maximum of greater than 20. A theme of gang rape also resonates from the qualitative analysis where descriptions of women being encircled by a group of men and then attacked are common. Some narratives provide detail about women being restrained by a group of men who each take turns assaulting the victim. More often, however, narratives simply state, “…. then they took turns raping me”. This high prevalence of gang rape is significant since the odds of contracting STIs or HIV increase as the number of assailants increases. Similarly, the risk of serious physical injury likely increases with multiple assailants and women are probably at higher risk for genital trauma, fistulas and bodily injury as a result. Such a high proportion of gang rape may be used as a method of male bonding and speaks to the widespread acceptability of sexual violence among armed combatants in South Kivu. Sexual slavery was reported in 12% of the attacks reported by survivors presenting to Panzi Hospital and like gang rape, was perpetrated largely by armed combatants. The amount of time spent in sexual slavery ranged from a day to several years. Young, single women were more likely to be taken as sex slaves. The brutality of rape in South Kivu has been one of the conflict’s defining characteristics and our results again speak to the horrific nature of the crimes. Women describe genital mutilation, instrumentation with sticks and weapons, forced rape between victims while held at gunpoint, and family members being forced to witness rape. In addition to the rape of young girls and elderly women, the atrocities also include rape of women in the advanced stages of pregnancy, rape of disabled women and rape of hospitalized patients recovering from recent surgery. But the brutality extends beyond the sexual violence. Within this dataset, women also describe forced cannibalism, being forced to drink bodily fluids such as urine, the slaughter of infants and young children in front of their mothers and the burning alive of family members. The ruthless nature of these attacks indicate that this is not rape for the sake of rape; instead these horrific acts are meant to terrorize and intimidate an entire population. The shame and humiliation inflicted by these crimes is intended to prohibit recovery and re-integration into society, and to thereby destroy the victims’ families and communities. Although the pattern of military rape in South Kivu was consistent within the data presented here, more recent trends indicate a potential shift in precipitating or motivating factors at work in the region. For example, evidence from beyond this dataset suggests increasing reports of male rape over the last several months. The targeting of men for sexual violence coincides with the joint DRC - Rwanda military offensive to disarm the FDLR.(53) Ten percent of the reported rape cases in Goma, North Kivu in June 2009 involved male victims and these reportedly occurred across a large geographic region. Although some men report being attacked by armed militias,(53) details of male rape are largely unknown including the identity of perpetrators, types of sexual violence, and consequences. While there have always been sporadic reports of male rape in Eastern DRC, these have been difficult to investigate since men have traditionally been even more reluctant than women to come forward after experiencing sexual violence. It is likely, given the contemporaneous nature of the reports, that this apparent willingness to come forward is linked to an actual increase in incidence. It is possible, however, that the recent trend of male rape results from decreased sexual violence stigma and therefore a new willingness on behalf of male victims to report it. Little has been documented about wartime rape targeting males and this is a topic requiring future study. 36