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WHO Library Cataloguing-in-Publication Data: Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines. 1.Spouse abuse - prevention and control. 2.Violence - prevention and control. 3.Battered women. 4.Sex offenses - prevention and control. 5.Women s health services. 6.Review. 7.Health policy. 8.Guideline. I.World Health Organization. ISBN 978 92 4 554859 1 (NLM classification: HV 6625) 世界卫生组织,2015 年 版权所有 世界卫生组织出版物可从世卫组织网站 (www.who.int) 获得, 或者自 WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland( 电话 :+41 22 791 3264; 传真 :+41 22 791 4857; 电子邮件 :bookorders@who.int) 购买 要获得复制许可或翻译世界卫生组织出版物的许可 无论是为了出售或非商业性分发, 应通过世卫组织网站 http:// www.who.int/about/licensing/copyright_form/en/index.html) 向世界卫生组织出版处提出申请 本出版物采用的名称和陈述的材料并不代表世界卫生组织对任何国家 领地 城市或地区或其当局的合法地位, 或关于边界或分界线的规定有任何意见 地图上的虚线表示可能尚未完全达成一致的大致边界线 凡提及某些公司或某些制造商的产品时, 并不意味着它们已为世界卫生组织所认可或推荐, 或比其它未提及的同类公司或产品更好 除差错和疏忽外, 凡专利产品名称均冠以大写字母, 以示区别 世界卫生组织已采取一切合理的预防措施来核实本出版物中包含的信息 但是, 已出版材料的分发无任何明确或含蓄的保证 解释和使用材料的责任取决于读者 世界卫生组织对于因使用这些材料造成的损失不承担责任

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l'i ~ffi'fy,j~tfclaudia Garcia-Morenoffi±e{]ffi~ r' mtt!:~.:e.1:fjh,g(who)~ffi~~~,li}f-jt ~(RHR) #illffo il~ Al.J~.illdmi~fa.;l~;:1-1t~tii Hl~l Mo WHOIRHRtf2009i 3r.l 17-19 B t:hf T..l!!t $/J/JE.xt:tcf:tJ!f;/J Mv$ # ~,!It i'x'i? W. 83 Packard~ ~4?~-f' ~ WJ,.Z..la.lai9JT~t!fi.il.J3f~ittl o WHO ~~fflt mf*13f~1j,t.ei. (GOG) 1.J, ff.!: Siti Hawa Ali, Maha A Almuneef, Jacquelyn Campbell, Padma Deosthali, Gene Feder (.±h\';), Kelsey L Hegarty, Louise M Howard, Rachel Jewkes, Ruxana Jina, Joanne Klevens, Sylvie Lo Fong Wong, Judith Mcfarlane, Harriet MacMillan, Sandra Martin, Jagadeesh Narayana Reddy, Josephine Njoroge, Ana Flavia Pires Lucas D'iveira, Aurora del Rio Zolezzi, Laura Sadowski, Agnes TiwarilOZhao Genglio ~jli lw~~f201 li 9r.l 12-14 Btt B f*.11i:1hfl.j WHO GDG4?i-5l..l1.Ji.J'i, ~,&GDG.1 ji fa ~fiw~~-~~~ffi-~1.j-~o*~~ ruijfa~~~$==~~1.00 (UK) 1.J;fff.mJVit&* ~f}j~.:e.1:.{~ff~~gene Feder, ~GDG1.J t11.-~. ~~ ~t~~lllfflwj. m~~ Witwatersrand*~l.JRuxana Jina, Jilij± B p;j 1i:1.JNaira Kalra, ~00 (USA) ~~~~~~* ~-Bt~1~-ffl*B1Sandra Martin, fa~oocook County ~~~ffli}f~*'l)usajf*~.±1f1.j Laura Sadowski:iiHj T ~ffii j 1.JiiElitf1ft o ttffim3f~~fi*am ~1.J~ff~ffl JJ.X..ITT 'fil.mgene Feder, Sandra Martin lolaura Sadowski (..l:t e..&), 12),JHPJJ'.Centre of Anusandhan Trust Sai Ashrayl.J-ftt~la~~.± Di.f!i)f ~ ~ iffl 'tl,c,, #1- ifa1 ff.! Padma Deosthali, l j ~F ~$ffl~ m4?tt~~- ~Rq:i~IY-J Rachel Jewkes, ~ IE 1.J~ ~WNancy Turnbullo * WH01.J1f: RHR1 J Metin Gulrnezoglu lo Joao Paulo Dias De Souza, ffi *41fil!.flJ4m.Jjj%i:ffl001.J Mark Van Ommeren, 1% ~ lo ~ jj ffi~ $1.JChristopher Mikton, HIV/AIDS$1 JMarco Antonio de Avila Vitoria ~IJ Rachel Baggaley, *EJ$~ij)gi~~l.Jr.z~.:E.1:.ffi.t9'1WHO~mf!-tg~1}0~, Alessandra C Guedes, lll* EJ ~*~m1 JWHO~litlfl!![R1} 0~1.Jlsabel Yordi, 1tMl'J~x-j"j~l j~{,~71f 11r-m: IY-lmmk. ~F~~iM~J~;iJffl 7 l'iijfii,if-i5ll JA~: Nicola Christofides, Lina Digolo-Nyagah, Jill Keesbury Bob Mash, Vivienne Nathanson, Michael Rodriguez, Francelina Romao, Nadine Wathen fa Jiuling Wu. ~jlii J 83Priya Shetty flj Penny Howeffi

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I 2.2 *~~1~ n~w=ttafjh 5 B~~~ffi~-~*ffl.jJffi~~ffi~~-C~ ~ M m~w>. ~~~~m *m jj8tj3dt., @~Jtltt~~~~~~;ffi~ljifit}jt-f* *~~3'(~ nw~~t~8t1e~* ~ A~ ~ < 1«P.~WH0.rintifl:lffin11sitrz;JJ~:tu (mhgap) -=fffiffi~, 2010) a o 6 ~~j(tt.hw ~~~~E~i* *~A~m m~ ff~ffi" ocm ~z;jj w~ "~ ( EMDR) '-=fj1ji@1jt~i,s(j=!ff ~il~ jjll~~- 1 {~15@~~!~ (PTSD) ~j( t!. 7 :t:e~~m=~~-b~&~tt-al~j(tt@ a -=f-ffi'wti!.~~f~~. 3t~5f11/9-ltM~ittiJ. M ~ *m n89~~@-=f~ 8tl ~ lrt*~m~~ifij CAf$jzs12M> ltlf~~/l:1, 'e! M~~tt~008tl~W.:t:EE~--- -=fx~~ tl!rnm~ji:iifijlf89ijl* m~ ~. ~iti-sl:t:e t :*:~~L~Jflf~;tz:~{j{}!~Ht-1:tmm, ~&:t:e~ {~q1{a11~8tjaftrtt~~~~. 9 ~m~ Rr***ffl nlrt, @S~'e!M~fi ~~-:t -~-~:t -~89~Sffiff-=fffi,~W :t:e~:*:li~l~fflf~{~t&aijj*if::f~~. faj~yeffl\ Af3t ~(~-=fffiffii3t #.I, m http: I / www. who. int/ mental health/ mhgap/ evidence/ en/ ) {~- ~ 3.1 ttu m.1as~~afj-=t=-ffi 3.1.1 ffi-f&~~ 1 o ~i1~1f1~ t1-ffm89j(fi~~* m~-~:i:~ <~ml'ti-sld, --t'e!m: 1aJ~YEtit 5 m:m~m891i ~o:i:~. ~ l@mkrjr~,c.,89 lyj, @::f-=f~~~gee~; {rli!llfi, @~illftm! l@ ttatm,~,: m~!!lllfl!il!)j, ~flmwt~~~~~t!t: m1~,!., #ffiwjmk~*nll*~u4?xt. mhgap intervention guide for mental, neurological and substance use disorders in non-specialized health settings. Geneva, World Health Organization, 2010 {http://whqlibdoc.who.int/publications/20 I 0/9789241548069 _ eng.pdf) b. ;(fi$atf cflr:2:w~j.!,\\j[~ii ffi, ~llt1kffl1t1t!!.~1taffcfl5'rm1 JiiEffl*~li.lHU~. ~ill:11.bij.tl!p:/&:t;r,!:j, "~FJ[ C ~iieffi" ~~7[fflI:$t. d ~~ i,.~ tt.x11±!r m:.m:t1hlt r 1 11'1*, ~We fj Psychological first aid. Geneva, World Health Organization, 2011 (whqlibdoc.who.int/publications/20 I l/9789241548205 _ eng.pdf).

II 11 ft~--t-7t~l'flm1:!ic.~, ic~~f4w-~~l!]jl rajmiie~ ~B~*ml'fl,#mff:i:oooo~~~ c~~ JUJli!IJM:. -e1m~m~) ~j:ic.~~-e1m: ft m~ ia:idaj ir-j flt faj lll,, m l'f.1 ~ m!: t,fljl 00.Jx\.~; HIV,fl]jtft!J.fiftffl~~ (STis) e{]jx\.~i:,c.,jl{jl ~~o 3.1.2 '.itfjji!l~ 12 ~111im~ :t il~ti11mfas~l*jm~~~ii cj:i~ ql,jjal'fl :t ~~tt~mg~ W-a ~{i~-0 13 tioejam..:e.~ ~1Jlm~~ ~m~tr:~itljlm o 1t#ip.fiU:IU. 5mg, ~.73Bl: fajfw;12-24,j,flte{]ux cj:i ~ {t!j: O. 75mgl'f.J~5'!-ff o!w*~~tr:~~ljl~. EJ~--~~-~~~~* fi~, ~flt~fflktt~cjzo*~l'flffi)o!w*~~d~[lj ljl~, *tfiil' P-JiHf~ (IUDs) EJm~fii~~~;iiljll'f] ~ti o ~ m!ijsti s l'fj )X\. ~.~~tt-~l'fj~tt~--~~ ~#( ffio ~ *m:tff-i1t. 2010) \ EJtEil~ li:ftmfisx P-1$.11.IUDso 14 jzo-~~ li::{ ~~:iiqz~*(r,jb1faj (5~).Z,15, ~~iiljl~y&j, B.Xf!t5i~ ) t-fqz*~it, ~~ Jffl ~*~~~::r-:lt~:i:1 JAii.iitF. 3.1.3 HIVaJI.JiiffiWi 15 ~m!ajil~ti{t~b721j,ff1z.j*j~l*(r,j~'tit'!~hiv -~J5fflmCP~)o~ffl~$~r. l ~W - )El~~HIY PEP:R::-N*~ rajmye~ c ~~ff- ~It.lUR (!LO) /WHO~ft1~ i i2008)d!jj.guidelines for medico-legal care of sexual violence survivors. Geneva, World Health Organization, 2003; Clinical management of rape survivors. Geneva, WHO/Office of the United Nations High Commissioner for Refugees (UNHCR), 2004 * -learning programme on Clinical management of rape survivors. Geneva, WHO/UNHCR/United Nations Population Fund (UNFPA), 2009. b WHO medical eligibility criteria. Geneva, World Health Organization, 2010. C ~ii.i~[$*. d Joittt /LO/ WHO guidelines on post-exposure prophylaxis to prevent HIV infection. Geneva, World Health Organization, 2008 5i

I 16 ~~~*Wii;HIVJx\.~!;}_~JE:Jl:~{t.fflPEP, jtt:p ~ffi: ffrr ±ig~(r~1 JHIV~~$. PEPl JPo~i'~b 1if!!a~1 JHIV~~~~,&!J\l{.iE (J!ll~O~i J"0) ~-fffil~w:. ~ffi~-~1 J~ii 11:PEP:n t:p {j!.ffl 1 Jm~~~m :ih~4m l J iih'j: ffl HIV{tffll J-a]"fj~tt. 17 ~l]~{j!ffl 7HIV PEP: - ~ m~mw:n. 11:n~~- r RUJJ l J ffl) ~ t:lht~hiv~~~lll iffl~[l* ~f~ti!! ~ Mll3n 115 M&:n <1t.ffl~~m m~)-ft«f~ H :n.«~~d ~~m~&1 J:n R4m~Mff:n l J~-@~moo m. 18 ~~ iffl@~:ll:pepfr:~t:pl J--t-.m mr,t. 3.1.4 ii~ffi/6~fl<j JIJ ffi!vi 19 x-tttflfil:fr:f~~~~@fjh~ffi~: ;&mtf* mwg ~.$.~. ~ -~~Mff:n l J~.@~~~-mm. 20 ZJff~ffi~#C~~ZJff~~~~B)@~ffl~ mmm~. @telt]}~~#-~~~.lfn.~z.jff:tfc~. 3l!l* B~~, 91Ux1lfill}?X~#. 3.1.5 l~\~=pffi 21 ~~1'!1it3!1l~iSl I Ois:i&l Jxt.Mll1*~. 22 ~~~$F.mffhl J@x1~~1 J~OO~~c3l!l~ *mrr.m ~ ttm ~ e~~~ ~-ffe) 0 ffi-~f'mf[, ~T fe] ~i.ieffl 5s ~l:'mfli, ~ffaj~ 5! iieffl faj~iiet1t *~JJQ.ffl~iiEffl 23 ~mz~mie.,~~fii.1/~ iaj. Joint /LO/WHO guidelines 011 post-exposure prophylaxis to prevent HIV i11fectio11. Geneva, World Health Organization, 2008 b tewi-1-hiv PEPl'.r-J ~A1Llli.JFJtt:j::i,.!tD.~$t~$ftr0%~3.7%Z faj. e Joint /LO/WHO guidelines on post-exposure prophylaxis to prevellf HIV infection. Geneva, World Health Organization, 2008. d ~~U5(#~ :t±irfe::tjul i. rir.j-1--f*, i&ffl Psychological first aid. Geneva, World Health Organization, 2011 (whqlibdoc.who.int/publications/201 1/9789241548205 _ eng.pdf). 5j 5i

3.2 5*Fa,~ffll-*"{lffffi 3.2.1 tara31-j3 F'9 a<jf-ij}i 24 m~ ~ ~Q~i,)( 1 O#i'i~l Jl: t.hu-( fa] tf:! iie ti. 25 ~~l:~~-~lqj-njhi~, fl iuw-~wtllaffl loj ~l:1itfl';- f~ ~,MMM-~. ~ B, ~BffB#.4. ~-#~~Fct~1-~~~~"FW ".FW.8 M~~tt ~~ ~~l Jm8 -~~~. #~~m~bfc~mffi~r~* ~ jjf-zl;l:~. 26 ~ ~ ~~ Fc ttw ~rr~nh c~ ~ {l\;- t:p~ nff~b11t~m1 Jnh>, ~~~ hw~~~ ~1 JE~f,fmS~~~~~iA~rr~1itfi ( CBT) G~~Jm.f{.Jli.~ll:fri! CEMDR) 27 ~-~-~~~ffi~--~- (~-~~,fflffl fa]~ iie ffl. jjj ~ 1 1 -~~tliaffl~~. * ~), ~~~OooGM Tffiffi~ <2010> b ~~tl{jl;f~fil!~~4. 3.2.3 ~afa31-j3 Fcl'.ru=i=-ffi 28 29 30 ( l~i=f ffi iffl~i;jj' Ji!.ht tp: I / www. who. int/ mental - health/ mhgap/ evidence/ en/) iffis~t!jlfi!.fpjn!i (~ ~.mi*:.t'c/ PTSD. 1QJ raj ~ ue tts PJ ~ 1 1 fflfffll~wtllafflrojjl!i, ~ B) fof!ffimhgap C ~Tffiiffi~;/J, TBN*~ff~-~. fflr~ffl~-.~~~ffi Ji!.http://www. :r, moi~. itt,=-ffiffitwm.ffi 7~ott~ff*flfl who. int/ ment al_ fiij R.fil t J 11hIE 1!ffi,~fn ~. health/oogap/ evidence/ en/) fl';- t:p~ Wl-~ ilfw~~~jni1h~fc~iat~!~ (PTSD), ~m~ rr~1arr ~;1Jaa.J1I.~~<E~R)~ ~ 8-fiPTSD.m~ *~l 1E~ffl &~ <ft~-~ $8* ~,~±fom~±>~ ~ m*m h~tt~ abl Jjdi:tl1!U!l- ~l:m:tr-jt-lfijii < ~~i)(l) ~l,!i,5( #.lh±l&::fe:.#1.'t#ol. ~!(,]1'-1*, i&~ ~ Psychological first aid. Geneva, World Health Organization, 2011 (whqlibdoc.who.int/publications/201 l/9789241548205 _eng.pdf). b mhgap intervention guide for mental. 11eurological and substance use disorders in 11011-specialized health settings. Geneva, World Health Organization, 2010 (http://whqlibdoc.who.int/pubtications/20 I 0/9789241548069 _ eng.pdf) ii 5si 51 51 5j 5!ii

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I 4 fl :X*WfffB.jJB<Jf5iffiiLl:tE.TI~fj{@ ~m~~pi~~e<j.~:te~~~~m~~ e<j~w~1'rpi~u.. 11'fllfT*1~ 1 Jm :it~{jt < ~ ~ltm!i!hm~:teiot-f, @~;jf tt*4~1id*fllii~-~) ii :/IJ}Jj:R: -*1tJJiUl3 ~iiew Hf#?.IN:ti ldtj: I){] 2. 2 ~ W~MB:j;iJ~~~1 Jfjfi ff.! "f,;,j 1uJ. J:iiHriiE!miW ffl' : ".TI~s ~-~~~~fflm*~~ffl ij 1 rtz:!i~~#1hl-~~t~? ' 1 WHO* tlc V 1fHifil JE J Y.. ~ 8 :0i HJr O'ff!lf '1: ~-. ~*- ~*~~-W~ttl Jffl~~~!i!r*-ti?.ilt1t~ (Kiely~, 2010) ~1:Ellffi.1* Tffl~*~iiEffl* ~ ffi~m~, ~~~ -t- ~ 11 s-g *!Jc vi' 1fl' r.p r,4 ir #J A tff-,tht-:j 14 :im \U, f±1ilf~ (SadowskilOCasteel, 2010: Ramsay ~. 2006: *1t~a{:J, WH020091 MRamsay~ 20061t~Jt~S{J}!~) 0 -=fffi1 Ji.iEffi~-F ~~?t~.~,~trri "f:,e,,31;,r1nt1:rooir=t r.m f&i ~ I ~"t1'l -=f Hi C Jii!. ilij i[~ q:i ~ ;E tll jjt "f B"J ~50 -ti* - ~T=ff'.!ii - ~~Tffl<*~tt~~~-~~~) ~~~~~~~M ~ = *M:5t{E l&j\00*/ :!m rr :Jfm: ~;kltl.. C l)'.jjt), w r-m C3Jjl) lo~!e C 17JJiD, - Jy!{Er.p~l&A oo ~ * ~~~ff~.~mttg,~ ~f~-ol, imxl.jijt.9jt.ti~1i1m.:fn41=-.ti~s-m~r * *a-g m. ~M-*W~ffleiJ~*=f fflffl~~~~~mm~ffi,{e~~~ffl~~ ~/MtFf tj:tfim~&*~~1yua11:~. ~~ -r litr ~ ~ 1it ~ ~ ~,e,, :fjil~ M=!r-J mt :5t, iffi J ~ Y.. mn~m ~~-~ffs{j~w~m.~* ~~~~~r.p,m-=fffls{j~~~~a#,* ~IB: *.iei.ma<j,c.,jj.-=fr9i.fa,c.-: i~w,. ~20Jjlfi::l~/ M.-&.fri,c.,f:ll/.-=ft,11 JliJf3t~.t1f ~~~~~*~ ~lf~~ tt.filffls{jm il:mbiljafi~ c 13r9D iu~~ C7J1i!) JiJTlf 1i)f~~~~mMR~M,~ffl~m~S{]W~ IA, M,rajJE~;/;J "11!]~ 11 wt "~~11t:m: " ~ tt ffi~mtt~d~m~i JW~ ~lfm~~,ff*~~$~, ~~ff*~11t 'ffi 4 ~ 'ffi I j,, ~ ff {ij1i}f 3t S{J %1: ~~ ~ )l o li}f 3t s-g :1 ~ 11:m~Hiij. 7 flhjfi~ijf~l Jfi:}/U[j!MOMeta *~ ~J - ~*mw~j, *~~~~ ~m~~***rmtfil #g, :( ~~ B*~JiJTffMT~E~~~. M~ J:( ~-1' JiJT~~*W~ffl hs-g~fitt, ~~:( ~ tt~~~f~~~tffifl!j!~b{]~w,. 1f 1i.)jl~Jf~i'ffi!tT ~fli~~s-g-=fffi C Kubany ~, 2004: Gilbert~, 2006: Lieberman ~. 2006: Kiely~, 2010: Zlotnick~, 2011) J! Wf~a:p &~JL-1'-1iJf3i:~ttM~ ~tt~~~ffl-~s{j~ttiffi M;E~S{J. # M ~ a~~* ~~Pin ~ *~~:5tff, ~ m~1t ~ ~1 tiz.~~ R-=fH~~s-gfilffl~81f~M. ~ lijf~ ~. ~~lf-=fbffl~. ttm~mrl*w#ffl h~tts-g~~~~fi~ffifi(citt)b{]lf~ % ~ I'!{] T 1'.!Ji PT n~ f'i ~ j> PTSD.fO j{jj lm ( :( qj M), ~~lf- )jl1ijf~*~t ~s-glli~m ~. ~w. ~-filffib~~ TBM~ lijf ~m ~S{J~mm A.M~al){]* w ~~. M;ET9~1f~ff~~a-=fffla<JM ~ 3t, M 4 Jjl ~ *Jt x..t!ffi m ~ ( Wingood, Gilbert, Laverde, Melendez), 1J,W~{91J1i}f ~ (Arinero),.f04J.9i5f1J'1J,t..llliJf~ (Cox, Limandri, Rinfert- Raynor, Kim) ~ ~ ~ S~-ffi~~~ftOO:JfM~, W~T~ ~:1 mtt~,~~~ moo~-=fffl~~~= ~~~*$~~~*~7- Kffi~*'@ 1iJf ~ i J ~~19:i-J-lll Jf m 81 Etl: ~~. x-.ff~~!)jl-=fffi, CBT=ffjifJUl~ffl-rlH} mahw-~p~dl'!{j~tt.ttm~m~a ~~----~.@~~~~~CITTs-gfil-~ m~;j;j~.~m ~*m#fflajjs{j~tt mt11csrnoo~isl~i.ieffln!o~.@.. Mffi,G~---M~~~ mt, ~ WHOfflf!fl{}!Jm;fJQ~itri9JiJil:Jtu ( mhgap) 1~wl (WHO, 2010) PJi,tiSl1 J, il~*w#fb:l:ij# ~-~~~ # S{J~ttm ~ # ~. ~M~tt-~S{J-~~--~ $.xiiujl!.ffvls{j~~avhlf~ <Howard~. 2010) 0

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