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Rape-prevention program cuts sexual assaults in Kenya

By Ronnie Cohen

NEW YORK (Reuters Health) - Self-defense and empowerment classes designed to arm girls with tools to prevent rape reduced sexual assaults among Kenyan students, a new study shows.

The number of rapes dropped 38 percent among adolescents living in high-crime Nairobi settlements 10 months after the classes began, the study found.

In addition, half of the nearly 2,000 girls enrolled in the intervention classes reported using skills learned in the program to stop a total of 817 sexual assaults, according to results published in Pediatrics.

"This is the first time anyone's proven you can prevent rape with a simple, low-cost intervention," Dr. Jake Sinclair told Reuters Health. "It's like a vaccine."

Sinclair, a pediatrician at John Muir Medical Center in Walnut Creek, California, and his wife, Lee Paiva, of No Means No Worldwide, created the series of classes after witnessing what they described as an epidemic of rape in Kenya.

Two sexual-assault researchers who were not involved with the current study said it highlights the potential and cost-effectiveness of self-defense classes for vulnerable students all over the world.

"I think this kind of training should be available to all girls and women," sociologist Jocelyn Hollander, from the University of Oregon in Eugene, told Reuters Health. "This is a way to reduce the rate of sexual assault on campus. It really needs to be not just in college but in high school and middle school."

Stanford University School of Medicine researchers in California designed, implemented and oversaw the data collection in the Kenyan study.

"When we looked at the data, we were very startled and pleasantly surprised. It's amazing," Dr. Yvonne Maldonado told Reuters Health. Maldonado is the senior author of the study and a Stanford pediatrics professor.

She said she envisions the program being used in a variety of settings - from schools and college campuses to the military.

A White House report issued in January estimates that nearly one in five American women - about 22 million - have been raped in their lifetimes. The attacks are particularly prevalent on college campuses, where one in five female students is sexually assaulted, the report says.

Programs like the one in the Kenyan study "should be made more readily available for women until sexual assault victimization rates are substantially reduced," Leanne Brecklin, who studies rape prevention at the University of Illinois Springfield, told Reuters Health in an email.

"Unfortunately, even though there are a lot of courses offered across the U.S., self-defense programs are still not readily available to girls and women across the country or even on most college campuses," she said.

In Kenya, the researchers enrolled 1,978 female students between the ages of 13 and 20 in 12 hours of empowerment training over six weeks. The students also received two-hour refresher courses three, six and 10 months later.

A comparison group of 428 adolescents took a 90-minute life-skills class. Currently the national standard in Kenya, the class touches on a range of topics, from sexual assault to sanitation and food safety.

Almost 18 percent of the girls who took the rape-prevention classes and 14 percent of girls in the comparison group reported being raped in the year before the program began.

That rate fell to 11 percent among girls who received the training almost a year after the program, but remained the same in the comparison group.

The authors calculate that the program cost $1.75 for each rape prevented and compare that to the $86 cost for one post-rape visit to a Nairobi hospital. The $86 does not include the cost of rape-related pregnancies and sexually transmitted infections, including HIV, nor does it take into account the psychological consequences for women who are assaulted.

"It costs us $1.75 to stop a rape," Sinclair said in a telephone interview from Kenya. "That's on the cost-effectiveness level of the smallpox vaccine."

Even girls who were sexually assaulted following the intervention showed signs of benefiting from the program. They were more likely to disclose assaults, enabling them to get support and medical care and possibly leading to identification and prosecution of the perpetrators, the researchers say.

The disclosure rate in the intervention group rose from 56 percent before the classes to 75 percent after them.

Prior research in the U.S. indicates that women and children trained in empowerment and self-defense are more likely to report having confidence and control over their lives and less likely to experience sexual assault, the authors of the current study write.

A pilot study of the current program showed participants were less than half as likely to be assaulted afterward.

The program, developed by No Means No Worldwide, includes roleplaying, facilitated discussions and training in setting boundaries and developing assertiveness, physical defenses and verbal skills.

"There's a huge arsenal girls can employ that starts with awareness. Girls have the power within themselves to prevent rape. You just have to give them the permission and the skills," Sinclair said.

He said the program also teaches girls to avoid risky situations like walking down a dark street while talking on a cellphone.

"We just believe in girl power," program designer Paiva told Reuters Health.

"If we teach girls, they'll do the rest," she said. "There's so much more going on in these classes that's not about kicking and punches. It's about standing up for yourself, knowing what to say, knowing your rights, speaking up for yourself."

SOURCE: http://bit.ly/1qYM9Vh Pediatrics, online April 14, 2014.

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