Records at the Maternity Hospital of Lima, Peru, found that 90 percent of young mothers ages 12 to 16 were pregnant as the result of rape. |
For some young people, sex is not voluntary.
- Some adolescents are forced to have sexual relations, are assaulted if they refuse to have sex or are forced to work as prostitutes in order to survive.
- Some victims of sexual abuse are assaulted by family members or acquaintances.
- The number of street children in the world is growing an estimated 40 million in Latin America, 10 million in Africa and 25 million in Asia. Many exchange sex for food, money or protection.
- In war or in refugee camps, sexual violence can be commonplace.
For girls and women, who typically have less power and less status in society, the short- and long-term health consequences of sexual violence can be physically and emotionally damaging.
- Physically battered females are more likely to experience repeat miscarriages and vaginal infections.
- Battered girls and women may be fearful of using contraception (or even discussing it with their partner), so they are more likely to experience unplanned pregnancies, seek unsafe abortions or acquire an STI.
- Violence does not stop during pregnancy. Complications can include preeclampsia, premature labor, miscarriage and low-birth-weight infants.
- Women and girls who are raped can suffer long-term health problems (chronic pelvic pain, headaches, asthma or irritable bowel syndrome), as well as psychological consequences (depression, fear, anxiety, low self-esteem or sexual dysfunction).
- Women and girls who are raped may be ostracized or blamed by their families and communities.
- Women who are sexually abused as children may be more likely to engage in risky sexual behavior and have an unplanned pregnancy.
Boys and young men can also be victims of sexual violence, abuse and rape, although less information is available about their long-term physical and psychological effects. You should be sensitive to their needs for counseling.
Questions to ask adolescents
Sexual violence and abuse carry stigma, shame and fear, so young people are not likely to volunteer information about their situation. You can be aware that coercion and violence occur and that these acts can have negative consequences on reproductive health. Through counseling, you can help identify young people who are victims or potential victims and provide services, either directly or through referral. It is important that you listen carefully to the young person when discussing violence. You can establish trust and rapport and create an atmosphere of respect and privacy elements that may be missing from the lives of young people who are victims of sexual violence.
"If you refuse, he's going to beat you, and you will give in to his desires by force."
Young woman in Senegal |
In counseling, you can ask:
- Have you ever been touched sexually against your will?
- When did it first occur? Is it still going on?
- Do you feel you are in immediate danger? Are you afraid to go home?
- Does your partner abuse alcohol or drugs? Are you more likely to be abused during episodes of drinking or drug-taking?
- Do you use alcohol or drugs to help you cope with the violence?
- How has this violence affected your daily life?
- How has it affected your views of sexual relationships today?
- Have you ever thought of suicide?
- Is there someone you can talk to about this?
If the client talks about suicide, you should immediately refer him or her to a mental health worker and follow up to make sure the client receives help.
Some experts recommend that all young adults should be questioned about sexual violence, especially if:
What you can do: sexual violence
In working with adolescents who have been victims of sexual violence or coercion, you can:
- Be sensitive and listen carefully to the client's needs.
- Treat any medical problems.
- Offer a pregnancy test, if available.
- Offer information about emergency contraceptive pills.
- Provide information about or services for STI/HIV screening and treatment.
- Offer information about routine contraceptive use.
- Refer young people to organizations that offer psychological counseling and legal advice, if available.
Questions for Providers and Program Managers about Counseling Victims of Sexual Violence |
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? Are counselors trained to identify victims of sexual violence or coercion? If not, how could counselors learn about this? Where are young people referred when they need legal, emotional or social support?
? Are there organizations in your community that work with young victims of sexual violence and coercion? What are the names and locations of these programs? How do you make adolescents aware of these programs?
? How can you work with these organizations so that you can refer clients to them and they can refer clients to you?
? What barriers or obstacles would you encounter? How could you overcome these obstacles? |
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