A Systematic Review of Healthcare Providers’ Approaches to Practices That Contribute to Secondary Victimization of Sexual Assault Survivors

Background/Objectives: Secondary victimization (SV) following sexual assault (SA) is known to compound negative health outcomes for survivors seeking help within formal systems, such as healthcare. While there have been advances in preventing SV and support for SA survivors seeking help within healthcare, experiences of SV persist alongside worsening health disparities, particularly among disenfranchised populations of women. This literature review aims to examine the literature on HCP approaches to practices that may contribute to the SV of SA survivors.

Methods: Following the PRISMA 2020 guidelines, the literature from three databases (PubMed, CINAHL Plus, and PsycINFO) was collected, followed by the screening of the titles, abstracts, and full texts of primary data sources available in full text and published in English between 2009 and 2022. The articles included for synthesis were appraised using the Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP), and the data extracted were analyzed using thematic analysis.

Results: Four HCP approaches to practice were found to potentially contribute to the SV of SA survivors: (1) incomprehensive care in clinical practice; (2) a lack of collaboration between inter-agencies, healthcare organizations, interdisciplinary teams, and HCPs with SA survivors; (3) barriers to HCP training and preparedness to respond to SA; and (4) failures to implement trauma-informed care (TIC) frameworks.

Conclusions: Based on these findings, we provide recommendations for the prevention and mitigation of the SV of SA survivors by integrating philosophical frameworks to guide healthcare practice, including person-centered care, trauma- and violence-informed care (TVIC), and cultural safety. We reflect on the current gaps identified from this systematic review and the need for future research to operationalize and measure SV after SA in healthcare.