Sexual Violence & Human Trafficking
Complete this week’s assigned readings, chapters 86 & 87. After completing the readings, post a short reflection, approximately 1 paragraph in length, discussing your thoughts and opinions about one or several of the specific topics covered in the textbook readings. pertaining to politics in associations and interest groups. Identify which one MSN Essential most relates to your selected topic in your discussion.
As a reminder, no scholarly sources are required and students do not have to reply to a classmate’s original post.
Family and Sexual Violence
Nursing and U.S. Policy
Kathryn Laughon, Angela Frederick Amar
“If the numbers we see in domestic violence were applied to terrorism or gang violence, the entire
country would be up in arms, and it would be the lead story on the news every night.”
Rep. Mark Green, Wisconsin
Our society is steeped in violence. In the most recent national statistics, more than 26 per 1000
people aged 12 years or older will be the victims of a violent crime (Truman, Langton, & Planty,
2013). Most of our violence prevention strategies prepare potential victims to ward off violent
attacks from strangers; yet, someone known to the victim perpetrates most violence against women,
children, and older adults. The intimate nature of this violence, often perpetrated behind closed
doors, has made these forms of violence less visible. However, the toll of violence on individuals
and societies is substantial. The World Health Organization has framed violence as a significant
public health problem (Truman, Langton, & Planty, 2013). A public health approach suggests an
interdisciplinary, science-based approach with an emphasis on prevention. Effective strategies draw
on resources in many fields, including nursing, medicine, criminal justice, epidemiology, and other
social scientists.
The purpose of this chapter is to provide an overview of state, federal, and health sector policies
regarding violence against women in the United States, briefly discuss policies related to violence
against children and older adults, and outline the resulting implications for nurses and directions
for future work.
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Intimate Partner and Sexual Violence Against Women
Intimate partner violence (IPV) is physical, sexual, or psychological harm inflicted by a current or
former partner (same sex or not) or a current or former spouse (Black et al., 2011). Almost one third
of American women experience being hit, slapped, or pushed by an intimate partner, and nearly a
quarter will experience serious forms of IPV during their lifetimes. Additionally, nearly one in five
women will experience a completed or attempted rape in their lifetimes. Men experience IPV and
rape as well, although at far lower rates than do women. About a quarter of men will experience
IPV (about 12% serious forms of violence) and nearly 1.5% a completed or attempted rape.
Although more than half of women reporting rape report that the assailant was an intimate partner
and 40% that the assailant was an acquaintance, men report that half of rapes were by
acquaintances and 15% by strangers; the number raped by an intimate partner was too small to
estimate.
The health effects of IPV and sexual violence are substantial and cost as much as $8.3 billion in
health care and mental health services for victims (Max et al., 2004). Violence is associated with a
wide range of health problems, including chronic pain recurring central nervous system symptoms,
vaginal and sexually transmitted infections and other gynecological symptoms, and diagnosed
gastrointestinal symptoms and disorders (Black et al., 2011). Mental health symptoms include
depression, anxiety, posttraumatic stress disorder, and alcohol and drug use (Black et al., 2011;
Campbell, 2002).
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State Laws Regarding Intimate Partner and Sexual
Violence
State laws address a number of issues important for nurses to understand. Most often, crime of IPV
and sexual violence are addressed through state laws. Most, although not all, states have laws
specifically providing enhanced penalties for assault and battery that occurs between intimate
partners. (It worth noting that most laws refer to domestic violence or family abuse rather than
IPV.) For example, at least 23 states have some form of mandatory arrest for IPV (Hirschel, 2008).
Research findings are mixed on whether mandatory arrest laws reduce reassault (Felson,
Ackerman, & Gallagher, 2005; Hirschel et al., 2007), although findings from at least one study
suggest that the overwhelming majority of victims support mandatory arrest laws (Barata &
Schneider, 2004). Additionally, states may have enhanced penalties, such as escalating third
offenses to felonies.
Until 1975, all states provided what is called the marital rape exemption under which it was
legally impossible to commit rape against one’s wife. Beginning in the mid-1970s, based in part on
nursing research, these laws began to change (Campbell & Alford, 1989). Although all states now
recognize marital rape as a crime, in some states it is still treated differently from rape by a
nonspouse (Prachar, 2010).
Nonlethal strangulation of women is a significant but often overlooked threat to public safety.
Most (80%) strangulations of women are committed by intimate partners (Shields et al., 2010). They
can result in significant physical health problems for victims (Taliaferro et al., 2009) and
substantially increase risk of later lethal violence (Glass et al., 2008). These cases can be difficult to
charge and prosecute commensurate with the severity of the crime (Laughon, Glass, & Worrell,
2009); therefore, a growing number of states have strengthened laws related to strangulation.
All states provide for civil protective orders in cases where victims have a reasonable fear of
violence from an assailant (Carroll, 2007). States vary widely, however, in who is eligible to obtain
an order and how the orders are obtained. For example, in some states minors or dating partners
may not be able to obtain orders of protection. Most states provide for civil protection orders
against assailants who are accused of sexual assault, but the procedures may be different from those
for protective orders against intimate partners. Studies of the effectiveness of these orders are mixed
(Logan & Walker, 2009; Prachar, 2010).
In addition to these criminal justice remedies, state laws may address other issues related to IPV
and sexual violence. As of 2010, 26 states had established intimate partner fatality review teams
(Durborow et al., 2010). Fatality review teams use a multidisciplinary, public health approach to
reviewing fatalities and identifying risk factors (Websdale, 1999). A handful of states require health
care providers to report domestic violence against competent adults. It is important to understand
that in most states, IPV and sexual assault are not mandatory reports unless there are other factors
present.
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Federal Laws Related to Intimate Partner and Sexual
Violence
There are two significant federal laws that address violence against women. The Family Violence
Prevention and Services Act was first authorized in 1984. It was most recently authorized through
2015 (Public Law [PL] 111-320 42 U.S.C. 10401, et seq.). It is the primary federal funding source for
domestic violence shelters and service programs in the United States. It also funds the work of state
coalitions on domestic violence, community-based violence prevention efforts, and a number of
smaller training and assistance programs.
The Violence against Women Act (VAWA) was first authorized in 1994 (Title IV, sec. 40001-40703
of the Violent Crime Control and Law Enforcement Act of 1994, HR 3355, signed as PL 103-322). As
states began creating the protective order and criminal statutes discussed earlier, the limitations of
this patchwork of remedies became apparent. The VAWA was therefore created to address the gaps
in state laws; create federal laws against domestic violence, including protection for immigrant
women and enhanced gun control provisions; and fund a variety of violence-related training and
other local programs (Valente et al., 2009). The law originally included a provision making crime
motivated by gender a civil rights offense. This provision was, however, found unconstitutional in
2000 (Brzonkala v. Morrison, 2000).
The VAWA represented a significant turning point in public policy related to violence against
women. Previously, women who received a protective order might find that violations that
occurred in other states could not be enforced. The full faith and credit provision of the VAWA
requires that protective orders be recognized and enforced across jurisdictional, state, and tribal
boundaries within the United States. Likewise, by creating federal crimes of domestic violence and
stalking, criminal acts that cross jurisdictional boundaries can now be more easily charged and
prosecuted. Under the VAWA, it is illegal for individuals subject to certain types of protective
orders or convicted of even misdemeanor domestic violence offenses to possess a firearm. Given
that risk of intimate partner homicide increases dramatically when firearms are available to the
assailant, this represents an important safeguard for women (Campbell et al., 2003). The VAWA
addressed the significant hardships faced by both legal and illegal immigrant women experiencing
abuse from their partners. The VAWA additionally funds a wide range of victim advocacy and
training programs, with the goal of ensuring that victims of violence receive consistent, competent
services in all communities.
Each subsequent renewal of the VAWA has strengthened these provisions. The latest renewal in
2013 expanded its definitions to explicitly include gay, lesbian, and transgender victims; expanded
the safeguards available to women assaulted in tribal territories; expanded housing provisions to
prohibit discrimination against victims of IPV in all forms of subsidized public…
