AP-HP, Jean Verdier Hospital, Department of Legal and Social Medicine, Avenue du 14 Juillet, F-93140 Bondy, France.
UFR SMBH, Sorbonne Paris Nord University, UFR SMBH, F-93100 Bobigny, France.
Int J Environ Res Public Health. 2023 Jul 15;20(14):6373. doi: 10.3390/ijerph20146373.
Sexual violence (SV) is widely prevalent around the world: according to studies, 18 to 51% of women and 1 to 9% of men experience it at some point in their lives. Yet, experiences of SV are rarely disclosed outside the private sphere. Pathologies, acute or chronic, can be associated with SV. The study of the links between SV and health is often fragmented, viewed through the lens of a specific pathology, yet SV certainly has an impact on the different dimensions of the functioning of survivors (physical, psychological, social, and so on), whether or not there is an identified pathology at the origin of this impact. No synthesis of the knowledge on functional impairment in adult sexual assault survivors has been identified to date. Therefore, we conducted a systematic review according to the PRISMA recommendations, focusing on the assessment via validated scales or standardized measurements of the different dimensions of functional impairment in sexual assault survivors aged 15 and over, excluding abuse in childhood and polyvictimization. We searched the Medline database from its inception to October 2022, identifying 1130 articles. Two evaluators carried out their analysis, and fifty-one articles were retained. In the end, only 13 articles were included. Their quality was assessed by referring to their compliance with STROBE recommendations. Of these 13 articles, only 4 have a quality level deemed to be satisfactory, and they relate to 4 dimensions of functioning: psychological, sexual, physical (pain), and social. The main results were that survivors reported increased restrictions of activities, sexual dysfunctions such as vulvodynia or dyspareunia, decreased social satisfaction and functioning, and decreased self-esteem and quality of life compared to the general population. To date, evidence for functional impairment is very limited, preventing researchers and clinicians from gaining clear and well-established knowledge about the functioning of sexual assault survivors. Research in this area needs to evolve urgently.
性暴力（SV）在全球范围内广泛存在：根据研究，18%至 51%的女性和 1%至 9%的男性在其一生中的某个时刻经历过性暴力。然而，性暴力的经历很少在私人领域之外公开披露。急性或慢性的病理学可能与 SV 有关。对 SV 与健康之间联系的研究往往是零散的，从特定病理学的角度来看待，但 SV 肯定会对幸存者的不同功能维度（身体、心理、社会等）产生影响，无论是否存在与这种影响相关的已确定的病理学。目前尚未确定对成年性侵犯幸存者功能障碍的知识进行综合。因此，我们根据 PRISMA 建议进行了系统评价，重点评估了通过经过验证的量表或标准化测量工具对 15 岁及以上性侵犯幸存者的不同功能障碍维度的评估，不包括儿童期虐待和多受害者。我们从 Medline 数据库的创建开始搜索，直到 2022 年 10 月，共确定了 1130 篇文章。两名评估员进行了分析，保留了 51 篇文章。最后，仅纳入了 13 篇文章。通过参考其对 STROBE 建议的遵守情况来评估其质量。在这 13 篇文章中，只有 4 篇文章的质量水平被认为是令人满意的，并且它们涉及到 4 个功能维度：心理、性、身体（疼痛）和社会。主要结果是，与一般人群相比，幸存者报告活动受限增加、性功能障碍，如外阴痛或性交困难、社会满意度和功能下降以及自尊心和生活质量下降。迄今为止，功能障碍的证据非常有限，这使得研究人员和临床医生无法清楚地了解性侵犯幸存者的功能。该领域的研究需要紧急发展。
