This evidence brief is focused on non-fatal strangulation (NFS) and acquired brain injury (ABI) in the context of sexual violence. It brings together Australian research and grey literature with supporting international evidence to define the issues and illuminate data gaps. 

This brief will be useful to people developing policies and practices to respond to and prevent NFS and ABI in the context of sexual violence and sexual choking. This will include women’s community health and other health workers, including sexual health, prehospital care, primary healthcare and allied health practitioners. It will also be of use to wider domestic, family and sexual violence sector workers and legal actors engaged with meeting the needs of women with experiences of NFS and ABI.

Key considerations

1. Australian prevalence data on non-fatal strangulation and brain injury is lacking and needed to support multidisciplinary, evidence-based responses.
2. A number of factors, including delayed and hidden signs and symptoms and a lack of understanding of the potential for non-fatal strangulation to cause brain injury, hamper appropriate medical referral and follow-up.
3. Service providers need to stay cognisant of legal and compensatory responses to nonfatal strangulation and increase specific and informed consent for sexual choking.
4. The normalisation of sexual choking as a mainstream sexual practice creates a need for accurate and up-to-date health and legal information.
5. Non-fatal strangulation and brain injuries can impact differently across different life stages and intersect with other forms of disadvantage and discrimination.