Current Advances in the Physiological Roles and Disease-Associated Mechanisms of ADAMTS16.

Sexual and gender-based violence (SGBV) is a major global public health issue that disproportionately affects women and girls []. It is estimated that one in three women experiences SGBV during their lifetime, and the situation in Sierra Leone is particularly severe []. A 2019 national survey revealed that approximately 62% of women aged 15–49 have endured physical or sexual violence [, ]. SGBV leads to significant and often enduring health consequences, including traumatic brain injuries, sexually transmitted infections, post-traumatic stress disorder, chronic pain conditions, and substance use disorders [–]. The high prevalence of SGBV in Sierra Leone reflects the compounding effects of persistent patriarchal gender norms, post-conflict reconstruction, and widespread economic vulnerability. SGBV stems from harmful patriarchal norms that reinforce gender inequality, limit women’s autonomy, and normalize mistreatment and abuse [, ]. Structural stressors such as poverty, political instability, and armed conflict can increase the risk of violence through several mechanisms, including increased economic dependence, weakened legal protections, and normalization of violence, which can drive perpetrators to assert control through traditional power hierarchies, ultimately worsening SGBV [–]. Sierra Leone’s historical context provides a particularly salient example of these dynamics. During the country’s 1991–2002 Civil War, an estimated 257,000 people suffered sexual violence, with 27% of cases involving multiple perpetrators []. In the aftermath of the war, poverty, weak institutional systems, and social destabilization further increased women’s vulnerability to violence, exacerbating barriers to protection, medical care, and legal recourse [].