Male and LGBT survivors of sexual violence in conflict situations: a realist review of health interventions in low-and middle-income countries

Conflict-related sexual violence (CRSV) against women and girls has been the subject of increasing research and scholarship. Less is known about the health of men, boys and lesbian, gay, bisexual, transgender (LGBT) and other gender non-binary persons who survive CRSV. This paper is the first systematic realist review on medical, mental health and psychosocial support (MHPSS) interventions that focusses on male and LGBT survivors of CRSV. The review explores the gender differences in context, mechanisms and outcomes that underpin interventions addressing the health and psychosocial wellbeing of male and LGBT survivors. The aim is to contribute to the design and delivery of gender-sensitive and, when needed, gender-specific approaches for interventions that respond to specific needs of different groups of all survivors. We conducted a systematic search of academic and grey literature to identify medical and MHPSS interventions that included men, boys and LGBT survivors. We identified interventions specifically targeting women and girls that we used as comparators. We then purposively sampled studies from the fields of gender and health, and sexual abuse against men and LGBT people for theory building and testing. We identified 26 evaluations of interventions for survivors of CRSV. Nine studies included male survivors, twelve studies focussed exclusively on female survivors and one study targeted children and adolescents. No intervention evaluation focussed on LGBT survivors of CRSV. The interventions that included male survivors did not describe specific components for this population. Results of intervention evaluations that included male survivors were not disaggregated by gender, and some studies did not report the gender composition. Although some mental health and psychosocial consequences of sexual violence against men and boys may be similar among male and female survivors, the way each process trauma, display symptoms, seek help, adhere to treatment and improve their mental health differ by gender. Initiatives targeting male and LGBT survivors of CRSV need to be designed to actively address specific gender differences in access, adherence and response to MHPSS interventions. Models of care that are gender-sensitive and integrated to local resources are promising avenues to promote the health of male and LGBT survivors of CRSV

The Intersection of Conflict-related Sexual Violence Against Men, Boys, and LGBTQI+ Persons and Human Trafficing

The genesis of the workshop was a desire to understand how conflict-related sexual violence (CRSV) intersects with the crime of trafficking and to examine the role that gender, sex, sexual orientation and gender identities/ expression (SOGIE) and age play in creating vulnerabilities. The workshop included keynotes and presentations by experts from the fields of CRSV, trafficking human beings (THB), and issues relating to SOGIE. The workshop explored the intersection of CRSV and THB against men, boys, and lesbian, gay, bisexual, transgender, transsexual, intersexual, and other individuals whose sexual and/or gender identity differs from the cis heterosexual. In 2016, United Nations (UN) Security Council Resolution 2331 addressed the nexus between trafficking in human beings and CRSV, as well as the gender-related nature of these crimes. In the 2018 report on CRSV, the UN Secretary-General reemphasized the importance of addressing the link with human trafficking for purposes of sexual exploitation in conflict. The armed conflict in Ukraine has again brought this problem to the foreground. Allegations of sexual violence, including against men and boys, have been reported to national and international agencies. But the complexity of the nexus between CRSV and human trafficking is still not well understood, particularly in the case of men, boys, and LGBTQI+ persons. The workshop brought together 36 international experts from each field of knowledge to identify and discuss possible lacunae in present research on the nexus between CRSV against men, boys, and LGBTQI+ persons and human trafficking; to assess potential legal, policy, and programmatic gaps in the responses to trafficked victims/survivors of CRSV; and to determine the need and direction for follow-up research on the topic

Pathways From HIV-Related Stigma to Antiretroviral Therapy Measures in the HIV Care Cascade for Women Living With HIV in Canada

Associations between HIV-related stigma and reduced antiretroviral therapy (ART) adherence are widely established, yet the mechanisms accounting for this relationship are underexplored. There has been less attention to HIV-related stigma and its associations with ART initiation and current ART use. We examined pathways from HIV-related stigma to ART initiation, current ART use, and ART adherence among women living with HIV in Canada