Репродуктивне здоров’я та сексуальне насильство: взаємодетермінація явищ

Background. The sexual violence forms a negative legal practice of violations of somatic human rights and a destructive impact on public life and human reproductive health. Objective of the study: to conduct an intercomplementary study of sexual violence as a destructive factor affecting human reproductive health. Materials and methods. The basis of the methodology is a comprehensive approach combining medical knowledge, concepts and principles of research, as well as social sciences and law. The epidemiological research method was used to analyze the causes of sexual violence in society and the prevalence of the problem in individual groups, regions and time dimensions. The cross-sectional method was used to analyze the consequences of sexual violence for the health of the nation by determining the attitude of society to such a problem, establishing its prevalence and the effectiveness of legal and organizational mechanisms for its resolution. The abstraction method allowed avoiding subjectivism and personal empiricism in scientific research. The author’s survey method allowed for an analysis of the social state of the outlined issues. 785 women of reproductive age participated in the author’s survey, conducted during 2022–2024 in 4 regions of Ukraine. The use of the highest level of evidence (including meta-analyses and systematic reviews) ensured the validity of the conclusions. Results. The modern understanding of the concept of sexual violence was determined and its negative consequences for the individual and society were established; forms of sexual violence were analyzed by subjects of origin; the causes of violent acts including rape and sexual harassment were established; relevant means of combating the problem of sexual violence were identified at the current stage of development of social culture and statehood. The special role of services that prevent and counteract manifestations of domestic violence, especially health care bodies, was emphasized. Conclusions. Analysis of reports by international organizations (UN, WHO, UNICEF) and doctrinal experiments conducted by scientists allow us to distinguish two areas of consequences according to the classification of the subject: those that affect the health of the person who suffered from violence (physical, sexual, reproductive, mental), and the economic and social mechanism of society and the state. The characteristic features of sexual violence are identified and substantiated. A grouping of types of sexual violence is carried out and it is proposed, in addition to actions committed by an intimate partner and non-partner, to single out sexual crimes committed as a means of waging war as a separate type. Proposals for improving the state mechanism for preventing and combating sexual violence are summarized.