Violences sexuelles entre partenaires intimes : caractéristiques et enjeux cliniques
Résumé
Introduction. – Intimate partner sexual violence is identified as a common form of intimate partner violence.
It is also the most widespread form of sexual violence in the world, with one woman in four affected during
her lifetime. In France, couple relationships appear to be the area of life most at risk of sexual victimization in
adulthood. However, our understanding of this phenomenon is limited, with few targeted studies in the
international literature and very little data in France. Most studies tend to focus on sexual violence in general
or intimate partner violence in general, without exploring in depth the characteristics and issues of sexual
violence when committed by a partner. While intimate partner violence is a major public health issue, what
do we know about intimate partner sexual violence and how can we use this information to provide a better
support for victims?
Objectives. – The aim of this article is to summarize the current state of the art about intimate partner sexual
violence, along two major lines: a descriptive line, focusing on the nature, extent, and expressions of sexual
violence in couples, as well as its clinical effects; and a food-for-thought line, focusing on the identification of
issues likely to contribute to the harmful power of intimate partner sexual violence.
Materials and methods. – Articles were selected from referenced databases, such as PubMed, PsycInfo and
Web of Science. The terms ‘‘intimate partner sexual violence’’ and ‘‘intimate partner rape’’ were used as first
choice, and then the keywords ‘‘intimate partner violence; domestic violence; domestic abuse; intimate
partner; relationship; battered women; spouse; wife; marital’’ were cross-referenced with the terms ‘‘rape;
sexual violence; sexual abuse; sexual coercion; unwanted sex; forced sex’’. The search for articles was carried
out between February 2021 and May 2021.
Results. – The literature tends to indicate that intimate partner sexual violence develops mainly in
relationships already marked by violence. It appears to be co-occurring with physical and psychological
violence by the partner elsewhere in the relationship, but also simultaneously with the abuses. Intimate
partner sexual violence is repetitive and has multiple expressions: their reality extends beyond intimate
partner rape. They seem to be associated with unique deleterious effects for the victims, and could be an
indicator of the severity of the overall situation of intimate partner violence, with increased post-traumatic
and depressive symptomatology, as well as a greater number of deaths by suicide and homicide. However,
they are still perceived as less serious than sexual violence by a non-partner or a stranger, both by society and
by the women affected. This discrepancy between the seriousness of sexual violence between partners and
its global and individual perception is to put into perspective with the dysfunctional dynamics of sexual
consent in violent relationships. However, the research is scarce, and more studies are needed to provide a
better understanding of the numerous aspects of intimate partner sexual violence.
Conclusions. – The clinical reality of intimate partner sexual violence is both worrying and poorly
understood. It must be recognized and addressed in treatment because of its traumatic potential and its
power regarding psychological confusion for the victims. The current state of knowledge indicates that
asking women who have experienced violence from their partner about sexual violence is an essential part of
practice. The professionals
Introduction. – Les violences sexuelles entre partenaires intimes sont identifie´ es comme l’une des
formes courantes de la violence conjugale. Elles constituent la forme de violence sexuelle la plus
re´pandue dans le monde. La compre´hension de ce phe´nome`ne d’ampleur est pourtant limite´ e, peu
d’e´tudes spe´cifiques dans la litte´ rature internationale et de tre` s rares donne´es en France sont
disponibles.
Objectifs. – L’objectif de cet article est de re´sumer l’e´ tat actuel des connaissances sur les violences
sexuelles entre partenaires intimes, selon deux axes principaux : un axe descriptif, centre´ sur la nature,
l’e´tendue et les expressions de la violence sexuelle dans le couple, ainsi que sur ses effets cliniques ; et un
axe de re´flexion, centre´ sur les proble´matiques susceptibles de contribuer aux conse´quences
psychologiques de la violence sexuelle entre partenaires intimes.
Me´thode. – Les articles ont e´ te´ se´ lectionne´ s dans les bases de donne´ es PubMed, PsycInfo et Web of
Science, a` partir d’une recherche par mots-cle´ s en anglais. Les termes "violence sexuelle entre
partenaires intimes" et "viol entre partenaires intimes" ont e´ te´ utilise´ s en premie` re intention, puis les
mots-cle´ s "violence entre partenaires intimes ; violence conjugale; partenaire intime ; relation ; femmes
battues ; conjoint(e) ; e´poux(se) ; marital" ont e´ te´ croise´ s avec les termes "viol ; violence sexuelle ; abus
sexuel ; coercition sexuelle ; rapport sexuel non consenti ; rapport sexuel force´ ". La recherche d’articles a
e´ te´ effectue´e entre fe´ vrier 2021 et mai 2021.
Re´sultats. – Ces violences sont co-occurrentes des violences physiques et psychologiques du partenaire,
re´pe´ titives dans la relation et aux expressions multiples : leur re´ alite´ de´ passe largement les contours du
viol conjugal. Elles semblent associe´ es a` des effets spe´cifiques pour les victimes et pourraient eˆtre un
indicateur de gravite´ de la situation globale de violences conjugales, associe´ es a` une symptomatologie
psycho traumatique et de´ pressive augmente´ e, et a` un plus grand nombre de de´ce` s par suicide et par
homicide. Elles restent, cependant, perc¸ues comme moins graves que les violences sexuelles d’un nonpartenaire
ou d’un inconnu, du fait d’un manque de compre´hension des dynamiques dysfonctionnelles
lie´ es au consentement sexuel dans les relations violentes. Les implications pratiques pour les
professionnels sont discute´ es, de meˆme que les futurs axes de recherche a` conside´ rer.
Conclusion. – La re´ alite´ clinique des violences sexuelles entre partenaires intimes est a` la fois
inquie´ tante et mal comprise. Elle doit eˆtre reconnue et aborde´e dans la prise en charge, en raison de son
potentiel traumatique et de son pouvoir en termes de confusion psychologique pour les victimes. L’e´ tat
actuel des connaissances indique que le fait de poser la question des violences sexuelles aux femmes
ayant subi des violences conjugales est un e´ le´ment essentiel de la pratique. Les professionnels en contact
avec ce public doivent eˆtre forme´ s en ce sens afin d’eˆtre en mesure d’apporter des re´ponses ade´quates.