Search results for: sexual health needs

Authors: Dorothy Ebere Adimora

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The study investigated the predictive power of home environment and peer pressure on disruptive behaviour and risky sexual behaviour of Secondary School Class Two Adolescents in Enugu State, Nigeria. The design of the study is a cross sectional survey of correlational study. The study was carried out in the six Education zones in Enugu state, Nigeria. Enugu State is divided into six education zones, namely Agbani, Awgu, Enugu, Nsukka, Obollo-Afor and Udi. The population for the study was all the 31,680 senior secondary class two adolescents in 285 secondary schools in Enugu State, Nigeria in 2014/2015 academic session. The target population was students in SSS.2 senior secondary class two. They constitute one-sixth of the entire student population in the state. The sample of the study was 528, a multi stage sampling technique was employed to draw the sample. Four research questions and four null hypotheses guided the study. The instruments for data collection were an interview session and a structured questionnaire of four clusters, they are; home environment, peer pressure, risky sexual behaviour and disruptive behaviour disorder questionnaires. The instruments were validated by 3 experts, two in psychology and one in measurement and Evaluation in Faculty of Education, University of Nigeria, Nsukka. The reliability coefficient of the instruments was ascertained by subjection to field trial. The adolescents were asked to complete the questionnaire on their home environment, peer pressure, disruptive behaviour disorder and risky sexual behaviours. The risky sexual behaviours were ascertained based on interview conducted on their actual sexual practice within the past 12 months. The research questions were analyzed using Pearson r and R-square, while the hypotheses were tested using ANOVA and multiple regression analysis at 0.05 level of significance. The results of this survey revealed that the adolescents are sexually active in very young ages. The mean age at sexual debut for the adolescents covered in this survey is a pointer to the fact that some of them started engaging in sexual activities long ago. It was also found that the adolescents engage in disruptive behaviour as a result of their poor home environment factors and association with negative peers. Based on the findings, it was recommended that the adolescents should be exposed to enhanced home environment such as parents’ responsiveness, organization of the environment, availability of appropriate learning materials, opportunities for daily stimulation and to offer a proper guidance to these adolescents to avoid negative peer influence which could result in risky sexual behaviour and disruptive behaviour disorder.

Keywords: parenting, peer group, adolescents, sexuality, conduct disorder

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Authors: Saba Nuzhat

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The present ethnographic study examines how domestic violence and authoritative knowledge affect the reproductive health of females; in terms of contraceptive behavior and induced abortion. This qualitative study has been conducted by collecting in depth informal interviews and case studies of 12 female respondents living in an urban slum of Keraniganj, located Dhaka city. The study depicts how multivariable factors are linked to a woman’s ability to contracept and make abortion decisions in a cultural context where being a wife infers to submission, limited mobility, sexual availability, and restricted autonomy on her own reproduction health. This study shows how violence is being normalized and socially acceptable, every time women do not adhere to go through expected gender roles. The study primarily explores the subjective experiences and perceptions of the females about contraceptive behavior as well as abortions from a medical anthropological perspective. A number of salient examples are highlighted into this paper where women who go through abortion or adopt various measures of contraceptives get highly influenced by authoritative knowledge or under the pressure of male dominance. The lack of female autonomy or prevalence of domestic violence challenges the gender equality of Bangladeshi society and female sovereignty in accessing sexual or reproductive rights. This paper remarks the significance of medical anthropological research that helps to understand the intricate interrelationship between authoritative knowledge and male dominance with female reproductive health in order to reduce women’s risk of experiencing domestic violence and to promote reproductive health autonomy for themselves for espousing contraceptive behaviors and abortion decisions.

Keywords: abortion, authoritative knowledge, contraception, domestic violence, reproductive health

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Authors: Avigail Moor

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Sexual violence against women occurs at alarmingly high rates, which have remained steady irrespective of the increased societal awareness of this problem, affecting an upward of 20% of women. It appears that all the public discourse on this topic, including research, prevention programs, and public campaigns have not made a noticeable dent in this prevalence. This calls for new course of action. Raising awareness regarding the preventive role of bystanders might be it. To that end, the present study sought to establish what promotes bystander intervention and what hinders it. Three hundred and twenty-four men and women, ranging in age from 20-40, participated in this study, completing self-report questionnaires on the topics under investigation. Results indicated that the proclivity to intervene as a bystander is impacted by various factors. The most consequential among them is gender, with twice as many women as men, 70% vs 38% respectively, being positively inclined to take action in such cases. Other significant factors included belief in rape myths and having empathy towards perpetrators, which reduced the likelihood of bystander intervention. Holding the attitude that it is possible to freely consent to sex while intoxicated had a similar impact. The discussion addresses various preventive implications.

Keywords: bystander intervention, sexual assault, rape prevention, rape myths

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Authors: Adekeye Joshua Temitope

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“Transgender” presents a complexion of ambiguity in the African context and it remains a contested topography in the discourse of sexual identity. The casts and stigmatisations towards transgender unveils vital facts and intricacies often ignored in the academic communities; the problems and oppressions of given sex/gender system, the constrain of monogamy and ignorance of fluidity of human sexuality thereby generating dual discords of “enforced heterosexual” and “unavoidable homosexual.” The African culture voids transgender movements and perceive same-sex sexual behavior as “taboo or bad habits” and this provide reasonable explanations for the failure of asserting for the sexual rights in GLBT movement in most discourse on sexuality in the African context. However, we could not deny the real existence of active flowing and fluidity of human sexuality even though its variants could be latent. The incessant consciousness of the existence of transgender practices in Africa either in form of bisexual desire or bisexual behavior with or without sexual identity, including people who identify themselves as bisexual opens up the vision for us to reconsider and reexamine what constitutes such ambiguity and controversy of transgender identity at present time. The notion of identity politics in gay, lesbian, and transgender community has its complexity and debates in its historical development. This paper analyses the representation of the historical trajectory of transgender practices by presenting the dynamic transition of how people cognize transgender practices under different historical conditions since the understanding of historical transition of bisexual practices would be very crucial and meaningful for gender/sexuality liberation movement at present time and in the future. The paper did a juxtaposition of the trajectories of bisexual practices between Anglo-American world and Africa, as it has certain similarities and differences within diverse historical complexities. The similar condition is the emergence of gay identity under the influence of capitalism but within different cultural context. Therefore, the political economy of each cultural context plays very important role in understanding the formation of sexual identities historically and its development and influence for the GLBT movement afterwards and in the future. By reexamining Kinsey’s categorization and applying Klein’s argument on individual’s sexual orientation this paper is poised to break the given and fixed connection among sexual behavior/sexual orientation/sexual identity, on the other hand to present the potential fluidity of human sexuality by reconsidering and reexamining the present given sex/gender system in our world. The paper concludes that it is obligatory for the essentialist and exclusionary trend at this historical moment since gay and lesbian communities in Africa need to clearly demonstrate and voice for themselves under the nuances of gender/sexuality liberation.

Keywords: heterosexual, homosexual, identity politics, queer politics, transgender

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Authors: Marybec Griffin

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Purpose: The purpose of this cross-sectional study was to get a better understanding of healthcare usage and satisfaction among young adult gay men (YAGM), including the facility used as the usual source of healthcare, preference for coordinated healthcare, and if their primary care provider (PCP) adequately addressed the health needs of gay men. Methods: Interviews were conducted among n=800 YAGM in New York City (NYC). Participants were surveyed about their sociodemographic characteristics and healthcare usage and satisfaction access using multivariable logistic regression models. The surveys were conducted between November 2015 and June 2016. Results: The mean age of the sample was 24.22 years old (SD=4.26). The racial and ethnic background of the participants is as follows: 35.8% (n=286) Black Non-Hispanic, 31.9% (n=225) Hispanic/Latino, 20.5% (n=164) White Non-Hispanic, 4.4% (n=35) Asian/Pacific Islander, and 6.9% (n=55) reporting some other racial or ethnic background. 31.1% (n=249) of the sample had an income below $14,999. 86.7% (n=694) report having either public or private health insurance. For usual source of healthcare, 44.6% (n=357) of the sample reported a private doctor’s office, 16.3% (n=130) reported a community health center, and 7.4% (n=59) reported an urgent care facility, and 7.6% (n=61) reported not having a usual source of healthcare. 56.4% (n=451) of the sample indicated a preference for coordinated healthcare. 54% (n=334) of the sample were very satisfied with their healthcare. Findings from multivariable logistical regression models indicate that participants with higher incomes (AOR=0.54, 95% CI 0.36-0.81, p < 0.01) and participants with a PCP (AOR=0.12, 95% CI 0.07-0.20, p < 0.001) were less likely to use a walk-in facility as their usual source of healthcare. Results from the second multivariable logistic regression model indicated that participants who experienced discrimination in a healthcare setting were less likely to prefer coordinated healthcare (AOR=0.63, 95% CI 0.42-0.96, p < 0.05). In the final multivariable logistic model, results indicated that participants who had disclosed their sexual orientation to their PCP (AOR=2.57, 95% CI 1.25-5.21, p < 0.01) and were comfortable discussing their sexual activity with their PCP (AOR=8.04, 95% CI 4.76-13.58, p < 0.001) were more likely to agree that their PCP adequately addressed the healthcare needs of gay men. Conclusion: Understanding healthcare usage and satisfaction among YAGM is necessary as the healthcare landscape changes, especially given the relatively recent addition of urgent care facilities. The type of healthcare facility used as a usual source of care influences the ability to seek comprehensive and coordinated healthcare services. While coordinated primary and sexual healthcare may be ideal, individual preference for this coordination among YAGM is desired but may be limited due to experiences of discrimination in primary care settings.

Keywords: healthcare policy, gay men, healthcare access, Affordable Care Act

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Authors: Piyanee Khumpao

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Under the Thai Penal Code and Customs Act, sex toys are criminalized and completely prohibited through the legal interpretation as obscene objects by law enforcement, despite there is no explicit legal sanction against them. The purpose of preventing people from accessing sex toys is to preserve public morals. However, sex toys are still available, exposed, and sold publicly in main cities throughout Thailand. They are easily observed by people of any age. This paper argues that sexuality is human nature and human right. Human deserves sexual pleasure as long as getting sexual pleasure does not inflict any harm on others. Using sex toys in private (individually and/or as a couple with mutual consent) does not constitute any harm nor degrade public moral. Therefore, the complete ban of sex toys shall be lifted and decriminalized. Nevertheless, the economic analysis illustrates that criminalization and prohibition of sex toys would lead to its black market – higher price and lower quantity. Although it is socially desirable to have fewer sex toys in the market, there will usually be high demand for them because sexual pleasure is natural and, hence, people have a lower price elasticity of demand for such things, including pornography. Thus, its deterrent effect is not very effective. Moreover, sex toys vendors still always exist because higher price incentivizes them to act illegally and may gain benefits from selling low-quality sex toys. Consequently, consumers do not have a choice to select high-quality sex toys at a reasonable price. Then, they are forced to purchase low quality sex toys at a higher price. They also may suffer from health issues as well as other harms from its dangerous/toxic substances since lower quality products are manufactured poorly to save costs. A law and economics approach supports the decriminalization of sex toys in Thailand. Other measures to control its availability shall be adopted to protect the vulnerable, such as children. Options are i) zoning or regulation on-premises selling sex toys as in Singapore, Japan, and China, ii) regulations of sex toys as medical apparatus like in the state of Alabama, and iii) the prevention of sex toys exposure in the real (physical) appearance (i.e., allowing virtual exposure of sex toys) like in India.

Keywords: human nature, law and economics approach, sex toys, sexual pleasure

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Authors: Todd G. Morrison, C. J. Bishop, Melanie A. Morrison

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An upsurge of hatred directed at sexual- and gender-marginalized persons (SGMPs) has been documented in numerous Western nations. The denial of gender-affirmative care for trans youth; the banning of books containing queer content (no matter how innocuous); the boycotting of products affiliated with queer influencers and with pride celebrations; and the silencing of sexual- and gender-marginalized teachers and academics (and their allies) constitute key ways in which this hatred now manifests itself. The health consequences for SGMPs living in environments characterized by hatred of queer people include elevated rates of depression, anxiety, suicidality, and substance misuse. Given these sequelae, in this paper, the authors outline the challenges that academics experience when adopting an advocacy role. The authors also provide an overview of specific strategies that SGMPs may find helpful when engaging with persons committed to harming queer people.

Keywords: queer people, resistance, minority rights, hate speech

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Authors: Mukondi Nethavhakone

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The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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Authors: Anusha Edirisinghe

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Sexual Gender based violence is a most common social phenomenon in higher education institutions. It has become a hidden crime of the Universities. Masculinities norms and attitudes are more influential and serve as key drivers and risk for ragging and SGBV. This research will reveal that in Sri Lankan universities, SGBV takes from the violence and murder of women students, assault and battery coerced sex, sexual harassment including harassment via information technology. This study focus is to prevention of ragging and SGBV in University system. Main objective of this paper describes and critically analyses of plight of ragging and SGBV in higher education institutions and legal and national level policy implementation to prevent these crimes in society. This paper is with special reference to ragging case from University of Kelaniya 2016. University Grant commission introduced an Act for the prevention of Ragging and gender standing committee established in Sri Lanka in 2016. And each university has been involved in the prevention of SGBV and ragging in higher education institutions. Case study from first year female student, reported sexual harassment was reported to the police station in May in 2016. After this case, the university has been implementing emergency action plan, short term and long term action plan. Ragging and SGBV task force was established and online complaint center opened to all students and academic and non- academics. Under these circumstances student complained to SGBV and other harassment to the university. University security system was strong support with police and marshals, and vigilant committees including lecturers. After this case all universities start to several programmes to stop violence in university

Keywords: higher Education, ragging, sexual gender-based violence, Sri Lanka

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Authors: Shakila Singh

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This research was conducted at a selected South African university campus with women students who drink alcohol. The purpose of the study was to examine their perspectives on the role of alcohol in their lives, their understandings about women’s vulnerability to alcohol-related sexual risk and their strategies against these. The study draws on feminist principles and practices to challenge gendered inequalities that legitimate and facilitate violence against women. Recognising the danger of focusing on risk management in ways that place the burden of responsibility entirely on young women to prevent their violation, this article focuses on women students’ agency in managing risk while taking up opportunities for self-discovery. Participation was voluntary, and a student-researcher administered an open-ended questionnaire to 55 participants. The findings suggest that young women position alcohol- use as a common activity at university, and that it gives them much pleasure. They recognise that it is riskier for women and articulate valuable strategies to manage the risk to their sexual safety when drinking. These include drinking within supportive networks, avoiding financial dependence, and managing their alcohol intake. This article argues that alcohol at university is an integral part of expressions of gender and sexuality and that risk-taking is a normal part of university students’ lives. Consequently, arguments about equality need to consider risk-taking as part of young people’s lives and promote ways of managing alcohol-related risks, rather than imagining that alcohol can be avoided entirely.

Keywords: alcohol-related sexual risk, drinking at university, managing risk, women students

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Authors: Rebekah Volgin, Jane Shakespeare-Finch, Ian Shochet

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Commercial sexual exploitation (CSE) and sex trafficking affect between 5000-7000 girls and women in Nepal each year and can have devastating physical and psychological consequences. Much research has documented these effects, however, there is no published longitudinal research that focuses on whether healing and growth outcomes are possible for survivors of CSE and sex trafficking. The narratives of 27 girls and women (13-22 years) were taken at two-time points during participation in a six-week group psychoeducation and art therapy program which was delivered across three NGO’s in Kathmandu, Nepal. These narratives form part of a larger ethnographic project. Thematic analysis of the data was undertaken. Themes emerging from time point 1 were: psychological distress in the form of anxiety and grief over loss of family, psychosomatic symptoms, empathy and compassion, and posttraumatic growth (PTG) in the form of new possibilities, relating to others and personal strength. Posttraumatic growth refers to positive changes in the aftermath of trauma. The themes emerging from time point 2, were: empathy and compassion and PTG (cognitive restructuring, new possibilities, relating to others and personal strength). Alongside the distress that these participants experienced, they also experienced positive outcomes such as empathy and compassion and psychological growth. Future research would advance knowledge by further examining the process of PTG in this population, if the changes observed were lasting, and if so, ways in which PTG can be facilitated or promoted.

Keywords: commercial sexual exploitation, human trafficking, posttraumatic growth, sexual trauma

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Authors: Humphrey Atwijukiire, Gladys Nakidde, Anne Tweheyo Otwine, Jane Kabami

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Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda Introduction: Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. This study explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Methods: We conducted 12 in-depth interviews using translated interview guide, and audio recorders. Participants were purposively enrolled in the study. The study was conducted at three public health facilities in Mbarara City. Data was analyzed using thematic content analysis. Approval for this research was obtained from Mbarara University Research Ethics Committee and administrative clearance from city clerk of Mbarara City. Results: The mean age of participants was 38 years. An equal number of males (six) and females participated. Most of them had at least secondary level education, only three had primary education. Experienced benefits of HIV serostatus disclosure included: social support and care; decisions regarding health, fertility, and child bearing; sharing information on HIV prevention and protection; positive living; and, ease of HIV disclosure. The challenges included: misunderstandings in the families. Conclusion: Socially, psychologically and financially PLWHIV have benefited from their negative partners. Health wise, they have been supported, and cared for, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Keywords: discordant couples, disclosure, experiences, HIV

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Authors: Aminreza Koohestani

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This paper intends to explore the existing safeguards available within the Iranian law in protecting refugees affected by Sexual and Gender-Based Violence (SGBV). The Iranian law afforded protection for women and girls against SGBV is scattered across various bodies of law. Moreover, the degree of protection provided by the law varies greatly from one type of SGBV to another. The paper discusses the scope of applicability of Iranian laws to refugees affected by SGBV as well as substantive and procedural laws afforded protection for survivors of SGBV.

Keywords: Iran, law, violence, women

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Authors: Ingrid van der Heijden, Kristen Dunkle, Rachel Jewkes

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Background: Emerging literature on prevalence shows that men with disabilities are four more times likely than men without disabilities to experience sexual violence during their lifetime. However, compared to women with disabilities, men with disabilities still have lesser experiences of violence. While empirical evidence on the prevalence of victimization of men with disabilities is emerging, there is scarcer evidence highlighting disabled men’s perpetration of different forms of violence, particularly intimate partner violence. We can assume that men are likely to be both perpetrators and victims of violence, making more complex the causes and risks of violence. Gender norms and disability stigma play important roles in men’s experiences of violence. Men may be stigmatized because of their inability to attain hegemonic masculine ideals of strength, control over women and sexual conquest, which makes them more susceptible to emotional, physical and sexual abuse. Little to no evidence exists of men with disabilities’ experiences of perpetration of intimate partner violence, family violence or community violence. So far studies on male victimization do not succeed to offer contextual evidence that would highlight why and how men with disabilities perpetrate and/or are victims of sexual or other forms of violence. Objective: The overall aim to highlight men with disabilities’ experiences of both victimization and perpetration, and how living up to normative and hegemonic ideals of masculinity and ‘ability’ shape their experiences. It will include: identifying how gender and impairments intersect and shape their experiences of violence; identifying the contexts of and risks for violence; identifying the impacts and consequences of violence on their lives (including mental health impacts), and identifying obstacles and enablers to support and interventions to prevent violence. Methodology: In-depth qualitative interviews with 20 men with disabilities participating in interventions conducted by the What Works Global Programme for violence prevention (DIFD) in Africa and Asia. Men with a range of disabilities will be invited to share their lifetime experiences of violence. Implications for Practice: The data from this study will be used to start thinking about strategies to include men with disabilities in violence prevention strategies for both men and women. Limitations: Because men will be participating in interventions, it is assumed that they will not have severe impairments that hamper their cognitive or physical ability to participate in the intervention activities - and therefore will be able to participate in the in-depth interviews. Of course, this is a limitation of the study as it does not include those men with severe disabilities – measured by the World Health Organization’s International Classification of Functioning - who may be more vulnerable and at higher risk of experiencing violence, and who are less likely to be able to access services and interventions.

Keywords: gender, men with disabilities, perpetration of violence, victimization

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Authors: Kathleen Canul

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Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

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Authors: Alan Collins

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This study explains how The People’s Tribunal empowered survivors of child abuse. It examines how People’s tribunals can be effective mean of empowerment; the challenges of empowerment – expectation v. reality; the findings and how they reflect other inquiry findings; and the importance of listening and learning from survivors. UKCSAPT “The People’s Tribunal” was established by survivors of child sex abuse and members of civil society to investigate historic cases of institutional sex abuse. The independent inquiry, led by a panel of four judges, listened to evidence spanning four decades from survivors and experts. A common theme throughout these accounts showed that a series of institutional failures prevented abuse from being reported; and that there are clear links between children being rendered vulnerable by these failures and predatory abuse on an organised scale. It made a series of recommendations including the establishment of a permanent and open forum for victims to share experiences and give evidence, better links between mental health services and police investigations, and training for police and judiciary professionals on the effects of undisclosed sexual abuse. The main findings of the UKCSAPT report were:-There are clear links between children rendered vulnerable by institutional failures and predatory abuse on an organised scale, even if these links often remain obscure. -UK governmental institutions have failed to provide survivors with meaningful opportunities for either healing or justice. -The vital mental health needs of survivors are not being met and this undermines both their psychological recovery and access to justice. -Police and other authorities often lack the training to understand the complex reasons for the inability of survivors to immediately disclose a history of abuse. -Without far-reaching changes in institutional culture and practices, the sexual abuse of children will continue to be a significant scourge in the UK. The report also outlined a series of recommendations for improving reporting and mental health provision, and access to justice for victims were made, including: -A permanent, government-funded popular tribunal should be established to enable survivors to come forward and tell their stories. -Survivors giving evidence should be assigned an advocate to assist their access to justice. -Mental health services should be linked to police investigations to help victims disclose abuse. -Victims who fear reprisals should be provided with a channel though which to give evidence anonymously.

Keywords: empowerment, survivors, sexual, abuse

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Authors: Margaret Schmuhl, Michelle Cubellis

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Violence against women (VAW) is a widespread social problem affecting nearly two million women in the United States each year. Recently, feminist criminologists have sought to examine patriarchy as a guiding framework for understanding violence against women. Literature on VAW often examines measures of structural gender equality, often overlooking ideological patriarchy which is necessary for structural inequality to remain unchallenged. Additionally, empirical literature generally focuses on extreme forms of VAW, rape, and femicide, often neglecting more common types of violence. This literature, under the theoretical guidance of the Liberal, Radical, and Marxist feminist traditions, finds mixed support for the relationship of patriarchy and VAW. Explanations for these inconsistencies may include data availability, and the use of different operationalizations of structural patriarchy. Research is needed to examine fuller operationalizations of patriarchy in social institutions and to extend this theoretical framework to the criminal justice response to VAW (i.e., clearance rates). This study examines sexual violence clearance rates under the theoretical guidance of these feminist traditions using incident- and county-level data from National Incident Based Reporting System and other sources in multilevel modelling. The findings suggest mixed support for the feminist hypotheses and that patriarchy and gender equality differentially affect arrest clearance rates and clearance through exceptional means for sexual violence.

Keywords: clearance rates, gender equality, multilevel modelling, patriarchy, sexual victimization, violence against women

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Authors: Safak Akdemir

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The main purpose of this research is to evaluate the relationships between childhood traumas and dissociative experiences, self-perceptions and early maladaptive schemas in male convicts convicted of sexual assault crimes in prison. In our study, male convicts in prison for the crime of sexual assault constitute the experimental group, and the participants matched with this experimental group in terms of education, age and gender constitute the control group. The experimental group of the research consists of 189 male individuals who are convicted in the Ministry of Justice, General Directorate of Prisons, Istanbul/Maltepe L Type Closed Prison. The control group of this study consists of 147 adult males matched with the experimental group in terms of age, gender and education parameters. A total of 336 adult male individuals are included in the sample of this study. 46% of the experimental group were convicted of only sexual assault, 54% of them were convicted of both sexual assault and murder, injury and drug crimes. Total of five data collection tools, namely the Personal Information Form created by S. A. & E. O., Childhood Trauma Questionnaire (CTQ), the Dissociative Experiences Scale (DES), the Rosenberg Self-Esteem Scale (RSES), and the Young Schema Questionnaire-Short Form (YSQ-SF3), were completed. DES cut-off score of 99 (52.39%) of 189 convicts in the experimental group and 12 (8.17%) of 147 people in the control group was found to be 30 and above, and this result indicates the presence of pathological dissociative experiences. 180 (95.23%) of the sexual assault convicts in the experimental group had at least one childhood trauma, 154 (81.48%) were emotional neglect, 140 (74.07%) were emotional abuse, 121 (64.02%) were physical neglect, 91 (4814%) physical abuse and 70 (37.03%) sexual abuse. 168 (88.88%) of the experimental group reported multiple type of trauma and 12 (6.34%) reported single type of trauma. While the childhood traumas, isolation, abandonment and emotional deprivation schema levels of the convicts with a DES cut-off score of 30 and above are higher than the convicts with a DES cut-off score of 30 and above, their self-esteem is lower than this group. Experimental group while childhood traumas, dissociative experiences and early maladaptive schemas are higher than the control group, their self-esteem levels are lower. Dissociative experiences, abandonment and emotional deprivation early maladaptive schemas are more common in convicts aged between 18-30 years compared to convicts aged 31 and over. In addition, dissociative experiences and early maladaptive schemas of male convicts who reported physical and sexual abuse were higher than those who did not report physical and sexual abuse, while their self-esteem was at a lower level. As a result, in terms of psychotraumatology and clinical forensic psychology, dissociative disorders developed under the influence of chronic childhood traumas, with clinical interviews and psychometric measurements to be made in terms of forensic psychiatry; it is of fundamental importance to evaluate it in terms of neurosis-psychosis distinction, disability retirement, custody, malpractice, criminal and legal capacity criteria.

Keywords: crime, sexual assault, criminology, rape crimes, dissocitative disorders, maladative schemas

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Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

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Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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Authors: Nabil Mohammed Nasser Salem

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International advertisements targeting the Arab world are usually modified to be compatible with the conservative culture in many Arab countries. The portrayal of female models in international advertisements in Arab magazines avoids direct sexual representation. Arab culture is guided by religious teachings and social restrictions that prohibit the display of many parts of the female body. Exposure of shoulders, arms, armpits, cleavage, legs, thighs, etc., of the female body is usually avoided in international advertisements published in Arab magazines. Exposure to parts of the female body other than the face and hands may be considered offensive in many parts of Arab countries. Although extensive research has been conducted on Arabic advertisements, to our best knowledge, there are no publications in the literature that address the recent changes in the visual sign system in international advertisements in Arab magazines using semiotics as a research method. The present study aims to analyze the changes in the visual sign system of international advertisements published in Arab magazines that promote female fragrances. It tries to analyze the differences in the sexual representations of the same female models in some selected advertisements during different periods. The magazines are randomly selected from the period between 2000 and 2019. The selection of magazines is based on their availability and popularity. The study focuses on the Dior Jadore ads because they reflect important changes in the appearance of the same female model between 2000 to 2019. The result of the study shows important changes in the sexual representation of the same female body. The Dior Jadore advertisement in 2000 shows only the head of the female model. The model is modestly portrayed and shows clear cultural and religious restrictions on the sexual representation of the female body. The result shows that the same female model is portrayed differently in the Dior Jadore advertisement from the period 2005 to 2019. These versions of advertisements show more parts of the female body that are covered in the older versions and show stronger sexual representations. The study is an important contribution as it fills an important gap in the literature by extending semiotic research to the study of recent visual changes in the sign system of international advertisements published in Arab magazines during an important period in the history of international advertisement targeting the Arab world, as they reflect changes in the sexual representation of female models.

Keywords: Arab magazine, female body, international advertisements, semiotics, sexual representation

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Authors: Chang Li Yu

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Resistances commonly happened during sexual offenders treatment program (SOTP), and removing resistances was one of the treatment goals on it. Studies concerning treatment effectiveness relied on pre- and post-treatment evaluations, however, no significant difference on resistance revealed after treatment, and the above consequences generally contributed to the low motivation for change instead. Therefore, the aim of this study was to investigate the resistance across each stage of change among sexual offenders (SO). The present study recruited prisoned SO in Taiwan, excluding those with literacy difficulties; finally, 272 participants were included. Of all participants completed revised version of URICA (University of Rhode Island Change Assessment) and resistance scale specifically for SO. The former included four stages of change: pre-contemplation (PC), contemplation (C), action (A), and maintain (M); the later composed eight types of resistance: system blaming, victims blaming, problems with treatment alliance, social justification, hopelessness, isolation, psychological reactance, and passive reactance. Both of the instruments were with well reliability and validity. Descriptive statistics and ANOVA were performed. All of 272 participants, age under 25 were 18(6.6%), 25-39 were 133(48.9%), 40-54 were 102(37.5%), and age over 55 were 19(7.0%); college level and above were 53(19.5%), high school level were 110(40.4%), and under high school level were 109(40.1%); first offended were 117(43.0%), and recidivist were 23(8.5%). Further deleting data with missing values and invalid questionnaires, SO with stage of change on PC were 43(18.9%), C were 109(47.8%), A were 70(30.7%), and on M were 6(2.6%). One-way ANOVA showed significant differences on every kind of resistances, excepting isolation and passive reactance. Post-hoc analysis showed that SO with different stages had their main resistance. There are two contributions to the present study. First, this study provided a clinical and theoretical measurement of evaluation that was never used in the past. Second, this study used an evidence-based methodology to prove a clinical perspective differed from the past, suggesting that resistances to treatment on SO appear the whole therapeutic process, when SO progress into the next stage of change, clinicians have to deal with their main resistance for working through the therapy.

Keywords: resistance, sexual offenders treatment program (SOTP), motivation for change, prisoned sexual offender

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Authors: O. E. Eberechi, G. P. Stevens

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Legal theory has been referred to as the explanation of why things do or do not happen. It also describes situations and why they ensue. It provides a normative framework by which things are regulated and a foundation for the establishment of legal mechanisms/institutions that can bring about a desired change in a society. Furthermore, it offers recommendations in resolving practical problems and describes what the law is, what the law ought to be and defines the legal landscape generally. Some legal theories provide a universal standard, e.g. human rights, while others are capable of organizing and streamlining the collective use, and, by extension, bring order to society. Legal theory is used to explain how the world works and how it does not work. This paper will argue for the application of the principles of legal theory in the achievement of access to justice for female victims of sexual violence in refugee camps in Africa through the analysis of legal theories underpinning the access to justice for these women. It is a known fact that female refugees in camps in Africa often experience some form of sexual violation. The perpetrators of these incidents may never be apprehended, prosecuted, convicted or sentenced. Where prosecution does occur, the perpetrators are either acquitted as a result of poor investigation, inept prosecution, a lack of evidence, or the case may be dismissed owing to tardiness on the part of the prosecutor, which accounts for the culture of impunity in refugee camps. In other words, victims do not have access to the justice that could ameliorate the plight of the victims. There is, thus, a need for a legal framework that will facilitate access to justice for these victims. This paper will start with an introduction, and be followed by the definition of legal theory, its functions and its application in law. Secondly, it will provide a brief explanation of the problems faced by female refugees who are victims of sexual violence in refugee camps in Africa. Thirdly, it will embark on an analysis of theories which will be a help to an understanding of the precarious situation of female refugees, why they are violated, the need for access to justice for these victims, and the principles of legal theory in its usefulness in resolving access to justice for these victims.

Keywords: access to justice, underpinning legal theory, refugee, sexual violence

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Authors: Sunha Ahn

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Intimate relationships have constructed our embodied experiences and emotional memories, which can become grounded as practical knowledge to some extent and play a critical role in social medicine, particularly, in our well-being and mental health. In South Africa, such relational factors are significant for young women and girls in their emotional development period of time, especially, working as the existence of social and relational pressures over feminine sexual health and choices. This, in turn, brings about the absence/lack of communication in intimate relationships, especially with their parents, which leads to a vicious cycle in sexual health behaviour choices. Drawing upon sociological and socio-anthropological understandings of HIV-related issues, this study provides narrative threads of evidence about South African teenage mothers from early-dating debuted to HIV infection. Their stories consist of a visualised figure in chronicle order, illustrating embodied journeys of sexual health choices surrounding uncommunicative relationships and socially-suppressive environments. Methodologically, this qualitative study explored data from mixed online methods: 1) a case study analysing online comments (N = 12,763) on the South African Springster's website, run by the UK-based NGO, namely, Girl Effect; and 2) In-depth online interviews (N = 21) were conducted with young SA women and girls (16-28 ages) recruited in Cape Town, Pretoria, and Johannesburg, SA. Participants consist of both those living with HIV and without. Ethical approval was gained via the College of Social Sciences Ethical Committee at the University of Glasgow, and informed consent was obtained verbally and in writing from participants in due course. Data were thematically applied to an iteratively developed codebook and analysed. There are three kinds of typical pressures as relational factors for them, including peer pressure, partners or boyfriends, and parents’ reactions. Under the patriarchal and religious-devoted social atmospheres, these relationships work as a source of scaredness among young women and girls who could not talk about their sexual health concerns and rights. Such an inability to communicate with intimate relationships, eventually, emerges as a perpetuated or taken-for-granted social environment in South Africa, insistently leading to an increase in unwanted pregnancies or new HIV infections in young South African women and girls. In this sense, this study reveals the pressing need for open communication between generations with accurate information about HIV/AIDS. This also implies that the sociological feminist praxes in South Africa would help eliminate HIV-related stigma as well as construct open space to reduce gender-based violence and sexually-transmitted infection. Ultimately, this will be a road for supporting sexually healthy decisions and well-being across South African generations.

Keywords: HIV, young women, South Africa, intimate relationships, communication, social medicine

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Authors: Søren Birkvad

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This paper traces the development of sexual cinematic freedom in the wake of an epoch-making event in Danish cultural history. As the first in the world, the Danes abolished all censorship for adults in 1969, making the tiny nation of Denmark the world’s largest exporter of pornography for several years. Drawing on the insights of social and cultural history and the focus point of the National Cinema direction of Cinema Studies, this study focuses on Danish film pornography in the 1960s and 1970s in its own right (e.g., its peculiar mix of sex, popular comedy and certain ‘feminist’ agendas). More importantly, however, it covers a broader pattern, namely the culturally deep-rooted tradition of freedom of speech and sexual liberalism in Denmark. Thus, the key concept of frisind (“free mind”) in Danish cultural history took on an increasingly partisan application in the 1960s and 1970s. It became a designation for all-is-permitted hippie excess but was also embraced by dissenting movements on the left, such as feminism, which questioned whether a free mind necessarily meant free love. In all of this, Danish cinema from the 1960s and 1970s offers a remarkable source of historical insight, simultaneously reminding us of a number of acute issues of contemporary society. These issues include gendered ideas of sexuality and freedom then and now and the equivalent clash of cultures between a liberal commercial industry and the accelerating political demands of the “sexual revolution.” Finally, these issues include certain tensions between, on the one hand, a purely materialistic idea of sexual freedom – incarnated by anything from pornography to many of the taboo-breaking youth films and avant-garde films in the wake of the 1968-rebellion – and, on the other hand, growing opposition to this anti-spiritual perception of human sexuality (represented by for instance the ‘closet conservatism’ of Danish art film star Lars von Trier of nowadays). All in all, this presentation offers a reflection on ideas of sexuality and gender rooted in a unique historical moment in cinematic history.

Keywords: Danish film history, cultural history, film pornography, history of sexuality, national cinema, sexual liberalism

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Authors: Sofia Mariani, Irene Leo

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The objective of the present study is to define the mediating role of attitudes that objectify and devalue women (hostile sexism, benevolent sexism, and sexual objectification of women) in the indirect correlation between exposure to televised sports and acceptance of rape myths. A second goal is to contribute to research on the topic by defining the role of mediators in exposure to different types of sports, following the traditional gender classification of sports. Data collection was carried out by means of an online questionnaire, measuring television sport exposure, sport type, hostile sexism, benevolent sexism, and sexual objectification of women. Data analysis was carried out using IBM SPSS software. The model used was created using Ordinary Least Squares (OLS) regression path analysis. The predictor variable in the model was television sports exposure, the outcome was rape myths acceptance, and the mediators were (1) hostile sexism, (2) benevolent sexism, and (3) sexual objectification of women. Correlation analyses were carried out dividing by sport type and controlling for the participants’ gender. As seen in existing literature, television sports exposure was found to be indirectly and positively related to rape myth acceptance through the mediating role of: (1) hostile sexism, (2) benevolent sexism, and (3) sexual objectification of women. The type of sport watched influenced the role of the mediators: hostile sexism was found to be the common mediator to all sports type, exposure to traditionally considered feminine or neutral sports showed the additional mediation effect of sexual objectification of women. In line with existing literature, controlling for gender showed that the only significant mediators were hostile sexism for male participants and benevolent sexism for female participants. Given the prevalence of men among the viewers of traditionally considered masculine sports, the correlation between television sports exposure and rape myth acceptance through the mediation of hostile sexism is likely due to the gender of the participants. However, this does not apply to the viewers of traditionally considered feminine and neutral sports, as this group is balanced in terms of gender and shows a unique mediation: the correlation between television sports exposure and rape myth acceptance is mediated by both hostile sexism and sexual objectification. Given that hostile sexism is defined as hostility towards women who oppose or fail to conform to traditional gender roles, these findings confirm that sport is perceived as a non-traditional activity for women. Additionally, these results imply that the portrayal of women in traditionally considered feminine and neutral sports - which are defined as such because of their aesthetic characteristics - may have a strong component of sexual objectification of women. The present research contributes to defining the association between sports exposure and rape myth acceptance through the mediation effects of sexist attitudes and sexual objectification of women. The results of this study have practical implications, such as supporting the feminine sports teams who ask for more practical and less revealing uniforms, more similar to their male colleagues and therefore less objectifying.

Keywords: television exposure, sport, rape myths, objectification, sexism

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Authors: Zaid Haris

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Since the beginning of time, transgender people have faced difficult circumstances, particularly in Pakistan. They have experienced discrimination, physical abuse, sexual assault, and murder in their lives. In response to their complaints, the Pakistani Supreme Court established a landmark that enables them to participate in society on an equal base. As a result, transgendered people living all around Pakistan have seen their legal, political, and cultural advocacy blossom since 2009. In order to provide and defend the human rights of Pakistan's transgender persons, this paper aims to identify and analyse the constitutional and legal framework set out there. The Supreme Court's momentous decision sparked legal reform in the nation for these rights, most notably the Transgender Persons (Protection of Rights) Act of 2017, a bill that was filed in Parliament. The implementation of the rights granted to transgender people in Pakistan, whether it relates to education, health, or any other area, requires close inspection. Additionally, for society to be accepting and inclusive, a significant and radical change in behaviour is required. This paper also includes the interviews of a few transgenders from Pakistan.

Keywords: discrimination, islam, pakistan, physical abuse, sexual assault, transgenders

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Authors: Susanna Menis

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The context of this study revolves around the theme of consent and the construction of unlawfulness in judicial decisions. It aims to explore the formation of societal perceptions of unlawfulness within the context of consensual sexual acts leading to harmful consequences. This study investigates how judges create legal rules that reflect social solidarity and protect against violence. Specifically, the research aims to understand the justification behind criminalising consensual sexual activity when categorised under different offences. The main question addressed in this study will evaluate the way judges create legal rules that they believe reflect social solidarity and protect against violence. The study employs a historical genealogy approach as its methodology. This approach allows for tracing back the original formation of societal perspectives on unlawfulness, thus highlighting the socially constructed nature of the present understanding. The data for this study will be collected through an extensive literature review, examining historical legal cases and documents that shape the understanding of unlawfulness. This will provide a comprehensive view of how social attitudes toward private sexual relations influenced the creation of legal rules. The theoretical importance of this research lies in its contribution to socio-legal scholarship. This study adds to the existing knowledge on the topic by exploring questions of unconscious bias and its origins. The findings shed light on how and why individuals possess unconscious biases, particularly within the judicial system. In conclusion, this study investigates judicial decisions concerning consensual sexual acts and the construction of unlawfulness. By employing a historical genealogy approach, the research sheds light on how judges create legal rules that reflect social solidarity and aim to protect against violence. The theoretical importance of this study lies in its contribution to understanding unconscious bias and its origins within the judicial system. Through data collection and analysis procedures, this study aims to provide valuable insights into the formation of social attitudes towards private sexual relations and its impact on legal rulings.

Keywords: consent, sexual offences, offences against the person, legal genealogy, social construct

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Authors: Luljeta Gashi, Naser Ramadani, Zana Deva, Dafina Gexha-Bunjaku

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The official HIV/AIDS data in Kosovo are based on HIV case reporting from health-care services, the blood transfusion system and Voluntary Counselling and Testing centres. Between 1986 and 2014, are reported 95 HIV and AIDS cases, of which 49 were AIDS, 46 HIV and 40 deaths. The majority (69%) of cases were men, age group 25 to 34 (37%) and route of transmission is: heterosexual (90%), MSM (7%), vertical transmission (2%) and IDU (1%). Based on existing data and the UNAIDS classification system, Kosovo is currently still categorised as having a low-level HIV epidemic. Even though with a low HIV prevalence, Kosovo faces a number of threatening factors, including increased number of drug users, a stigmatized and discriminated MSM community, high percentage of youth among general population (57% of the population under the age of 25), with changing social norms and especially the sexual ones. Methods: Data collection was done using self administered structured questionnaires amongst 249 high school students. Data were analysed using the Statistical Package for Social Sciences (SPSS). Results: The findings revealed that 68% of students know that HIV transmission can be reduced by having sex with only one uninfected partner who has no other partners, 94% know that the risk of getting HIV can be reduced by using a condom every time they have sex, 68% know that a person cannot get HIV from mosquito bites, 81% know that they cannot get HIV by sharing food with someone who is infected and 46% know that a healthy looking person can have HIV. Conclusions: Seventy one percent of high school students correctly identify ways of preventing the sexual transmission of HIV and who reject the major misconceptions about HIV transmission. The findings of the study indicate a need for more health education and promotion.

Keywords: Kosovo, KPAR, HIV, high school

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Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Obada Ahmad Al Jayyousi, Ihdaa Mahmoud Bani Khalaf, Eman E. Alshial

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Background: Bipolar disorder, formerly known as manic depression, is a mental health status that leads to extreme mood swings that include emotional lows (depression) and highs (mania or hypomania). This systematic review and meta-analysis aimed to assess the safety and efficacy of lithium versus valproate among bipolar patients. Methods: A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until June 2022. Studies comparing lithium versus valproate among bipolar patients were selected for the analysis, and all relevant outcomes were pooled in the meta-analysis using Review Manager Software. Results: 11 Randomized Clinical Trials were included in this meta-analysis with a total of 4159 patients. Our meta showed that lithium was superior to valproate in terms of Young Mania Rating Scale (YMRS) (MD = 0.00 with 95% CI, (-0.55 – 0.55; I2 = 0%), P = 1.00). The results of the Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored the valproate treated group (MD = 1.41 with 95% CI, (-0.15 – 2.67; I2 = 0%), P = 0.03). Concerning the results of the Montgomery-Asberg Depression Rating Scale (MADRS), the results showed that the lithium was superior to valproate (MD = 0.03 with 95% CI, (-0.80 to 0.87; I2 = 40%), P = 0.94). In terms of the sexual side effect, we found that the valproate was superior to lithium (RR 1.19 with 95% CI, (0.74 to 1.91; I2 = 0%), P = 0.47). The lithium-treated group was superior in comparison to valproate treated group in terms of Abnormal Involuntary Movement Scale (AIMS) (MD = -0.03 with 95% CI (-0.38 to 0.32; I2 = 0%), P = 0.87). The lithium was more favorable in terms of Simpson-Agnes scale (MD = -0.40 with 95% CI, (-0.86 to 0.06; I2 = 0%), P = 0.09). The results of the Barnes akathisia scale showed that the overall effect of the valproate was more favorable in comparison to lithium (MD = 0.05 with 95% CI, (-0.12 to 0.22; I2 = 0%), P = 0.57). Conclusion: Our study revealed that on the scales of efficacy Lithium treated group surpassed Valproate treated group in terms of Young Mania Rating Scale (YMRS), Abnormal Involuntary Movement Scale (AIMS) and Simpson-Agnes scale, but valproate surpassed it in Barnes Akathisia scale. Furthermore, on the scales of depression Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored Valproate treated group, but Lithium surpassed valproate in terms of Montgomery-Asberg Depression Rating Scale (MADRS). Valproate surpassed Lithium in terms of sexual side effects.

Keywords: bipolar, mania, bipolar-depression, sexual dysfunction, sexual side effects, treatment

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Authors: Esther Gumboh

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While the definition of rape has evolved over the years and now differs from one jurisdiction to another, at the heart of the offence remains the absence of consent on the part of the victim. In simple terms, rape consists in non-consensual sexual intercourse. Therefore, the core issue is whether the accused acted with the consent of the victim. Once it is established that the act was consensual, a conviction of rape cannot be secured. Traditionally, rape within marriage was impossible because it was understood that a woman gave irrevocable consent to sex with her husband throughout the duration of the marriage. This position has since changed in most jurisdictions. Indeed, Malawian law now recognises the offence of marital rape. This is a victory for women’s rights and gender equality. Curiously, however, the definition of marital rape endorsed differs from the standard understanding of rape as non-consensual sex. Instead, the law has introduced the concept of unreasonableness of the refusal to engage in sex as a defence to an accused. This is an alarming position that undermines the protection sought to be derived from the criminalisation of rape within marriage. Moreover, in the Malawian context where rape remains an offence only men can commit against women, the current legal framework for marital rape perpetuates the societal misnomer that a married woman gives a once-off consent to sexual intercourse by virtue of marriage. This takes us back to the old common law position which many countries have moved away from. The present definition of marital rape under Malawian law also sits at odd with the nature of rape that is applicable to all other instances of non-consensual sexual intercourse. Consequently, the law fails to protect married women from unwanted sexual relations at the hands of their husbands. This paper critically examines the criminalisation of marital rape in Malawi. It commences with a historical account of the conceptualisation of rape and then looks at judgments that rejected the validity of marital rape. The discussion then moves to the debates that preceded the criminalisation of marital rape in Malawi and how the Law Commission reasoned to finally make a recommendation in its favour. Against this background, the paper analyses the legal framework for marital rape and what this means for the elements of the offence and defences that may be raised by an accused. In the final analysis, this contribution recommends that there is need to amend the definition of marital rape. Better still, the law should simply state that the fact of marriage is not a defence to a charge of rape, or, in other words, that there is no marital rape exemption. This would automatically mean that husbands are subjected to the same criminal law principles as their unmarried counterparts when it comes to non-consensual sexual intercourse with their wives.

Keywords: criminal law, gender, Malawi, marital rape, rape, sexual intercourse

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