Sexual violence, including childhood sexual abuse and adult sexual assault, is a significant public health problem. The purpose of the proposed research is to develop a midrange theory that describes, explains, and predicts men and women's responses to sexual violence and guides clinical interventions for individuals seeking healthcare who have experienced sexual violence. Grounded theory methods will be used to revise and expand a theoretical framework proposed by Draucker and Stem in 2000 entitled "Forging Ahead in A Dangerous World: Women's Responses to Sexual Violence by Male Intimates." Using this framework as a starting point, we intend to develop a midrange theory using two sources of data: a) published reports of qualitative studies that describe individuals' responses to sexual violence, and b) narratives and documents obtained from a large, diverse community sample of men and women who have experienced sexual violence. The theory will provide a typology reflecting experiential variations of sexual violence across the lifespan, describe the unique challenges faced by men and women who live through different types of sexual violence, and map trajectories of change over time. Specific aims are to: a) Refine and expand the categorization of experiences of sexual violence identified in the framework previously developed by the PI and colleagues, b) Identify the basic social psychological processes, including critical junctures related to recovery, used by individuals in each category to manage their lives during and after their victimizing experiences, c) Explore the role of social structural forces (cultural, social, economic, institutional), including those of the healthcare system, on responses to sexual violence, d) Examine the influence of gender on responses to sexual violence by comparing men and women's experiences, and e) Based on the theory, develop a sexual violence nursing assessment guide that may be used by staff nurses who care for victims of sexual violence in their daily practices. Following completion of this project, the next step in the research program would be to implement and evaluate the assessment guide on several nursing units and use qualitative outcome analysis to further validate the theory and analyze the clinical application process. The long-range goal is to build and validate a repertoire of theory-based assessment and intervention strategies for healthcare providers who work with survivors of sexual violence in a variety of settings. [unreadable] [unreadable] [unreadable]