(PS10-62) Conceptualizing Stigma in the Context of Sexual Violence Research: A Systematic Review

Abstract Text:

Background: Sexual violence, defined as any sexual act or attempt to engage in a sexual act through force, coercion, or without one’s consent, encompasses various forms of harm, such as child sexual abuse, intimate partner sexual violence, and drug-facilitated sexual assault. Sexual violence is prevalent worldwide and associated with adverse mental and physical health outcomes, such as posttraumatic stress disorder, substance use disorder, and chronic pain. Stigma about experiencing sexual violence has been linked with poor physical and mental health, revictimization, and diminished engagement with support services. However, stigma has not been operationalized consistently across studies, leading to challenges in synthesizing and comparing findings. Recognizing the inconsistencies in how stigma is conceptualized, this systematic review aims to generate a more comprehensive understanding of sexual violence stigma by examining how it is defined and measured in empirical studies.

Method: Studies were identified by searching online databases in October 2024. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched for peer-reviewed articles in six databases—APA PsycINFO, CINAHL, Embase, PubMed, Scopus, and Web of Science—using keywords (“sexual”, “violence”, “stigma”, “measure”) and related terms. Studies were eligible if they were: 1) published in English; 2) published in a peer-reviewed journal; 3) quantitative studies with at least ten participants; 4) focused on sexual violence; and 5) included operationalizations and measures of sexual violence stigma. Covidence was used for title and abstract screening as well as full-text reviews. Inductive thematic analysis is in progress.

Results: Of the 11,641 articles identified in the search, 67 met criteria for inclusion. Studies were primarily cross-sectional (k = 42), community-based (k = 22), and conducted in the U.S. (k = 38), the Democratic Republic of Congo (k = 10), and Canada (k = 7). Sexual violence stigma was defined and measured across all levels of the socio-ecological model. At the individual level (k = 46), stigma was characterized as survivors’ self-blame and internalized shame surrounding the sexual violence experience. At the interpersonal level (k = 36), stigma included negative social reactions (e.g., discrimination) resulting from survivors’ disclosure of sexual violence, mental health outcomes, or treatment seeking. At the structural level (k = 9), stigma was reflected in cultural norms, institutional policies, and laws.

Discussion: Stigma was operationalized in a variety of ways that spanned each level of the socio-ecological model. However, few studies examined stigma at the structural level, and longitudinal studies are needed to shed light on the mechanism of stigma in relation to sexual violence exposure and health outcomes. Moreover, future studies should examine how sexual violence stigma intersects with other forms of stigma, including race, gender, sexual orientation, and disability to enhance cultural- and identity-affirming care.