{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T20:24:48Z","timestamp":1787084688587,"version":"build-2736575974"},"reference-count":21,"publisher":"Weston Medical Publishing","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Disaster Med"],"abstract":"<jats:p>Introduction: Mass gatherings create complex operational challenges for emergency and disaster medical systems. While preparedness planning often emphasizes trauma, intoxication, and environmental illness, sexual violence represents an under-recognized but significant medical and operational concern with direct implications on emergency medical services (EMS) operations. These incidents not only threaten individual safety but also strain on-site medical and psychosocial response systems. Findings are discussed in the context of disaster preparedness and prehospital operations.Objective: To synthesize the prevalence, risk factors, reporting patterns, and prevention\/response strategies for sexual violence at mass gatherings, and to translate these findings into actionable implications for EMS systems and event medical planning.Methods: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews methodology, we searched nine databases (MEDLINE, Embase, Scopus, Web of Science, PsycINFO, EBSCOhost, PubMed, Science Direct, CINAHL) and gray literature for studies addressing sexual violence at events with &gt;1,000 attendees. Two reviewers independently screened records; discrepancies were adjudicated by a third reviewer. Sixteen studies met eligibility criteria. Data were extracted on prevalence, risk factors, reporting behaviors, and prevention or response strategies. Findings were analyzed thematically to identify implications for EMS preparedness and patient care.Results: Sexual violence was consistently under-recognized and underreported at mass gatherings. Six major themes emerged: (1) substance use, (2) environmental vulnerabilities, (3) risk concentration among young women, (4) bystander inaction, (5) normalization of harassment, and (6) limited effectiveness of prevention strategies. Victims often disclosed informally to friends or event staff rather than law enforcement or EMS clinicians. Across studies, opportunities emerged for EMS systems to strengthen preparedness through trauma-informed training, private treatment areas, surveillance integration, and referral pathways to sexual assault response services.Conclusion: EMS clinicians and event medical teams play a critical role in identifying, treating, and referring victims of sexual violence during mass gatherings. Event medical planning should explicitly anticipate sexual violence cases by incorporating trauma-informed training, private and secure treatment areas, and referral pathways to sexual assault response networks. By embedding these practices within incident command and preparedness frameworks, EMS agencies can play a proactive role in protecting vulnerable populations and enhancing survivor outcomes at high-risk events. These changes will strengthen both clinical care and overall safety at mass gatherings.<\/jats:p>","DOI":"10.5055\/ajdm.0532","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T19:30:49Z","timestamp":1784575849000},"page":"201-217","source":"Crossref","is-referenced-by-count":0,"title":["Preparedness for sexual violence at mass gatherings: A scoping review of medical and operational implications for emergency and disaster response systems"],"prefix":"10.5055","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6786-384X","authenticated-orcid":false,"given":"Piercarla","family":"Martinez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7827-661X","authenticated-orcid":false,"given":"Julia","family":"Campos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7258-4188","authenticated-orcid":false,"given":"Sheryl","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1844-3439","authenticated-orcid":false,"given":"Dana","family":"Mathew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3008","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"102521","unstructured":"World Health Organization: What is WHO\u2019s role in mass gatherings? 2019. Available at https:\/\/www.who.int\/news-room\/questionsand-answers\/item\/what-is-who-s-role-in-mass-gatherings. Accessed September 2025."},{"key":"102522","doi-asserted-by":"crossref","unstructured":"Sampsel K, Godbout J, Leach T, et al.: Characteristics associated with sexual assaults at mass gatherings. Emerg Med J. 2016; 33(2): 139-143. DOI: 10.1136\/emermed-2015-204689.","DOI":"10.1136\/emermed-2015-204689"},{"key":"102523","doi-asserted-by":"crossref","unstructured":"Fileborn B, Wadds P, Tomsen S: Sexual harassment and violence at Australian music festivals: Reporting practices and experiences of festival attendees. Aust N Z J Criminol. 2020; 53(2): 194-212. DOI: 10.1177\/0004865820903777.","DOI":"10.1177\/0004865820903777"},{"key":"102524","doi-asserted-by":"crossref","unstructured":"Bows H: \u201cIt\u2019s like a drive-by misogyny\u201d: Sexual violence at UK music festivals. Violence Against Women. 2024; 30(2): 372-393. DOI: 10.1177\/10778012221120443.","DOI":"10.1177\/10778012221120443"},{"key":"102525","doi-asserted-by":"crossref","unstructured":"Palamar JJ, Griffin M: Non-consensual sexual contact at electronic dance music parties. Arch Sex Behav. 2020; 49(3): 909-917. DOI: 10.1007\/s10508-019-01568-y.","DOI":"10.1007\/s10508-019-01568-y"},{"key":"102526","doi-asserted-by":"crossref","unstructured":"Sanchez ZM, Sanudo A, Carlini CM, et al.: Sexual aggression in Brazilian nightclubs: Associations with patrons\u2019 characteristics, drug use, and environmental factors. Arch Sex Behav. 2019; 48(2): 609-618. DOI: 10.1007\/s10508-018-1322-4.","DOI":"10.1007\/s10508-018-1322-4"},{"key":"102527","doi-asserted-by":"crossref","unstructured":"Peterson ZD, Carver DN, Klann EM, et al.: Sexual harassment and assault in public spaces: Individual vulnerability and contextual risk factors. Sex Roles. 2023; 89(11-12): 685-701. DOI: 10.1007\/s11199-023-01416-3.","DOI":"10.1007\/s11199-023-01416-3"},{"key":"102528","doi-asserted-by":"crossref","unstructured":"Foran AM, Cruwys T, Rathbone JA, et al.: Multiple group membership and trust protect against distress in the context of unwanted sexual experiences at a youth mass gathering. J Interpers Violence. 2026; 41: 1015-1036. DOI: 10.1177\/08862605251318278.","DOI":"10.1177\/08862605251318278"},{"key":"102529","doi-asserted-by":"crossref","unstructured":"Aborisade RA: Sexual violence at music festivals and the \u2018theory of silence\u2019: Unravelling the \u2018hideous\u2019 sexual assault problem in Nigerian open-air musical events. J Victimol Vict Justice. 2021; 4(1): 68-87. DOI: 10.1177\/25166069211031136.","DOI":"10.1177\/25166069211031136"},{"key":"102530","doi-asserted-by":"crossref","unstructured":"Williams KJ, Murray DW: Perceptions of sexual assault at music festivals. Event Manag. 2022; 26(7): 1521-1536. DOI: 10.3727\/152599522X16419948391195.","DOI":"10.3727\/152599522X16419948391195"},{"key":"102531","doi-asserted-by":"crossref","unstructured":"Tricco AC, Lillie E, Zarin W, et al.: PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018; 169: 467-473. DOI: 10.7326\/M18-0850.","DOI":"10.7326\/M18-0850"},{"key":"102532","doi-asserted-by":"crossref","unstructured":"Baillie G, Fileborn B, Wadds P: Gendered responses to gendered harms: Sexual violence and bystander intervention at Australian Music Festivals. Violence Against Women. 2022; 28(3-4): 711-739.","DOI":"10.1177\/10778012211012096"},{"key":"102533","doi-asserted-by":"crossref","unstructured":"Wadds P, Fileborn B, Tomsen S: Carnival, sexual violence and harm at Australian Music Festivals. Br J Criminol. 2022; 62(1): 1-17. DOI: 10.1093\/bjc\/azab047.","DOI":"10.1093\/bjc\/azab047"},{"key":"102534","doi-asserted-by":"crossref","unstructured":"Bows H, King H, Measham F: Perceptions of safety and experiences of gender-based violence at UK music festivals. J Gender-Based Violence. 2023; 7(1): 74-92. DOI: 10.1332\/239868021X16439111624553.","DOI":"10.1332\/239868021X16439111624553"},{"key":"102535","unstructured":"Papisova V: Sexual harassment was rampant at Coachella 2018. Teen vogue. 2018. Available at https:\/\/www.teenvogue.com\/story\/coachella-sexual-harassment-2018. Accessed September 2025."},{"key":"102536","doi-asserted-by":"crossref","unstructured":"Lindo JM, Siminski P, Swensen ID: College party culture and sexual assault. Am Econ J Appl Econ. 2018; 10(1): 236-265. DOI: 10.1257\/app.20160031.","DOI":"10.1257\/app.20160031"},{"key":"102537","doi-asserted-by":"crossref","unstructured":"Pernecky T, Abdat S, Brostroem B, et al.: Sexual harassment and violence at events and festivals: A student perspective. Event Manag. 2019; 23(6): 855-870. DOI: 10.3727\/152599518X15403853721277.","DOI":"10.3727\/152599518X15403853721277"},{"key":"102538","doi-asserted-by":"crossref","unstructured":"Kilpatrick DG, Resnick HS, Ruggiero KJ, et al.: Drug-Facilitated, Incapacitated, and Forcible Rape: A National Study. Washington, DC: National Institute of Justice, 2007.","DOI":"10.1037\/e667182007-001"},{"key":"102539","unstructured":"Pollard J: Glastonbury festival introduces women-only space to combat sexual assault. The Guardian. August 2016. Available at https:\/\/www.theguardian.com\/music\/musicblog\/2016\/jun\/15\/glastonbury-female-only-sisterhood-safe-space. Accessed September 2025."},{"key":"102540","unstructured":"NZ Herald: Laneway festival adds safe spaces for women. 2017. Available at https:\/\/www.nzherald.co.nz\/nz\/laneway-festival-addswomens-safety-area-after-live-tv-incident\/25CGOOELXUI43EOSJAIQ2WJVOI\/. Accessed September 2025."},{"key":"102541","doi-asserted-by":"crossref","unstructured":"Fileborn B, Wadds P, Barnes A: Setting the stage for sexual assault: The dynamics of gender, culture, space and sexual violence at live music events. In Towards Gender Equality in the Music Industry. London: Bloomsbury, 2019: Chapter 7. DOI: 10.5040\/9781501345531.ch-007.","DOI":"10.5040\/9781501345531.ch-007"}],"container-title":["American Journal of Disaster Medicine"],"original-title":[],"link":[{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/ajdm\/article\/download\/4064\/4344","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/ajdm\/article\/download\/4064\/4344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T19:30:21Z","timestamp":1787081421000},"score":1,"resource":{"primary":{"URL":"https:\/\/wmpllc.org\/ojs\/index.php\/ajdm\/article\/view\/4064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":21,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,7,20]]}},"URL":"https:\/\/doi.org\/10.5055\/ajdm.0532","relation":{},"ISSN":["1932-149X","1932-149X"],"issn-type":[{"value":"1932-149X","type":"electronic"},{"value":"1932-149X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,1]]}}}