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Acknowledgements

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H]^gaZn@LVc\[dgi]ZYZkZadebZcid[i]^hgZedgi#

Executive summary

I]^hgZk^Zl]ZgZV[iZg!i]ZGZk^ZlYdXjbZcihXjggZcianVkV^aVWaZgZhZVgX]cY^c\hdci]ZeZgXZe"
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U eZgXZei^dchVcYgZhedchZhd[ldbZck^Xi^bhidhZmjVak^daZcXZ0VcY
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eVgihdgVcdW_ZXi#
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VcYgVeZWnhigVc\Zgh!l^i]V[dXjhdci]ZaViiZg#

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idgZ[Zgid^cY^k^YjVahl]d]VkZZmeZg^ZcXZYhZmjVak^daZcXZ#

RAPE: HOW WOMEN, THE COMMUNITY AND THE HEALTH SECTOR RESPOND

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EXECUTIVE SUMMARY

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Introduction

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Societal perceptions of sexual

violence and its victims

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SOCIETAL PERCEPTIONS OF SEXUAL VIOLENCE AND ITS VICTIMS

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11

12

Societal responses to sexual

violence and its victims

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13

14

RAPE: HOW WOMEN, THE COMMUNITY AND THE HEALTH SECTOR RESPOND

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15

Women victims perceptions

of sexual violence

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16

RAPE: HOW WOMEN, THE COMMUNITY AND THE HEALTH SECTOR RESPOND

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WOMEN VICTIMS PERCEPTIONS OF SEXUAL VIOLENCE

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17

18

The responses of women victims

to sexual violence

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THE RESPONSES OF WOMEN VICTIMS TO SEXUAL VIOLENCE

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19

20

RAPE: HOW WOMEN, THE COMMUNITY AND THE HEALTH SECTOR RESPOND

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THE RESPONSES OF WOMEN VICTIMS TO SEXUAL VIOLENCE

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21

22

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23

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25

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27

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29

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30

RAPE: HOW WOMEN, THE COMMUNITY AND THE HEALTH SECTOR RESPOND

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31

Acute, short- and long-term

interventions

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32

RAPE: HOW WOMEN, THE COMMUNITY AND THE HEALTH SECTOR RESPOND

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33

34

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35
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36

RAPE: HOW WOMEN, THE COMMUNITY AND THE HEALTH SECTOR RESPOND

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37
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41

Therapeutic approaches to survivors

mental health needs

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42

RAPE: HOW WOMEN, THE COMMUNITY AND THE HEALTH SECTOR RESPOND

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THERAPEUTIC APPROACHES TO SURVIVORS MENTAL HEALTH NEEDS

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43

44

Criminal justice system interventions

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45

46

Conclusions and areas

for future research

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References

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6XdhiV B '%%'# 8daaZXi^c\ Zk^YZcXZ [dg YdbZhi^X VcY hZmjVa VhhVjai/ =^\]a^\]i^c\ k^daZcXZ V\V^chi ldbZc ^c
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REFERENCES

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8VbeWZaa G &..-# I]Z Xdbbjc^in gZhedchZ id gVeZ/ K^Xi^bh ZmeZg^ZcXZh l^i] i]Z aZ\Va! bZY^XVa! VcY bZciVa
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REFERENCES

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HX^ZcXZVcYBZY^X^cZ!**/&'(&&'))#
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55

56

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REFERENCES

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57

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REFERENCES

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CZgkdjhVcYBZciVa9^hZVhZ!&,*/.%.)#

59

60

RAPE: HOW WOMEN, THE COMMUNITY AND THE HEALTH SECTOR RESPOND

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REFERENCES

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aZcXZ6\V^chiLdbZc!&/(*&#
kdc@ZgZch]Von?<ZiVa#'%%'#:g^igZV/B^a^iVgndXXjeVi^dc!hZmjVak^daZcXZ!VcY=>K#M>K>ciZgcVi^dcVa6>9H8dc"
[ZgZcXZ!7VgXZadcV!HeV^c#
LVa`Zg:6!@VidcL?&..+#GZhZVgX]^c\i]Z]ZVai]Z[[ZXihd[k^Xi^b^oVi^dc/I]ZcZmi\ZcZgVi^dc#EhnX]dhdbVi^X
BZY^X^cZ!*-/&+&,#
LVgY8&..*#6ii^ijYZhidlVgYgVeZVcYgVeZk^Xi^bh/HjgkZngZhZVgX]#6ii^ijYZhidlVgYgVeZ/;Zb^c^hiVcYhdX^Va
ehnX]dad\^XVaeZgheZXi^kZh#AdcYdc!J@!HV\ZEjWa^XVi^dch/(-+*#
LVi]Zc8C!BVXB^aaVc=A'%%(#>ciZgkZci^dch[dgk^daZcXZV\V^childbZc#?djgcVad[i]Z6bZg^XVcBZY^XVa6hhd"
X^Vi^dc!'-./*-.+%%#
LViih8=ZiVa#&..-#L^i]]daY^c\d[hZmVcY[dgXZYhZm/9^bZch^dchd[k^daZcXZV\V^chiO^bWVWlZVcldbZc#
GZegdYjXi^kZ=ZVai]BViiZgh!+/*,+*#
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Lda[Z?!@^bbZga^c\G&..,#<ZcYZg^hhjZh^ci]ZVhhZhhbZcid[edhiigVjbVi^XhigZhhY^hdgYZg#>c/L^ahdc?E!@ZVcZ
IBZYh6hhZhh^c\ehnX]dad\^XVaigVjbVVcYEIH9#CZlNdg`!CN!<j^a[dgYEgZhh/&.''(-#
Lda[Z ? Zi Va# &..)# EdhiigVjbVi^X higZhh Y^hdgYZg VcY lVg"odcZ ZmedhjgZ Vh XdggZaViZh d[ eZgXZ^kZY ]ZVai] ^c
[ZbVaZK^ZicVblVgkZiZgVch#?djgcVad[8dchjai^c\VcY8a^c^XVaEhnX]dad\n!+'/&'(*&')%#
Ldg`bVc?:!;gZZWjg\:L&...#6cZmVb^cVi^dcd[YViZgVeZ!k^Xi^bYgZhh!VcYeZgXZ^kZgkVg^VWaZhl^i]^ci]Z
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LdgaY=ZVai]Dg\Vc^oVi^dc'%%'#LdgaYgZedgidck^daZcXZVcY]ZVai]#<ZcZkV!LdgaY=ZVai]Dg\Vc^oVi^dc#
LdgaY=ZVai]Dg\Vc^oVi^dc'%%(#<j^YZa^cZh[dgi]ZbZY^Xd"aZ\VaXVgZd[k^Xi^bhd[hZmjVak^daZcXZ#<ZcZkV!LdgaY
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VXfjV^ciVcXZVcYYViZgVeZ#K^daZcXZ6\V^chiLdbZc!*/,.+#
Ndjc\ LL! 7gVX`Zc 68! <dYYVgY B6! BVi]Zhdc H  i]Z CZl =Vbeh]^gZ HZmjVa 6hhVjai BZY^XVa :mVb^cVi^dc
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61

63
ANNEX 1

Resource persons and

organizations contacted

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64
ANNEX 2

Internet resources consulted

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ANNEX 2. INTERNET RESOURCES CONSULTED

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65

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ANNEX 3

Literature databases and

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112
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ANNEX 4. EMPIRICAL STUDIES REVIEWED

113






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ANNEX 4. EMPIRICAL STUDIES REVIEWED

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