{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:40:51Z","timestamp":1791229251083,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T00:00:00Z","timestamp":1626220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Psychology and Psychoth"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Rape stigma, both external and self\u2010stigmatization (self\u2010blame), is associated with adverse health outcomes. Understanding its origins and resilience factors is critical for reducing and preventing it. We describe the prevalence of rape stigma, the characteristics of women experiencing it and the pathways to experiencing greater stigma. The Rape Impact Cohort Evaluation study enrolled 852 women aged 16\u201340\u2009years who had been raped from post\u2010rape care centres in Durban, South Africa. We present a descriptive analysis of the baseline data, a multinomial logistic regression model of factors associated with different levels of stigma and a structural equation model (SEM). Most women reported stigmatizing thoughts or experiences, with self\u2010stigmatizing thoughts being more prevalent than external stigmatization. The multinomial model showed that experiences of childhood or other trauma, emotional intimate partner violence (IPV), having less gender equitable attitudes and food insecurity were significantly associated with medium or high versus low levels of stigma. Internal and external stigma were significantly associated with each other. Women who had been previously raped reported less stigma. The SEM showed a direct path between food insecurity and rape stigma, with poorer women experiencing more stigma. Indirect paths were mediated by more traditional gender attitudes and childhood trauma experience and other trauma exposure. Our findings confirm the intersectionality of rape stigma, with its structural drivers of food insecurity and gender inequality, as well as its strong association with prior trauma exposure. Rape survivors may benefit from gender\u2010empowering psychological support that addresses blame and shame.<\/jats:p>","DOI":"10.1002\/cpp.2637","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T09:13:35Z","timestamp":1624612415000},"page":"328-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Pathways to and factors associated with rape stigma experienced by rape survivors in South Africa: Analysis of baseline data from a rape cohort"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4330-6267","authenticated-orcid":false,"given":"Rachel","family":"Jewkes","sequence":"first","affiliation":[{"name":"Gender and Health Research Unit South African Medical Research Council  Cape Town South Africa"},{"name":"Office of the Executive Scientist South African Medical Research Council  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-6646","authenticated-orcid":false,"given":"Shibe","family":"Mhlongo","sequence":"additional","affiliation":[{"name":"Gender and Health Research Unit South African Medical Research Council  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0471-4978","authenticated-orcid":false,"given":"Esnat","family":"Chirwa","sequence":"additional","affiliation":[{"name":"Gender and Health Research Unit South African Medical Research Council  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5118-786X","authenticated-orcid":false,"given":"Soraya","family":"Seedat","sequence":"additional","affiliation":[{"name":"Anxiety and Stress Disorder Unit Stellenbosch University  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0235-6716","authenticated-orcid":false,"given":"Bronwyn","family":"Myers","sequence":"additional","affiliation":[{"name":"Alcohol, Tobacco and Other Drug Research Unit South African Medical Research Council  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2131-8344","authenticated-orcid":false,"given":"Nasheeta","family":"Peer","sequence":"additional","affiliation":[{"name":"Non\u2010Communicable Disease Research Unit South African Medical Research Council  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2039-6212","authenticated-orcid":false,"given":"Claudia","family":"Garcia\u2010Moreno","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research World Health Organization (WHO)  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3071-5544","authenticated-orcid":false,"given":"Kristin","family":"Dunkle","sequence":"additional","affiliation":[{"name":"Gender and Health Research Unit South African Medical Research Council  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6138-6256","authenticated-orcid":false,"given":"Naeemah","family":"Abrahams","sequence":"additional","affiliation":[{"name":"Gender and Health Research Unit South African Medical Research Council  Cape Town South Africa"},{"name":"School of Public Health and Family Medicine, Faculty of Health Sciences University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017296"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/sjp.2019.9"},{"key":"e_1_2_11_4_1","volume-title":"Childhood trauma questionnaire: A retrospective self\u2010report: Manual","author":"Bernstein D. P.","year":"1998"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2019.104075"},{"key":"e_1_2_11_6_1","volume-title":"Confirmatory factor analysis for applied research","author":"Brown T.","year":"2006"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.10113"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69523-8"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0204956"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0219125"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327019eb0904_5"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000245"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5861-3"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(01)00294-5"},{"issue":"6","key":"e_1_2_11_15_1","article-title":"Gender and sexuality: Emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention","volume":"13","author":"Jewkes R.","year":"2010","journal-title":"Journal of the International AIDS Society"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1505-5-25"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1524838016673601"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/07399332.2014.903953"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359105320950799"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0175240"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13031-018-0142-4"},{"key":"e_1_2_11_22_1","unstructured":"N\u00f6thlingJ AbrahamsN JewkesR MhlongoS LombardC HemmingsS &Seedat S(n.d.).Risk and protective factors affecting the symptom trajectory of PTSD post\u2010rape."},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(02)00304-0"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.70.4.867"},{"key":"e_1_2_11_25_1","unstructured":"SandilandsM JewkesR Baguma LeleU &Scott N. (2017).Faith engagement gender norms and violence against women and girls in conflict\u2010affected communities: Baseline research in Ituri Province Democratic Republic of Congo.What Works to Prevent Violence Against Women and Girls Project. Retrieved from London."},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2010.542122"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.52.12.1615"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327906mbr2502_4"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/camh.12435"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02291170"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/0886260510372940"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00911821"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2014.04.003"},{"key":"e_1_2_11_34_1","unstructured":"WeathersFW BlakeDD SchnurrPP KaloupekDG MarxBP &Keane T. (2013).The Life Events Checklist for DSM\u20105 (LEC\u20105)\u2014Interview [measurement instrument].https:\/\/www.ptsd.va.gov"}],"updated-by":[{"DOI":"10.1002\/cpp.2777","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:00:00Z","timestamp":1660694400000}}],"container-title":["Clinical Psychology &amp; Psychotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cpp.2637","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cpp.2637","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cpp.2637","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T14:02:06Z","timestamp":1692972126000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cpp.2637"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,14]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/cpp.2637"],"URL":"https:\/\/doi.org\/10.1002\/cpp.2637","archive":["Portico"],"relation":{"correction":[{"id-type":"doi","id":"10.1002\/cpp.2777","asserted-by":"object"}]},"ISSN":["1063-3995","1099-0879"],"issn-type":[{"value":"1063-3995","type":"print"},{"value":"1099-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,14]]},"assertion":[{"value":"2021-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}