In prison, as in the outside world, sexual violence occurs when acts of a sexual nature are imposed by force or coercion. Detention places are, by their very essence, coercive environments where the notion of consent cannot be understood in isolation from the relationship of authority between those with power (be they guards or detainees) and those without. The powerful can, often unchallenged by outside oversight, impose formal and informal rules and regulations. Moreover, the scarcity which is a feature of even the best-run detention environment may lead detainees to engage in acts of a sexual nature in order to access basic goods or services, such as food, water and health care. Sex is further used in detention to pay debts, to gain access to means of communication and to obtain protection. As a result, in detention what may seem to be consensual sex is often far from it, and acts of sexual violence may not be perceived as such. By virtue of its mandate, the ICRC comes face-to-face with different manifestations of sexual violence in detention and aims to develop a multidisciplinary approach to securing detainees’ safety from sexual violence. This includes combating torture and other forms of ill-treatment, but also ensuring acceptable conditions of detention and equitable access to food,water,health services,and soon.It also includes supporting better management and oversight, restoration and maintenance of family contacts, and respect for legal safeguards. In this interview, Dr Raed Aburabi, an ICRC detention doctor, provides a first-hand account of the many manifestations of sexual violence in detention, and reflects on the multiple related needs of detainees and the ways in which an institution such as the ICRC can work to address them.