Browsing by Subject "Sexual violence"

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    How do sexual violence survivors who must share common social spaces and mutual social relationships with their perpetrators represent their navigation of a secondary victimisation?
    (2025) Israel, Jahaan; Bennett, Jane
    This research explores the way sexual violence survivors navigate their experiences of secondary victimisation when they have to share social spaces with their perpetrator(s). Existing literature on secondary victimisation primarily focuses on court processes and psychological impacts, highlighting the ways survivors of sexual violence face re- traumatisation in institutional settings. However, there remains limited research on the daily social realities of survivors, specifically their interactions and shared environments with perpetrators, outside of familial contexts. This dissertation addresses this gap by exploring how survivors of sexual violence experience and make sense of these social dynamics, particularly within the context of secondary victimisation. Using qualitative methods, data were collected through in-depth interviews with seven participants who shared their lived experiences. Key findings include the significant impact re-encountering perpetrators has on the emotional wellbeing of victims, social relationships, and how they perform academically; the non-linear nature of the 'aftermath'; and the manner in which victims find solidarity in survivors that have been through something similar. My interviewees shed light on the way e-spaces can be platforms of empowerment (by giving survivors the chance to find community and a place for them to practice their activism) and/or secondary traumatisation (as there is potential for them to be exposed to perpetrators). This study contributes to a deeper understanding of the lived realities of survivors, emphasising the urgent need for supportive interventions that account for the ongoing risks of shared social spaces.
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    ImpACT+, a coping intervention to improve clinical outcomes for women living with HIV and sexual trauma in South Africa: study protocol for a randomized controlled trial
    (2022-08-18) Sikkema, K J; Rabie, S; King, A; Watt, M H; Mulawa, M I; Andersen, L S; Wilson, P A; Marais, A; Ndwandwa, E; Majokweni, S; Orrell, C; Joska, J A
    Background Addressing sexual trauma in the context of HIV care is essential to improve clinical outcomes and mental health among women in South Africa. Women living with HIV (WLH) report disproportionately high levels of sexual trauma and have higher rates of posttraumatic stress disorder. Adherence to antiretroviral therapy (ART) may be difficult for traumatized women, as sexual trauma compounds the stress associated with managing HIV and is often comorbid with other mental health disorders, further compromising care engagement and adherence. ART initiation represents a unique window of opportunity for intervention to enhance motivation, increase care engagement, and address the negative effects of trauma on avoidant coping behaviors. Mental health interventions delivered by non-specialists in low- and middle-income countries have potential to treat depression, trauma, and effects of intimate partner violence among WLH. This study will examine the effectiveness of Improving AIDS Care after Trauma (ImpACT +), a task-shared, trauma-focused coping intervention, to promote viral suppression among WLH initiating ART in a South African clinic setting. Methods This study will be conducted in Khayelitsha, a peri-urban settlement situated near Cape Town, South Africa. Using a hybrid type 1 effectiveness-implementation design, we will randomize 350 WLH initiating ART to the ImpACT + experimental condition or the control condition (three weekly sessions of adapted problem-solving therapy) to examine the effectiveness of ImpACT + on viral suppression, ART adherence, and the degree to which mental health outcomes mediate intervention effects. ImpACT + participants will receive six once-a-week coping intervention sessions and six monthly maintenance sessions over the follow-up period. We will conduct mental health and bio-behavioral assessments at baseline, 4, 8, and 12 months, with care engagement data extracted from medical records. We will explore scalability using the Consolidated Framework for Implementation Research (CFIR). Discussion This trial is expected to yield important new information on psychologically informed intervention models that benefit the mental health and clinical outcomes of WLH with histories of sexual trauma. The proposed ImpACT + intervention, with its focus on building coping skills to address traumatic stress and engagement in HIV care and treatment, could have widespread impact on the health and wellbeing of individuals and communities in sub-Saharan Africa. Trial registration Clinicaltrials.gov NCT04793217 . Retrospectively registered on 11 March 2021.