH, Elklit A, Nielsen LH. A Danish model for treating victims of rape and sexual assault: the multidisciplinary public approach. J Aggress Maltreat Trauma. 2009;18(8):886–905.CrossRef
41.
Nesvold H, Worm AM, Vala U, Agnarsdottir G. Different nordic facilities for victims of sexual assault: a comparative study. Acta Obstet Gynecol Scand. 2005;84(2):177–83.CrossRef
42.
43.
Greeson MR, Campbell R. Sexual assault response teams (SARTs): an empirical review of their effectiveness and challenges to successful implementation. Trauma Violence Abuse. 2013;14(2):83–95.CrossRef
44.
Campbell R, Patterson D, Lichty LF. The effectiveness of sexual assault nurse examiner (SANE) programs: a review of psychological, medical, legal, and community outcomes. Trauma Violence Abuse. 2005;6(4):313–29.CrossRef
45.
Logan TK, Cole J, Capillo A. Sexual assault nurse examiner program: characteristics, barriers, and lessons learned. J Forensic Nurs. 2007;3(1):24–34.CrossRef
46.
Keygnaert I, Van Impe M, Van Braeckel D. Naar een holistische aanpak van seksueel geweld in België: eindrapport haalbaarheidsstudie centra seksueel geweld. [towards a holistic approach of sexual assault in Belgium: final report of the sexual assault care Centre feasibility study]. Ghent: International Centre for Reproductive Health, Ghent University; 2016. [in Dutch]
47.
Taeymans M, Defour ME, Gengoux V, Marcotte A. Evaluatie van de COL 10/2005 betreffende de Seksuele Agressieset. [evaluation of the COL 10/2005 concerning the sexual aggression set]. Brussels: Dienst voor het Strafrechtelijk Beleid/Service de la Politique criminelle; 2014. [in Dutch]
48.
Ingemann-Hansen O, Charles AV. Forensic medical examination of adolescent and adult victims of sexual violence. Best Pract Res. 2013;27(1):91–102.CrossRef
Metadata
Title
Towards a more integrated and gender-sensitive care delivery for victims of sexual assault: key findings and recommendations from the Belgian sexual assault care centre feasibility study
Authors
Bavo Hendriks
Anke Marie-Josée Aimé Vandenberghe
Laura Peeters
Kristien Roelens
Ines Keygnaert
Publication date
01-12-2018
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2018
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-018-0864-3

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