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Sexual violence is a major public health problem that exacts a toll on the health and well-being of millions of individuals, communities, and broader society. Decades of research have improved our understanding of the nature and scope of the problem, including disparities in the burden of sexual violence across populations. Researchers have also documented the substantial short- and long-term effects of sexual violence on survivors and estimated the economic burden to society that results. In recent years, the field has made strides by identifying evidence-based approaches for primary prevention of sexual violence at each level of the social ecology. Perhaps most importantly, the field has begun to move toward a focus on shared risk and protective factors for co-occurring and interconnected forms of violence, a new strategic direction for violence prevention aimed at maximizing the impact of prevention efforts and resources. This chapter reviews what we know about the nature and burden of sexual violence—and how we can prevent it.


Sexual violence, as defined by the Centers for Disease Control and Prevention (CDC), includes any sexual act committed or attempted by another person without the victim's freely given consent or against someone unable to consent or refuse.1 This definition encompasses a range of unwanted sexual behaviors, including sexual penetration of a victim or being made to sexually penetrate someone else resulting from the use of physical force, alcohol/drug intoxication, or nonphysical pressure (i.e., sexual coercion). Sexual violence also includes intentional sexual touching or noncontact acts of a sexual nature that are unwanted and without victim consent.1 Sexual violence can occur at any age (e.g., against children or adults), anywhere (e.g., at home, work, school, or in public), and by any type of perpetrator (e.g., friend, spouse or intimate partner, relative, coworker, acquaintance, or stranger). As such, it overlaps substantially with other domains of violence research. For example, sexual violence against children is frequently considered in the context of research on childhood abuse and neglect (see Chapter 176: Child Abuse and Neglect), while sexual violence within the context of an intimate relationship is often addressed in research on intimate partner violence (see Chapter 178: Intimate Partner Violence Prevention). Although a majority of sexual violence involves a male perpetrator and a female victim, sexual violence can also occur between people of the same sex and can involve a woman perpetrating sexual violence.2–4

The term sexual violence—used most often in social science and public health research and practice—captures a broad range of sexually violating behaviors that may or may not meet the legal standards for criminal behavior in every state or jurisdiction.5 In contrast, the terms rape and sexual assault originate in legal definitions of criminal sexual behavior, capturing more defined subsets of unwanted sexual acts that vary by jurisdiction. Rape typically refers—in a legal context—to nonconsensual sexual penetration that results ...

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