Added: October 1, 2016 – Last updated: October 1, 2016


Authors: I. Ba and R(ay) S. Bhopal

Title: Physical, mental and social consequences in civilians who have experienced war-related sexual violence

Subtitle: A systematic review (1981–2014)

Journal: Public Health

Volume: Published online before print


Year: 2016 (Received: March 11, 2016, Received in revised form: July 24, 2016, Accepted: July 25, 2016, Published online: September 10, 2016)

Pages: 15 pages

ISSN: 0033-3506 – Find a Library: WordCat

Language: English

Keywords: Modern History: 20th Century, 21st Century | Types: Wartime Rape


Link: Public Health (Restricted Access)



Raj Bhopal, Centre for Population Health Sciences, University of Edinburgh


Objectives: To identify the health outcomes of sexual violence on civilians in conflict zones between 1981 and 2014.
Study design: Systematic review.
Methods: For the purpose of this study, we defined sexual violence as sexual torture including, individual rape, gang rape, and sexual slavery. All types of conflicts were included (intrastate, interstate, and internationalized intrastate). Quantitative and mixed-method studies, reporting any physical, mental, and social consequences, were retrieved from Medline, Embase, Global Health, Global Health Library, WHOLIS, Popline, and Web of Sciences (n = 3075) and from checking reference lists and personal communications (n = 359). Data were analyzed using Microsoft Excel and MetaXL. Given inherent variation, the means derived from combining studies were misleading; thus, we focused on the range of values.
Results: The 20 studies were from six countries, five in Africa (18 studies), and especially in Democratic Republic of Congo (12 studies). The number of subjects varied from 63 to 20,517, with 17 studies including more than 100 subjects. Eight studies included males. Gang rape, rape, and abduction were the most commonly reported types of sexual violence. Sixteen studies provided data on physical outcomes of which the most common were pregnancy (range 3.4–46.3%), traumatic genital injuries/tears (range 2.1–28.7%), rectal and vaginal fistulae (range 9.0–40.7%), sexual problems/dysfunction (range 20.1–56.7%), and sexually transmitted diseases (range 4.6–83.6%). Mental health outcomes were reported in 14 studies, the most frequent being post-traumatic stress disorder (range 3.1–75.9%), anxiety (range 6.9–75%), and depression (range 8.8–76.5%). Eleven studies provided social outcomes, the most common being rejection by family and/or community (range of 3.5–28.5%) and spousal abandonment (range 6.1–64.7%).
Conclusions: Wartime sexual violence is highly traumatic, causing multiple, long-term negative outcomes. The number and quality of studies published does not match the significance of the problem. The findings highlight the need for care of the survivors and their relatives and raise concerns about how they and their children will be affected in the long term.« (Source: Public Health)


    Search strategy and selection criteria
    Selection of the studies, quality assessment and data extraction and analysis
    Results of the search
    Quality assessment criteria: score out of four
    Setting, subjects' characteristics and methodology of included studies
    Types of sexual violence experienced by the subjects
    Physical consequences of sexual violence
    Mental and social consequences of sexual violence
    Observations on differences between men and women
    Range of outcomes and prevalence rates
    Overview of findings
    Mutually reinforcing consequences of sexual violence
    The intergenerational effects of war-related sexual violence
    Inadequate access to health services
    Limitations of the review
  Author statements
    Ethical approval
    Competing interests
  Appendix A. Supplementary Material

Wikipedia: Types of rape: Wartime sexual violence