Because of a growing older population, the sexual health (SH) of older adults, including sexual violence (SV), is becoming an increasingly important public health concern. Yet, reliable SV prevalence rates and risk factors are lacking, due to methodological shortcomings in current studies. SV research involves challenges regarding safety and disclosure, especially in older adults. In this paper, we reflect on the methods used in a sexual health and violence (SH&V) study in older adults balancing between privacy rules imposed by the General Data Protection Regulation (GDPR) and ethical and safety guidelines. To ensure the acceptability of the questionnaire, it was tested in a two-phase pilot study. To maximize SV disclosure, the questionnaire built up gradually towards the more sensitive SV modules. Interviewers were trained to approach participants in a non-judgmental manner. Due to GDPR, our data collection method was changed from a random sampling via the National Register to a cluster random probability sampling with a random walk finding approach. Older adults were willing to discuss SH&V during a structured face-to-face interview with trained interviewers. Following strict safety guidelines, no major incidents were reported. The cluster random probability sampling with random walk finding approach provided an adequate sampling frame, but was inefficient and time-consuming. Doing research on SH&V in older adults is feasible but requires a substantial investment of time and the challenges involved may incur greater costs. In order to guarantee further research on sensitive topics in older adults, we recommend that an interdisciplinary expert group consisting of researchers, donors, and policymakers investigates how GDPR and public health research in hard-to-reach populations can be better matched.

Background Sexual violence (SV) is an important public health problem which may cause long-lasting health problems. SV in older adults remains neglected in research, policies and practices. Valid SV prevalence estimates and associated risk factors in older adults are currently unavailable. In this study we measured lifetime and past 12-months sexual victimisation in older adults living in Belgium, its correlates, assailant characteristics and the way that victims framed their SV experiences. Methods SV was measured using behaviourally specific questions based on a broad definition of SV. Participants were selected via a cluster random probability sampling with a random route finding approach. Information on sexual victimisation, correlates, assailant characteristics and framing was collected via structured face-to-face interviews with adults aged 70 years and older living in Belgium (community-dwelling, assisted living and nursing homes). Results Among the 513 participants, the lifetime SV prevalence was 44% (55% F, 29% M). Past 12-months prevalence was 8% (9% F, 8% M). Female sex and a higher number of sexual partners were associated with lifetime SV (p < .05), non-heterosexual sexual orientation with past 12-months SV (p < .05). Correlates identified to be linked to elder abuse and neglect in previous studies were not linked with SV in our sample. ‘Someone unknown’ was identified as most common assailant. Conclusions Sexual victimisation appears to be common in older adults in Belgium. Both correlates and assailant characteristics seem to differ from previous studies on elder abuse and neglect. Recognizing older adults as a risk group for sexual victimisation in research, policies and practices is of the utmost importance.

Background: Sexual violence (SV) is an important public health problem which may cause long-lasting health problems. SV in older adults remains neglected in research, policies and practices. Valid SV prevalence estimates and associated risk factors in older adults are currently unavailable. Objective: To measure lifetime and past 12-months sexual victimisation in older adults living in Belgium, its correlates, assailant characteristics and the way that victims framed their SV experiences. Design: Cross-sectional general population study. Setting: Community-dwelling, assisted living and nursing homes. Participants: 513 people of 70 years and older living in Belgium. Methods: SV was measured using behaviourally specific questions based on a broad definition of SV. Participants were selected via a cluster random probability sampling with a random route finding approach. Information on sexual victimisation, correlates, assailant characteristics and framing was collected via structured face-to-face interviews. Results: Lifetime SV prevalence was 44% (55% F, 29% M). Past 12-months prevalence was 8% (9% F, 8% M). Female sex and a higher number of sexual partners were associated with lifetime SV (p <.05), non-heterosexual sexual orientation with past 12-months SV (p <.05). Correlates generally linked to elder abuse and neglect were not linked with SV. ′Someone unknown ′ was identified as most common assailant. Conclusions: SV appears to be common in older adults in Belgium. Both correlates and assailant characteristics seem to differ from previous studies on elder abuse and neglect. Recognising older adults as a risk group for sexual victimisation in research, policies and practices is of the utmost importance.

Background: Because of a growing older population, the sexual health (SH) of older adults, including sexual violence (SV), is becoming an increasingly important public health concern. Yet, reliable SV prevalence rates and risk factors are lacking, due to methodological shortcomings in current studies. SV research involves challenges regarding safety and disclosure, especially in older adults. In this paper we reflect on the methods used in a SH&V study in older adults balancing between GDPR imposed privacy rules and ethical and safety guidelines. Methods: To ensure the acceptability of the questionnaire, it was tested in a two-phase pilot study. To maximise SV disclosure, the questionnaire built up gradually towards the more sensitive SV modules. Interviewers were trained to approach participants in a non-judgemental manner. Due to GDPR, our data collection method was changed from a random sampling via the National Register to a cluster random probability sampling with a random route finding approach. Results: Older adults were willing to discuss SH&V during a face-to-face interview with trained interviewers. Following strict safety guidelines, no major incidents were reported. The cluster random probability sampling with random route finding approach provided an adequate sampling frame, but was inefficient and time-consuming. Conclusion: Doing research on SH&V in older adults is feasible, but requires a substantial investment of time and the challenges involved may incur greater costs. Research institutions, donors, and policy makers should convene to investigate how problems related to GDPR can be solved, especially regarding research on sensitive topics and hard to reach populations.

Background: Conducting research in hard-to-reach populations such as applicants for international protection (AIPs) brings along a number of research challenges. This is especially true for sexual violence (SV) research. Methods: We developed a study design with the intent to reach AIPs in a randomized and anonymous manner including potential illiterate respondents as well, while avoiding as much bias as possible. However, this method was developed just before the entry into force of the new European General Data Protection Regulation (GDPR), upon which important new research challenges emerged. Results: This paper describes the original study design developed to estimate SV prevalence in AIPs in Belgium. We discuss the impact of the GDPR on the recruitment strategy applied to conduct a survey on SV in a randomly selected sample of AIPs, the adapted approach to conduct the study beyond GDPR and lessons learned for future research on sensitive topics in hard-to-reach populations such as AIPs. Conclusions: To achieve reliable prevalence numbers and provide high-quality data on SV in AIPs while respecting the GDPR regulations, studies will require an approach that has become significantly more time consuming and resource-intensive to implement.

Background: Conducting research in hard-to-reach populations such as applicants for international protection (AIPs) brings along a number of research challenges. This is especially true for sexual violence (SV) research.Methods: We developed a study design with the intent to reach AIPs in a randomized and anonymous manner including potential illiterate respondents as well, while avoiding as much bias as possible. However, this method was developed just before the entry into force of the new European General Data Protection Regulation (GDPR), upon which important new research challenges emerged. Results: This paper describes the original study design developed to estimate SV prevalence in AIPs in Belgium. We discuss the impact of the GDPR on the recruitment strategy applied to conduct a survey on SV in a randomly selected sample of AIPs, the adapted approach to conduct the study beyond GDPR and lessons learned for future research on sensitive topics in hard-to-reach populations such as AIPs. Conclusions: To achieve reliable prevalence numbers and provide high-quality data on SV in AIPs while respecting the GDPR regulations, studies will require an approach that has become significantly more time consuming and resource-intensive to implement.

Cet article interroge le regard que portent nos sociétés sur les violences sexuelles subies par les personnes âgées, en explorant l’âgisme comme facteur qui peut expliquer la perception actuelle entourant la sexualité et les violences sexuelles envers elles. Bien que la violence sexuelle soit une thématique largement étudiée, sur le plan international, peu de recherches se concentrent sur les personnes âgées. Suivant les différentes perspectives et disciplines, leur prévalence à l’encontre des personnes âgées varie entre 0,9 et 15 %. À l’instar des populations plus jeunes, les personnes âgées ayant subi des violences sexuelles sont également plus à risques de subir une victimisation secondaire si elles ne sont pas crues lors de leur témoignage. La victimisation secondaire consiste à revivre le traumatisme par un événement lié ou non au traumatisme initial. Les professionnels de la santé ne sont pas formés pour accueillir, détecter et orienter leurs patients âgés, victimes de violences sexuelles. Cet article se termine en proposant quelques pistes de réflexion quant au modèle de société dans laquelle nous aimerions vivre et vieillir.

No abstract