Sexual violence research across levels of the social ecology: from the individual to the societal

ABSTRACT

Sexual violence is a common and harmful form of trauma. In this article collection, EJPT features research on sexual violence spanning levels of the social ecology. First, we discuss the individual-level studies in this collection, which report on sexual violence prevalence, impact, prevention, and intervention. These papers highlight best practices for assessing sexual assault (i.e., via behaviorally-specific questionnaires), indicate the substantial and enduring mental health effects of sexual violence, and suggest that a number of prevention and intervention strategies are feasible and promising. Then, we highlight studies that broaden their lens to survivors’ interpersonal relationships: these studies provide new evidence for the relationship between social support and posttraumatic stress. Broadening the lens further still to community service systems, the studies in this collection highlight the utility of evaluating the functioning of service systems and obtaining input from stakeholders in these systems; they also suggest that digital technologies are a promising strategy to expand reach to interventions. Finally, at the broadest level of the social ecology, these studies suggest that there is still work to do as a society to promote positive change in terms of views of sexual violence and policies that increase access to needed help, and that such changes can impact individual survivors’ experiences. Considered together, this collection clearly demonstrates that sexual violence does not happen in a vacuum, and it highlights the need for more contextually-focused research on this important social issue.

HIGHLIGHTS

• Sexual violence has enduring mental health effects, but prevention and intervention are feasible.

• Systems change efforts should aim to improve the support survivors get from their interpersonal relationships and the service systems in their communities.

• Societal change is still needed in terms of views of sexual violence and policies that promote care access.

1. Introduction

A half century of scholarly research has compellingly documented the prevalence and impact of sexual violence and has yielded highly-effective treatments for its psychological effects. More than fifteen years after Tarana Burke first coined the phrase “Me Too,” and seven years after the first groundswell of the #MeToo movement, the broader public awareness of the prevalence and impact of sexual violence is perhaps higher than ever. Despite this remarkable progress of science and advocacy, sexual violence still occurs at high rates, and too many survivors are unable to access effective support or treatment.

Like layers of an onion, the contexts surrounding individual people at risk of or affected by sexual violence can be conceptualized as a series of nested levels, starting with the most immediate contexts (e.g., family, friends) and ending with the most distal (e.g., society as a whole). To make true advancements in preventing and responding to sexual violence, we must focus both on individual people and on the contexts that surround them. Although relatively less common than individual-level research, research that examines levels of the social ecology surrounding individuals can amplify the magnitude of our scientific progress in this topic area by providing a full, contextualized picture of the phenomenon of sexual violence. The contributions in this article collection span these levels.

Bronfenbrenner’s ecological systems theory (Bronfenbrenner, 1979) provides an organizing framework in which these levels can be understood. The individual level is at the centre of the onion and reflects characteristics of individual people (e.g., whether or not they have experienced sexual violence, the impact of sexual violence on their mental health). The microsystem is the first layer surrounding the centre, and it includes survivors’ interpersonal relationships with family, friends, romantic partners, and others. Exosystems are an intermediate layer that include service systems and organizations (e.g., community-based sexual assault centres) that survivors might access. The outermost layer, the macrosystem, includes societal norms (e.g., rape myths) and conditions (e.g., racism, economic inequality). None of these levels are truly independent: each is influenced by the other.

2. In this issue

In this article collection, we have included 22 original papers that illuminate the issue of sexual violence and the social ecology surrounding it (see Table 1 and Figure 1). These papers include 2 reviews, 1 study protocol, 18 primary studies, and 1 letter to the editor. We have organized the contributions by the primary level of the social ecology under consideration.

Table 1.

Articles Included in the Special Issue.

#	Authors and Year	Title	Article type	Country	Study population	Study design	Level of the social ecology	Topic category
1	Baert et al. (2023)	Mental health of sexual assault victims and predictors of their use of support from in-house psychologists at Belgian Sexual Assault Care Centres	Research	Belgium	Help-seeking adolescent and adult survivors of past-week sexual assault	Chart review	Individual	Impact of sexual assault on survivors
2	Doerr et al. (2023)	Sexual violence affects adolescents’ health and prosocial behaviour beyond other violence exposure	Research	Nigeria	Adolescents	Cross-sectional survey	Individual	Impact of sexual assault on survivors
3	Fields et al. (2022)	Drug-facilitated sexual assault, impaired trauma memory, and implications for mental health treatment	Research	United States	Help-seeking survivors of past-month sexual assault	Chart review	Individual	Impact of sexual assault on survivors
4	Mhlongo et al. (2023)	Depression and post-traumatic stress symptoms two years post-rape and the role of early counselling: Rape Impact Cohort Evaluation (RICE) Study	Research	South Africa	Help-seeking adolescent and adult female survivors of past-20-day sexual assault	Prospective survey	Individual	Impact of sexual assault on survivors
5	Pijpers et al. (2022)	Risk factors for PTSD diagnosis in young victims of recent sexual assault	Research	Netherlands	Help-seeking child and adolescent survivors of past-week sexual assault	Chart review	Individual	Impact of sexual assault on survivors
6	Anderson et al. (2023)	A comparison of two strategies to assess sexual violence: General vs. specialized trauma screening strategies in two high-risk substance use health disparity samples	Research	United States	Rural college women (sample 1) and adults in an urban setting seeking detox treatment (sample 2)	Cross-sectional survey	Individual	Prevalence of sexual assault
7	Miggantz et al. (2023)	Alcohol-involved sexual assault in the U.S. military: A scoping review	Review	United States	N/A	Scoping review	Individual	Prevalence of sexual assault
8	Braun et al. (2024)	Mindful self-compassion for veteran women with a history of military sexual trauma: Feasibility, acceptability, potential benefits, and considerations	Research	United States	Veteran women receiving mental healthcare from VA or Vet Center with a history of military sexual trauma	Uncontrolled pilot	Individual	Prevention & intervention efforts
9	Busser et al. (2023)	A novel therapeutic fencing programme for female sexual assault victims	Letter to Editor	France	Not described	Pilot uncontrolled trial	Individual	Prevention & intervention efforts
10	Proença et al. (2022)	Interpersonal psychotherapy versus sertraline for women with posttraumatic stress disorder following recent sexual assault: A randomized clinical trial	Research	Brazil	Women with PTSD after recent sexual assault	Randomized controlled trial	Individual	Prevention & intervention efforts
11	Senn et al. (2023)	Testing the effectiveness of a sexual assault resistance programme in ‘real-world’ implementation	Research	Canada	University women	Quasi-experimental effectiveness trial	Individual	Prevention & intervention efforts
12	Howe and Dworkin (2024)	The day-to-day relationship between posttraumatic stress symptoms and social support after sexual assault	Research	United States	Female survivors of past-10-week sexual assault participating in clinical trial	Prospective survey	Microsystem	Relationship between social support and survivor mental health
13	van Stolk-Cooke et al. (2024)	Associations of past-year overall trauma, sexual assault and PTSD with social support for young adult sexual minority women	Research	United States	Young adult sexual minority women	Cross-sectional survey	Microsystem	Relationship between social support and survivor mental health
14	Gilmore et al. (2023)	Teen Well Check: An e-health prevention programme for substance use, sexual assault, and sexual risk behaviours for adolescents in primary care	Research	United States	Adolescents and providers	Intervention development	Exosystem	Expanding the reach of interventions via digital technologies
15	Knipschild et al. (2024)	BLAME-LESS STUDY: A two-arm randomized controlled trial evaluating the effects of an online psychoeducation programme for adolescents who have experienced physical/sexual violence or sexual abuse. Rationale, study design, and methods.	Study Protocol	Netherlands	Adolescent survivors referred from other healthcare settings	N/A (study protocol)	Exosystem	Expanding the reach of interventions via digital technologies
16	Covers et al. (2022)	Development of multidisciplinary sexual assault centres in the Netherlands	Research	Netherlands	Help-seeking survivors of sexual assault	Chart review	Exosystem	Functioning of community-based services
17	Bender et al. (in press)	Developing and implementing survivor-centered approaches for college student-athletes: Perspectives from athletic department, Title IX, and campus advocacy personnel	Research	United States	Campus personnel	Qualitative interviews	Exosystem	Responsiveness of service systems to special populations
18	Blackburn et al. (2024)	Preventing sexual violence in sexual orientation and gender diverse communities: A call to action	Review	United States	N/A	Narrative review	Macrosystem	Systems of oppression
19	Vahedi et al. (2024)	A qualitative investigation of gender-based violence prevention and response using digital technologies in low resource settings and refugee populations	Research	Brazil, Guatemala, Iraq, and Italy	Gender-based violence service providers	Qualitative interviews	Macrosystem	Environmental conditions
20	Bhuptani et al. (2024)	Cross-sectional examination of correlates of sexual victimization disclosure via #metoo	Research	United States	Adults who disclosed adolescent or adult sexual assault	Cross-sectional survey	Macrosystem	Social movements
21	Delker et al. (2024)	How do young men narrate the redemption story of a sexual assault perpetrator?	Research	United States	Cisgender heterosexual college men	Qualitative story completion	Macrosystem	Sociocultural norms and narratives
22	O’Shea et al. (2024)	Rethinking sexual violence labels: Exploring the impact of “victim” and “survivor” discourse	Research	Canada and United States	University students	Qualitative data from interactive textbook	Macrosystem	Sociocultural norms and narratives

Figure 1.

Papers in the special issue organized by level of the socioecological model.

2.1. Individual-level research

Individual-level research examines survivors of sexual violence or people who might be at risk of sexual violence without specific attention to the contexts in which sexual violence occurs or survivors recover. Of course, contexts are made up of individual people, and thus individual-level research is critically important as part of a holistic social ecological understanding of the phenomenon of sexual violence. In this special issue, individual-level research is included that assesses the prevalence of sexual violence, the impact of sexual violence on survivors, and individual-level prevention and intervention efforts.

Assessing the prevalence of sexual violence. Although decades of research has assessed the prevalence of sexual violence, gaps remain in our understanding of how often sexual violence occurs. Research in this article collection contributes to addressing these gaps. First, Miggantz and colleagues (2023) conducted a scoping review of the prevalence of alcohol-involved military sexual violence. They found that, among women, 0–83% of military sexual violence involved alcohol, and among men, 14–66% of military sexual violence involved alcohol. They noted that these estimates were highly variable due to inconsistencies in methods, and they called for more precision in measurement of this phenomenon. The second article on this topic in the article collection attends to measurement precision. Anderson and colleagues (2023) compared two strategies for assessing sexual violence: behaviorally-specific questionnaires and a general trauma screening questionnaire. Behaviorally-specific questionnaires include descriptions of unwanted and nonconsensual sex acts and tactics rather than terms like “rape” or “sexual violence” – often used in general trauma screening questionnaires – that might be understood in different ways by different people. They found that behaviorally-specific questionnaires identified more cases of sexual violence victimization among men (but not women) seeking detoxification treatment services and rural college women. Relevant to the Miggantz review, Anderson et al. also found that general trauma screening questionnaires tended to miss cases of alcohol-involved sexual violence.

Characterizing the impact of sexual violence on survivors. Sexual violence is a well-documented risk factor for many negative health and mental health outcomes. Multiple studies in this article collection aimed to characterize these outcomes. First, in a study from Nigeria, Doerr et al. (2023) enrolled adolescents and found that exposure to higher-severity sexual violence was associated with more behavioural and health problems. The remaining articles characterized the mental health of survivors seeking help from community service systems within the first month following sexual violence (Baert et al., 2023; Fields et al., 2022; Mhlongo et al., 2023; Pijpers et al., 2022).

Both Baert et al. (2023) and Fields et al. (2022) used a chart review approach to characterize the mental health and help-seeking of survivors presenting for services in the United States and Belgium, respectively. Baert and colleagues found that many had pre-existing mental health problems, about 1 in 4 were experiencing moderate to severe distress, and a substantial minority had evidence of suicide risk. Fields and colleagues found high rates of substance use disorder among drug-facilitated sexual violence survivors who had voluntarily ingested substances during the assault, as compared to those who had involuntarily ingested substances. In contrast, those reporting involuntary ingestion had prominent relationship distress.

Both Pijpers et al. (2022) and Mhlongo et al. (2023) used prospective survey-based designs. Pijpers et al. (2022) enrolled Dutch children accessing presenting to a multidisciplinary sexual assault centre in the Netherlands within a week of sexual violence. This analysis identified that posttraumatic stress symptoms are high immediately after sexual violence and decrease over the first month post sexual violence. Early symptoms were predictive of PTSD risk at one month post sexual violence. This study’s focus on children is a significant contribution to the prospective research on the mental health effects of sexual violence. Mhlongo et al. (2023) studied South African women seeking services within 20 days of sexual violence. The use of a 2-year prospective design to assess the mental health effects of sexual violence in the global south, itself, represents a major contribution to the scant body of prospective literature. However, in an especially innovative contribution, this study also included a comparison group of women recruited from primary care settings. They found elevated rates of PTSD and depression 2 years after sexual violence relative to the comparison group, providing some of the strongest evidence to date of the long-term impact of sexual violence on mental health.

Testing the impact of individual-level prevention and intervention efforts. Several articles in this collection test individual-level prevention and intervention efforts. Individual-level prevention programmes and interventions aim to make changes within specific people, and they do not explicitly aim to alter the environments around these people. Individual-level prevention programmes (e.g., self-defense) aim to make changes within individuals’ behaviour that reduce their risk for sexual violence, and individual-level interventions (e.g., medication, therapy) aim to make changes in individual survivors that promote their recovery after sexual violence. Individual-level and contextual prevention/intervention are complementary: individual-level interventions and prevention programmes that are offered to enough people in a context could change the context itself, and individual-level interventions will always be necessary to serve those who are missed by contextually-focused intervention and prevention efforts.

One study (Senn et al., 2023) tested the effectiveness of a sexual violence prevention program. This programme, EAAA, was previously found to be efficacious in a randomized controlled trial, and it aimed to impart resistance and self-defense skills to university women. In a quasi-experimental study conducted in Canada, they compared university students who attended programme sessions to students who signed up but did not attend. They found significant reductions in risk for completed rape associated with attendance at the programme. Although these reductions were smaller than those observed in the randomized controlled trial, this nevertheless provides evidence that the effects of this programme can be maintained in a real-world setting.

Several studies tested interventions for sexual violence survivors using uncontrolled pre-post designs (Braun et al., 2024; Busser et al., 2023) or randomized controlled trial designs (Proença et al., 2022). These studies described a range of interventions, and found evidence for approaches including traditional therapy, mindfulness, a physical activity intervention, and medication. For example, Braun and colleagues (2024) evaluated a mindful self-compassion intervention among 8 women Veterans in the United States who had experienced military sexual trauma. They found pre-post improvements in PTSD and depression among participants along with evidence for the feasibility and acceptability of the programme. In addition, Proença and colleagues (2022) conducted a randomized controlled trial comparing interpersonal psychotherapy to sertraline to treat PTSD among women survivors of past-6-month sexual violence in Brazil. They found decreases in PTSD and depressive symptoms in both conditions, and they did not observe differences by condition. This represents one of the first trials of a medication for PTSD among survivors of recent sexual violence.

Summary. Although individual-level research focuses primarily on individuals, patterns of experiences among individuals can inform change among providers (i.e., in exosystems) and/or reflect realities at a population level (i.e., in macrosystems). With this in mind, several key findings emerged in the articles included in this collection. First, with regard to sexual violence prevalence, these articles indicate that efforts to understand population-level prevalence will be obscured if the measurement of sexual violence is not precise, clear, and consistent. General trauma screening questionnaires appear to be insufficient in contributing to this body of knowledge. Behaviorally-specific questionnaires might better identify cases of sexual violence in populations where commonly-used terms like rape or sexual violence might be interpreted differently. Second, regarding the impact of sexual violence on survivors, these studies provide compelling evidence for both the immediate and the enduring mental health effects of sexual violence. Among those seeking care immediately following sexual violence, posttraumatic stress is often high, and symptoms tend to decrease over time but persist for many. These findings expand the understanding of this recovery process to a broader range of populations and a longer time frame than previously considered. Providers working as part of the response to recent sexual violence can use these findings to validate and normalize survivors’ experiences. In addition, the finding that many survivors seeking acute post-assault care have pre-assault mental and substance use disorders highlights that providers should be prepared to conceptualize the co-occurrence of these disorders with posttraumatic stress and develop a treatment plan that considers these conditions as well. Finally, the articles in this collection on prevention and intervention strategies confirm that reducing sexual violence risk is possible in a real-world setting and that a variety of interventions are tolerable and associated with symptom improvement among survivors. These findings could ultimately expand the range of options available to individuals seeking prevention or intervention services.

2.2. Microsystems: survivors’ experiences in interpersonal relationships

The most immediate level of the social ecology surrounding individuals is their interpersonal relationships, called “microsystems” in Bronfenbrenner’s ecological model (Bronfenbrenner, 1979). This level is important to understand in sexual violence research because most survivors disclose sexual violence to at least one person in their microsystem, which includes their informal (i.e., not professional) relationships with friends, romantic partners, family, and others. Survivors often receive negative responses from informal supporters that are associated with worse long-term recovery outcomes (Dworkin et al., 2019). Importantly, though, sexual violence and its impact on survivors can also, over time, lead to losses of social support among survivors (Jaffe et al., 2022).

Relationship between social support and survivor mental health. Two studies conducted in the United States – van Stolk-Cooke et al. (2024) and Howe and Dworkin (2024) – shed light on this topic by examining relationships between survivors’ self-reported social support and posttraumatic stress in the first year after sexual assault. First, van Stolk-Cooke et al. (2024) found that sexual minority women who had experienced past-year sexual violence tended to have less intimate partner support, and this was especially true if they had higher levels of posttraumatic stress. Although the cross-sectional nature of this analysis precluded examination of the direction of this relationship, it nevertheless highlights the relevance of social support among sexual minority women. Second, Howe and Dworkin (2024) conducted a secondary analysis of daily data from survivors of past-10-week sexual assault with elevated alcohol use and posttraumatic stress who were participating in a clinical trial. They found that, on days that survivors reported that their social interactions were more pleasant than typical, they tended to have lower posttraumatic stress symptoms on the following day. They did not identify prospective relationships from posttraumatic stress to next-day social support. This provides the first evidence for the directionality of the day-to-day relationship between social support and posttraumatic stress among survivors of recent sexual assault.

Summary. These studies provide continued evidence of the possibility that survivors’ informal supporters could be an important and largely untapped intervention target in the first year after sexual violence. They both suggest a negative relationship between social support and posttraumatic stress in this period of time, and they provide some initial evidence that positive social interactions could reduce posttraumatic stress on a day-to-day basis. This could inform contextually-focused interventions that aim to improve supporters’ ability to respond effectively and buffer survivors against losses of social support.

2.3. Exosystems: improving the community response to survivors

Expanding the lens further, research focused on exosystems examines the community services (e.g., rape crisis centres) and systems (e.g., criminal justice system, healthcare system) which aim to prevent and respond to sexual violence. There are many barriers to getting best-practice community responses to those in need, including a lack of trained providers and a lack of survivor time or resources to enable attendance (Zinzow et al., 2022). As a result, many who could benefit from such community responses do not access them. Understanding the functioning and accessibility of these services and systems is important both because they directly impact survivors who seek help from them, but also because they contribute to a community climate around sexual violence.

Evaluating the functioning of community-based services. One key strategy for understanding the community response to sexual assault survivors involves evaluating how systems responses are being delivered to survivors. Covers et al. (2022) conducted a chart review to evaluate the functioning of multidisciplinary sexual assault centres in the Netherlands over their first 4 years of operation. They found that these centres served a large number of survivors over the initial period. They noted that the centres are highly accessible, quality controlled, and successful at maintaining referral partnerships from the police. However, they noted that these centres appear to be less accessible to men and older adults, forensic medical examinations are not standardized, and there is a lack of immediately accessible mental health services for non-acute survivors. This demonstrates that newly-established collaborative community responses can be important resources for survivors even in their initial years of operation.

Increasing the responsiveness of service systems to special populations. Certain populations have heightened risk for sexual assault victimization or negative impacts of such victimization. The needs of these populations are important to keep in mind to ensure that services and interventions are responsive to all. With this in mind, Bender and colleagues (in press) considered how campuses in the United States can prevent and respond to sexual violence in a survivor-centered manner, with an emphasis on the needs of college student-athletes. They conducted qualitative interviews with multiple campus personnel, most of whom were involved with athletics programming, about their insights into survivor-centered campus responses. Although the interviewees were not specifically asked about the unique needs of student-athletes, it is nevertheless notable that this topic did not emerge more prominently given the participants’ institutional roles. Instead, many of the themes identified in these interviews highlighted the need for standardized campus-wide approaches (e.g., online reporting tools, transparent communications with survivors by the Title IX office) that centre the needs and concerns of survivors. However, two key insights were mentioned specific to student-athletes. First, student-athletes’ busy schedules can interfere with attendance at sexual violence prevention programming, and diversifying the format could increase accessibility. Second, student-athletes might be especially concerned about confidentiality in reporting given that student-athlete communities are often close-knit. In light of the many high-profile reports of victimization of student athletes in the United States, it is heartening to learn that best-practice responses implemented by many campuses were endorsed by those involved in athletics programming.

Expanding the reach of individual-level interventions via digital technologies. Two articles in this issue address a digital tool intended to bridge gaps in survivor access to community responses to sexual violence (Gilmore et al., 2023; Knipschild et al., 2024). The process described by Gilmore et al. (2023) is notable for its description of how input from users can benefit the development of digital interventions. The researchers conducted a user experience study of a new intervention, Teen Well Check, that aims to prevent substance use, sexual violence, and sexual risk behaviours among adolescents in the United States seeking primary care services. Drawing from a user-centered design approach, the authors solicited feedback on the draft intervention from both providers and adolescents themselves. The intervention was rated highly by both groups, indicating its potential promise. Tools like these – which are intended to be available at a natural point of service system contact – could greatly expand adolescents’ access to preventative interventions.

Summary. The articles in this special issue focused on exosystems highlight the issue of ensuring survivor access to needed care. They indicate that process evaluations and feedback from those within systems can point to both strengths and areas of growth that can inform systems change efforts. They also suggest that digital technologies are a promising strategy to expand reach to interventions. Together, this highlights that there is still room for systems change that could be beneficial to survivors’ access to care.

2.4. Macrosystems: the impact of societal norms and conditions

The broadest layer of the social ecology, the macrosystem, considers societies as a whole. In relation to sexual violence, elements of the macrosystem include sociocultural norms and narratives (e.g., sexual-violence-supportive norms, cultural values and expectations), structures (e.g., laws, policies, media), and environmental conditions (e.g., poverty, natural disasters, war) (Dworkin & Weaver, 2021). Systems of oppression (e.g., racism, sexism, heterosexism) are reflected across these elements of macrosystems. Social movements aim to produce change in macrosystems. Articles in this collection address various aspects of macrosystems.

Sociocultural norms and narratives. Sociocultural norms and narratives relevant to sexual violence can include various shared ideas regarding what sexual violence is, how sexual violence happens, how and why sexual violence impacts on survivors, and how sexual violence should be responded to (Dworkin & Weaver, 2021). Two studies in this collection used innovative qualitative methods to understand how undergraduate students in North America view concepts related to sexual violence. First, O’Shea et al. (2024) examined understandings of “victim” and “survivor” labels by gathering qualitative data from an interactive textbook. They analyzed these data through the lens of rape culture, and they found that undergraduates’ perspectives reflected broader rape myths. The study found that that there are agreed-upon negative societal narratives regarding the term “victim,” but views of the label of “survivor” are more mixed. Second, Delker et al. (2024) used the qualitative story completion method to understand how undergraduate men might view paths to redemption for a sexual violence perpetrator. They found that participants struggled to imagine how the perpetrator came to take personal accountability. Together, these studies provide an important snapshot of post-MeToo attitudes around sexual violence among college students.

Environmental conditions. Societal conditions can include poverty, inequality, natural disasters, and war. In an innovative and ambitious undertaking, Vahedi et al. (2024) examined the use of digital tools in preventing and responding to gender-based violence in the face of challenging environmental conditions: in low-resource settings and among refugee populations. This qualitative study involved interviews with key informants in Brazil, Guatemala, Iraq, and Italy. This study found that such tools can sometimes magnify inequalities, and there are important risks associated with delivering digital interventions that cannot be ignored.

Systems of oppression. Systems of oppression span elements of macrosystems: they are reflected in societal norms, structures, and environmental conditions. One article in this collection addressed prevention of sexual violence among minoritized communities with attention to the role of systems of oppression. Blackburn et al. (2024) conducted a narrative review of efforts to prevent sexual violence in sexual orientation and gender diverse communities. They identified a number of prevention programmes that are designed specifically for members of these communities, and they called for universal prevention programming to include more content responsive to the unique needs of sexual and gender minoritized populations. They also highlighted that a comprehensive approach to preventing sexual violence in sexual orientation and gender diverse communities must involve addressing the systems of oppression – homophobia, sexism, and transphobia – that contribute to perpetration of sexual violence against members of these communities. In light of increases in homophobic and transphobic public discourse in the United States and beyond, articles like this that maintain focus on the needs of the LGBTQ+ community are critically important.

Social movements: Changing in macrosystems. As society evolves in its understanding of sexual violence, it is important to understand how survivors engage with these changes. One study in this article collection examined how survivors engaged with the #MeToo movement. Bhuptani et al. (2024) conducted a cross-sectional survey study examining characteristics of survivors who disclosed their sexual violence online as part of the #MeToo movement versus survivors who disclosed in person. They found that survivors with higher levels of emotion-focused coping were more likely to disclose via #MeToo, whereas survivors of sexual violence involving coercion tactics were less likely to disclose via #MeToo. This suggests that the #MeToo movement gave some – but not all – survivors an opportunity to disclose.

Summary. These studies highlight several key considerations at the broadest level of the social ecology. They suggest that, although progress has been made, there is still more work to be done as a society to develop views of sexual violence that promote positive change. They make a compelling case that is important to address societal factors that impede the safe, effective, and equitable reach of interventions. They also provide a potent example of how social movements can impact the recovery experiences of individuals. Although societal change can be a more challenging and nebulous target, the past 10 years have demonstrated that such change is possible.

3. Conclusions and future research

Together, these innovative studies provide a rich and dimensional examination of the phenomenon of sexual violence across layers of the social ecology. At the individual level, it is clear from these studies that sexual violence is common and harmful, but more research is needed that improves our measurement of these phenomena and rigorously tests a variety of interventions addressing sexual violence. When considering microsystems, these studies highlight the relationship between social support and negative mental health effects of sexual violence, and they point to the need for interventions to improve survivors’ social support. At the level of exosystems, these studies suggest that collaborative community responses can be useful to many survivors even early in their operation, and they point to digital mental health tools as a promising strategy to incorporate into these community responses. Finally, at the level of the macrosystem, these studies highlight the many advancements that have been made in how global societies view and respond to sexual violence, but they suggest that more work is needed to increase the equity and productivity of these views and responses.

Sexual violence does not happen in a vacuum. Sociocultural contexts clearly affect the likelihood of sexual violence and the experience of survivors. Given this, it is heartening that science is increasingly shifting the burden of preventing and responding to sexual violence from individual survivors to the contexts surrounding them. However, this is a challenging and often nebulous endeavour, and thus, science in this area is still less common. There is much more work needed on how these levels of the social ecology affect each other and survivors. No studies in this article collection examined societal structures, such as laws and policies, that have enormous impacts on survivors. Research on interventions that target social ecologies – and microsystems in particular – is also sorely needed.

In addition, these studies highlight the important work being done on sexual violence as a global problem, but still, more than half of these articles were conducted in the United States or Canada. This bias limits our ability as a scientific community to prevent and respond to sexual violence globally. Efforts to reduce this bias this are underway: the Global Collaboration on Traumatic Stress has brought together a multinational team of researchers to study the phenomenon of sexual violence around the world (www.global-psychotrauma.net/interpersonal-violence). This could serve as a model for similar efforts. As part of this process, researchers in settings with governmental and institutional scientific support should strive to develop collaborative relationships with researchers in less-well-resourced settings that could serve this goal.

We hope that these studies inspire future researchers to think broadly about the phenomenon of sexual violence. By doing so, we believe that large advances in decreasing its likelihood and protecting survivors will be possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).