Sexual abuse

Sexual abuse is any sort of unwanted sexual activity that could happen to men or women of any age. It includes penetration using force, making threats or taking advantage of victims able to give consent. If done by partner or intimate, it could include derogatory name calling, refusal to use contraception, deliberately causing unwanted physical pain during sex, deliberately passing on sexual diseases or infections and using objects, toys, or other items (e.g. baby oil or lubricants) without consent and to cause pain or humiliation.

The term also covers any behavior by an adult or older adolescent towards a child to stimulate any of the involved sexually. The use of a child, or other individuals younger than the age of consent, for sexual stimulation is referred to as child sexual abuse or statutory rape.

Types of sexual violence:

• Rape - Rape is when someone has sex, or tries to have sex, with someone else without their permission.

• Date rape - If someone are dating or have met socially commits an act of sexual violence against someone else, it is referred to as date rape.

• Drink spiking - When someone uses a drug to force someone else into a sexual act it is referred to as drink spiking. Drugs used in this way are known as date rape drugs. Alcohol—added to someone’s drink without them knowing—is the most common date rape drug.
• Incest - Incest is when someone is forced into sexual activity with a member of their family or step-family.
• Sexual assault - Sexual assault is any unwanted sexual touching or exposure (e.g. if someone displays their genitals in public).
• Sexual harassment - Sexual harassment is any form of unwelcome sexual attention which includes touching or other physical contact, making remarks with sexual connotations, requesting sexual favours, or displaying offensive material.
• Up-skirting or secret filming - 'Up-skirting’ refers to filming under someone’s clothing with a hidden camera. 

In the emergency room, emergency contraceptive medications are offered to women raped by men because about 5% of such rapes result in pregnancy. Preventative medication against sexually transmitted infections are given to victims of all types of sexual abuse (especially for the most common diseases like chlamydia, gonorhea, trichomoniasis and bacterial vaginosis) and a blood serum is collected to test for STIs (such as HIV, hepatitis B and syphilis). Any survivor with abrasions are immunized for tetanus if 5 years have elapsed since the last immunization. Short-term treatment with a benzodiazepine may help with acute anxiety and antidepressants may be helpful for symptoms of posttraumatic stress disorders, depression and panic attacks.

Symptoms

• anal or vaginal soreness
• an unusual discharge
• sexually transmitted infection (STI)
• pregnancy

Associated diseases

• chlamydia
• gonorhea
• trichomoniasis
• bacterial vaginosis
• HIV (human immunodeficiency virus)
• hepatitis
• syphilis

Complications

Significant links with functional gastrointestinal disorders, nonspecific chronic pain, psychogenic seizures, and chronic pelvic pain are found in victims of sexual abuse. 

The acquisition of one or more sexually transmitted diseases (STD) is also a significant complication of sexual assault. The risk of infection by pathogens varies from less than 1 to 50% depending on the nature of the assault, the organism studied and the background prevalence of STD in the general community. The correct diagnosis of STD depends upon optimal collection and appropriate laboratory testing of clinical specimens. 

Risk factors

• alcohol and drug use
• delinquency
• empathic deficits
• general aggressiveness and acceptance of violence
• early sexual initiation
• coercive sexual fantasies
• preference for impersonal sex and sexual-risk taking
• exposure to sexually explicit media
• hostility towards women
• adherence to traditional gender role norms
• hyper-masculinity
• suicidal behavior
• prior sexual victimization or perpetration

Prevention

There is great variety in the types of prevention programs that exists, their target groups, the methods, and their specific contexts. Offender management is the approach that aims to control known offenders, for example, registries, background employment checks, longer prison sentences and various intervention programs. It is a tertiary prevention initiative that acts mostly in the individual sphere and, as such, presents certain inherent limitations in regards to preventing sexual abuse from happening in the first place.

Preventative medication against sexually transmitted infections are given to victims of all types of sexual abuse (especially for the most common diseases like chlamydia, gonorhea, trichomoniasis and bacterial vaginosis) and a blood serum is collected to test for STIs (such as HIV, hepatitis B and syphilis). Any survivor with abrasions are immunized for tetanus if 5 years have elapsed since the last immunization. Short-term treatment with a benzodiazepine may help with acute anxiety and antidepressants may be helpful for symptoms of posttraumatic stress disorder, depression and panic attacks.

Sexual abuse from childhood, rape or a painful first sexual experience is the most common psychological causes of vaginismus (a defense against recalling the painful memories). Vaginismus is the involuntary (not under the woman’s conscious control) clamping of the vaginal muscles that does not allow penetrative sex needed for pregnancy.

Failure to consummate the marriage (the inability to deposit semen in the vagina) is one of the reasons some couples are unable to have a baby. Added to the stress of the sexual dysfunction, they now have to cope with the additional insult of being unable to conceive naturally.

Among men and women suffering from sexual abuse the risk of developing a depression is higher. Posttraumatic stress disorder is therefore one of the possible consequences of childhood sexual abuse. The prevalence of posttraumatic stress disorder in sexually abused children and adolescents ranges from 21% to 74%, however the prevalence of infertility ranges from case to case.

Possible consequences following sexual abuse inlude vaginismus. Successful vaginismus treatment does not require drugs, surgery, hypnosis, nor any other complex invasive technique. Effective treatment approaches combine pelvic floor control exercises, insertion or dilation training, pain elimination techniques, transition steps, and exercises designed to help women identify, express and resolve any contributing emotional components.