Introduction
The world is currently experiencing the biggest migratory crisis since World War II, with an increasing number of refugees. According to the United Nations High Commissioner for Refugees (UNHCR) report, 65.6 million people were forced to move because of persecution, conflict, widespread violence or human rights violations in 2016. Of these, 22.5 million were refugees; 2.8 million, asylum seekers; and 40.3 million, internally displaced persons within their own countries1.
Sexual violence (SV), defined as a sexual act or attempt to obtain a sexual act without the voluntary consent of the victim or with someone unable to consent or refuse2, is considered a present threat during forced displacement and the search for asylum3,4. In times of war, women and girls are more vulnerable to rape and are at greater risk for other forms of SV, such as early or forced marriage, intimate partner abuse, child sexual abuse, sexual exploitation and trafficking4. SV has also been perpetrated against men and boys as a tactic of war or during detention and interrogation5; they may suffer rape, sexual torture, mutilation, humiliation, enslavement, and forced incest6. This risk persists during the escape journey and after the reception in apparently safe destinations7.
The consequences can be extremely serious. In women, it can lead to mental disorders, obstetric complications, sexual dysfunctions, unwanted pregnancies, unsafe abortions and sexually transmitted infections8,9. Among men, in addition to infections and mental disorders, sexual dysfunction, somatic complaints, sleep disorders, withdrawal from relationships, attempted suicide, alcohol and drug abuse, and violent behavior are common8,10. In childhood, sexual abuse may also be accompanied by guilt, shame, eating disorders, cognitive distortions, mental disorders, sexual and relationship problems, and school absenteeism11.
OBJECTIVE:
To synthesize data about the prevalence of sexual violence (SV) among refugees around the world.
METHODS:
A systematic review was conducted from the search in seven bibliographic databases. Studies on the prevalence of SV among refugees and asylum seekers of any country, sex or age, whether in English, French, Spanish and Portuguese, were eligible.
RESULTS:
Of the 2,906 titles found, 60 articles were selected. The reported prevalence of SV was largely variable (0% to 99.8%). Reports of SV were collected in all continents, with 42% of the articles mentioning it in refugees from Africa (prevalence from 1.3% to 100%). The rape was the most reported SV in 65% of the studies (prevalence from 0% to 90.9%). The main victims were women in 89% of the studies, all the way, especially when still in the countries of origin. The SV was perpetrated particularly by intimate partners, but also by agents of supposed protection. Few studies have reported SV in men and children; the prevalence reached up to 39.3% and 90.9%, respectively. Approximately one-third of the studies (32%) were carried out in refugee camps and more than half (52%) in health services using mental health assessment tools. No study has addressed the most recent migratory crisis. Meta-analysis was not performed due to the methodological heterogeneity of the studies.
CONCLUSIONS:
SV is a prevalent problem affecting refugees of both sexes, of all ages, throughout the migratory journey, particularly those from Africa. Protection measures are urgently needed, and further studies, with more appropriate tools, may better measure the current magnitude of the problem.
SUMMARY: https://www.ncbi.nlm.nih.gov/pubmed/31553381
Извор: WUNRN – 29.09.2019
