Assault and care characteristics of victims of sexual violence in eleven Médecins Sans Frontières programs in Africa. What about men and boys?

PLoS One. 2020 Aug 4;15(8):e0237060. doi: 10.1371/journal.pone.0237060. eCollection 2020.

Abstract

Background: Often neglected, male-directed sexual violence (SV) has recently gained recognition as a significant issue. However, documentation of male SV patients, assaults and characteristics of presentation for care remains poor. Médecins Sans Frontières (MSF) systematically documented these in all victims admitted to eleven SV clinics in seven African countries between 2011 and 2017, providing a unique opportunity to describe SV patterns in male cases compared to females, according to age categories and contexts, thereby improving their access to SV care.

Methods and findings: This was a multi-centric, cross-sectional study using routine program data. The study included 13550 SV cases, including 1009 males (7.5%). Proportions of males varied between programs and contexts, with the highest being recorded in migratory contexts (12.7%). Children (<13yrs) represented 34.3% of males. Different SV patterns appeared between younger and older males; while male children and adolescents were more often assaulted by known civilians, without physical violence, adult males more often endured violent assault, perpetrated by authority figures. Male patients presented more frequently to clinics providing integrated care (medical and psychological) for victims of violence (odds ratio 3.3, 95%CI 2.4-4.6), as compared to other types of clinics where SV disclosure upon admission was necessary. Males, particularly adults, were disproportionately more likely to suffer being compelled to rape (odds ratio 12.9, 95%CI 7.6-21.8).Retention in SV care was similar for males and females.

Conclusions: Patterns of male-directed SV varied considerably according to contexts and age categories. A key finding was the importance of the clinic setup; integrated medical and SV clinics, where initial disclosure was not necessary to access care, appeared more likely to meet males' needs, while accommodating females' ones. All victims' needs should be considered when planning SV services, with an emphasis on appropriately trained and trauma-informed medical staff, health promotion activities and increased psychosocial support.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Africa / epidemiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant
  • Male
  • Men
  • Middle Aged
  • Rape / statistics & numerical data
  • Sex Offenses / statistics & numerical data*
  • Young Adult

Grants and funding

The authors received no specific funding for implementing this study. Publication was supported by the Structured Operational Research and Training Initiative (SORT IT), a global partnership led by the Special Program for Research and Training in Tropical Diseases at the World Health Organization (WHO/TDR). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.