Media Analysis of HIV Attributable to Sexual Assault in a Global Context

Krystel Tossone, MA, MPHKent State UniversityOctober 19th, 2012

CERC Health Disparities InstituteAimee Budnik, MS, RD, CLC; Laura Schuch, MPH; Eric Jefferis, PhD

Overview of Presentation

• Scope of Problem• Aim of Study• Methods of Inquiry• Results: GIS Analysis• Results: Thematic Analysis• Discussion

Scope of Problem• Dual epidemic of HIV and sexual assault (SA)– Southern Africa1

– Conflict-ridden areas2

• Prevalence generally unknown– Varies by region?– Intimate partner violence (IPV) as risk factor3

• Post-Exposure Prophylaxis (PEP) delivery difficult– Prescriber4,5

– Region’s policies?– Individual and interpersonal barriers61. Kim JC, Martin LJ, & Denny L. (2003). Rape and HIV-post exposure prophylaxis: Addressing the dual epidemics in South Africa. Reproductive Health

Matters, 11(22): 101-112. 2. Spiegel PB, Bennedsen AR, Claass J, Bruns L, Patterson N, Yiweza D, & Schilperoord M. (2007). Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: A systematic review. The Lancet, 369: 2187-2195. 3. Gielen AC, McDonnell KA, O’Campo PJ. (2002). Intimate partner violence, HIV status and sexual risk reduction. AIDS and Behavior, 6(2): 107-116. 4. Christofides NJ, Jewkes RK, Webster N, Penn-Kekana L, Abrahams N, Martin LJ. (2005). “Other patients are really in need of medical attention”- the quality of health services for rape survivors in South Africa. Bulletin of the World Health Organization, 83(7): 495-502. 5. Bakhru A, Mallinger JB, & Fox MC. (2010). Postexposure prophylaxis for victims of sexual assault: treatments and attitudes of emergency room physicians. Contraception, 82: 168-172. 6. Abrahams N & Jewkes R. (2010). Barriers to post-exposure prophylaxis (PEP) completion after rape: a South African qualitative study. Culture, Health and Sexuality, 12(5): 471-484.

Aim of Study

• To explore the social perception of HIV attributable to SA (HIVSA) by using the media1. What is the thematic representation among the

articles?2. What is the geographic distribution of articles

found and their relationship with themes found?

Methods

• LexisNexis global news article search– “Sexual Assault” AND “HIV” – December 1985 to April 2012– English-speaking only

• Thematic and Content Analyses– 1st round: 2-coder independent article search (n = 999)– 2nd round: Independent theme development (n = 409)– 3rd round: Independent Coding and final theme

reconciliation (n = 380)• ArcGIS Analysis

Source: World Health Organization data repository, 2009.

Source: United Nations Office on Drugs and Crime: Sexual Violence, Varied Years.

Major Theme 1: Calling for Change in “Cultures of Silence”

• Identification of a need to change the attitudes of a society– Less emphasis on police reporting, more on SA

services– Allow SA survivors to receive PEP– Pass testing & notification laws

• Yet, stereotyped advice still continues– Victim responsibility of SA

Major Theme 2: Dual Trauma of HIV and Sexual Assault

• Early 90s: HIV is a “death sentence” for victim– Rapists with known HIV+ have higher sentencing

• Difficulties with uncertainty of HIV status– Managing getting tested, waiting for results– Delay in knowing offender’s status– Calling for laws to pacify victim

• An assault is worse if offender knows + status

Major Theme 3: Who is/not Allowed as a Victim/Offender in Society

• Classist/Nationalist stereotypes of offenders– “Laborer”, “farm worker”– Immigrants and natives as “brutes”

• Protectors of society and those in high power should not be offenders– Parents, police, military, older members– Shocking violations- increase in article frequency?

• The most victimized are those who have the least responsibility over their actions– Children, mentally handicapped are victims– Prisoners, men, drug/alcohol users are not

Conclusions

• Geographic Results:– Disparity in the articles represented and the co-

prevalence of HIV and SA• Thematic Results: – Universal and regional themes– Recognition for social/policy changes– What are missing regions experiencing?

What’s Next?

• Hypothesis-generating exercise– How do regions differ in discourse of HIVSA?– Do other regions experience HIVSA at similarly to S. Africa?– How can media impact/inform society of HIVSA?

• Further exploration of article search– Temporality of articles– Statistical analysis– Discourse in other languages

• Can the audience give remarks on the subject of HIVSA relative to their region or culture?