School of Social Sciences, University of New South Wales, Sydney, Australia.
PLoS One. 2013 May 15;8(5):e62600. doi: 10.1371/journal.pone.0062600. Print 2013.
Sexual violence is highly prevalent in armed conflict and other humanitarian crises and attracting increasing policy and practice attention. This systematic review aimed to canvas the extent and impact of initiatives to reduce incidence, risk and harm from sexual violence in conflict, post-conflict and other humanitarian crises, in low and middle income countries. Twenty three bibliographic databases and 26 websites were searched, covering publications from 1990 to September 2011 using database-specific keywords for sexual violence and conflict or humanitarian crisis. The 40 included studies reported on seven strategy types: i) survivor care; ii) livelihood initiatives; iii) community mobilisation; iv) personnel initiatives; v) systems and security responses; vi) legal interventions and vii) multiple component interventions. Conducted in 26 countries, the majority of interventions were offered in African countries. Despite the extensive literature on sexual violence by combatants, most interventions addressed opportunistic forms of sexual violence committed in post-conflict settings. Only one study specifically addressed the disaster setting. Actual implementation of initiatives appeared to be limited as was the quality of outcome studies. No studies prospectively measured incidence of sexual violence, although three studies provided some evidence of reductions in association with firewood distribution to reduce women's exposure, as did one program to prevent sexual exploitation and abuse by peacekeeping forces. Apparent increases to risk resulted from lack of protection, stigma and retaliation associated with interventions. Multiple-component interventions and sensitive community engagement appeared to contribute to positive outcomes. Significant obstacles prevent women seeking help following sexual violence, pointing to the need to protect anonymity and preventive strategies. This review contributes a conceptual framework for understanding the forms, settings, and interventions for conflict and crisis-related sexual violence. It points to the need for thorough implementation of initiatives that build on local capacity, while avoiding increased risk and re-traumatisation to survivors of sexual violence.
性暴力在武装冲突和其他人道主义危机中普遍存在，越来越引起政策制定者和实践者的关注。本系统综述旨在评估在中低收入国家减少冲突、冲突后和其他人道主义危机中性暴力的发生、风险和危害的各项举措的范围和影响。共检索了 23 个文献数据库和 26 个网站，使用数据库特定的关键词搜索了 1990 年至 2011 年 9 月出版的关于性暴力和冲突或人道主义危机的文献。40 项纳入研究报告了 7 种策略类型：i）幸存者护理；ii）生计举措；iii）社区动员；iv）人员举措；v）系统和安全响应；vi）法律干预；vii）多部分干预。这些研究在 26 个国家进行，大多数干预措施是在非洲国家提供的。尽管有大量关于战斗人员实施的性暴力的文献，但大多数干预措施都涉及冲突后环境中发生的机会主义形式的性暴力。只有一项研究专门针对灾害环境。干预措施的实际实施情况似乎受到限制，结果研究的质量也不高。没有研究前瞻性地衡量性暴力的发生率，尽管有三项研究提供了一些证据表明，与分配薪柴以减少妇女受害风险有关，而一项防止维和部队性剥削和性虐待的方案也起到了这种作用。由于缺乏保护、耻辱感和报复，风险似乎明显增加。多部分干预措施和敏感的社区参与似乎有助于取得积极成果。由于干预措施而导致的风险增加，明显阻碍了妇女寻求性暴力后的帮助，这表明需要保护她们的匿名性和采取预防策略。本综述为理解冲突和危机相关的性暴力的形式、环境和干预措施提供了一个概念框架。它指出，需要彻底实施各项举措，这些举措要建立在当地能力的基础上，同时避免对性暴力幸存者增加风险和再次创伤。
