a mutual flywheel effect between partners that is manifested by an escalation in the violence. A violent spin may occur in any other forms of violence, but in Intimate partner violence the added value is the mutual spin, based on the unique situation and characteristics of intimate relationship. The primary prevention strategy with the best evidence for effectiveness for intimate partner violence is school-based programming for adolescents to prevent violence within dating relationships. Evidence is emerging for the effectiveness of several other primary prevention strategies—those that: combine microfinance with gender equality training; promote communication and relationship skills within communities; reduce access to, and the harmful use of alcohol; and change cultural gender norms. Sexual Sexual violence is any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed against a person's sexuality using coercion, by any person regardless of their relationship to the victim, in any setting. It includes rape, defined as the physically forced or otherwise coerced penetration of the vulva or anus with a penis, other body part or object. Population-level surveys based on reports from victims estimate that between 0.3 and 11.5% of women reported experiencing sexual violence. Sexual violence has serious short- and long-term consequences on physical, mental, sexual and reproductive health for victims and for their children as described in the section on intimate partner violence. If perpetrated during childhood, sexual violence can lead to increased smoking, drug and alcohol misuse, and risky sexual behaviors in later life. It is also associated with perpetration of violence and being a victim of violence. Many of the risk factors for sexual violence are the same as for domestic violence. Risk factors specific to sexual violence perpetration include beliefs in family honor and sexual purity, ideologies of male sexual entitlement and weak legal sanctions for sexual violence. Few interventions to prevent sexual violence have been demonstrated to be effective. School-based programmes to prevent child sexual abuse by teaching children to recognize and avoid potentially sexually abusive situations are run in many parts of the world and appear promising, but require further research. To achieve lasting change, it is important to enact legislation and develop policies that protect women; address discrimination against women and promote gender equality; and help to move the culture away from violence. Elder maltreatment Elder maltreatment is a single or repeated act, or lack of