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Original Contribution
August 4, 2010

Association of Sexual Violence and Human Rights Violations With Physical and Mental Health in Territories of the Eastern Democratic Republic of the Congo

Author Affiliations

Author Affiliations: Department of Family Medicine, McGill University, Montreal, Canada (Dr Johnson); Harvard Humanitarian Initiative, Harvard University, Boston, Massachusetts (Drs Johnson and Scott); Division of Women's Health, Brigham and Women's Hospital, Boston, Massachusetts (Drs Scott and Lawry); International Medical Corps, Goma, DRC (Ms Rughita); Department of Statistics, Carnegie Mellon University, Pittsburgh, Pennsylvania (Ms Asher); StatAid, Takoma Park, Maryland (Ms Asher and Mr Kisielewski); Special Operations Command Africa–United States Africa Command, Stuttgart, Germany (Dr Ong); International Health Division, Office of the Assistant Secretary of Defense for Health Affairs, Falls Church, Virginia (Dr Lawry); and Uniformed Services University of the Health Sciences, Bethesda, Maryland (Dr Lawry).

JAMA. 2010;304(5):553-562. doi:10.1001/jama.2010.1086
Abstract

Context Studies from the Eastern Region of the Democratic Republic of the Congo (DRC) have provided anecdotal reports of sexual violence. This study offers a population-based assessment of the prevalence of sexual violence and human rights abuses in specific territories within Eastern DRC.

Objective To assess the prevalence of and correlations with sexual violence and human rights violations on residents of specific territories of Eastern DRC including information on basic needs, health care access, and physical and mental health.

Design, Setting, and Participants A cross-sectional, population-based, cluster survey of 998 adults aged 18 years or older using structured interviews and questionnaires, conducted over a 4-week period in March 2010.

Main Outcome Measures Sexual violence prevalence and characteristics, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), human rights abuses, and physical and mental health needs among Congolese adults in specific territories of Eastern DRC.

Results Of the 1005 households surveyed 998 households participated, yielding a response rate of 98.9%. Rates of reported sexual violence were 39.7% (95% confidence interval [CI], 32.2%-47.2%; n = 224/586) among women and 23.6% (95% CI, 17.3%-29.9%; n = 107/399) among men. Women reported to have perpetrated conflict-related sexual violence in 41.1% (95% CI, 25.6%-56.6%; n = 54/148) of female cases and 10.0% (95% CI, 1.5%-18.4%; n = 8/66) of male cases. Sixty-seven percent (95% CI, 59.0%-74.5%; n = 615/998) of households reported incidents of conflict-related human rights abuses. Forty-one percent (95% CI, 35.3%-45.8%; n = 374/991) of the represented adult population met symptom criteria for MDD and 50.1% (95% CI, 43.8%-56.3%; n = 470/989) for PTSD.

Conclusion Self-reported sexual violence and other human rights violations were prevalent in specific territories of Eastern DRC and were associated with physical and mental health outcomes.

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