Abstract
Objective: We sought to investigate correlates of anogenital injuries (AGIs) in adolescents. Methods: Our retrospective study included sexually assaulted female patients aged 12 to 17 reporting attempted or completed vaginal or anal penetration between 2002 and 2011. Forensic nurses performed anogenital examinations using colposcopy, digital macrovisualization, and toluidine blue dye application. We reviewed case files for AGIs and demographic and sexual assault characteristics. Results: Of the 1961 sexual assault examinations that met our inclusion criteria, 59.6% displayed AGIs. Our logistic regression model using 1752 examinations found the following variables associated with less injury: intercourse within 5 days prior to assault (OR 0.72, 95% CI = 0.55 to 0.95); post-coital interval of 49-72 (OR 0.50, 95% CI = 0.36 to 0.71), 73-96 (OR 0.41, 95% CI = 0.25 to 0.68), and 97-120 hours (OR 0.26, 95% CI = 0.13 to 0.51). Only lack of prior sexual experience was associated with increased injury (OR 2.01, 95% CI = 1.58 to 2.55). Conclusions: In our adolescent patient population, examination findings of AGIs correlate with variables related to time from assault and prior sexual experience.
Highlights
Medical professionals are often the first contact for sexually assaulted minors, and relevant findings, physical injuries, including anogenital injuries (AGIs), may be available for a brief period of time [1,2]
We hypothesized that intercourse 5 days prior, stranger assault, and sexual inexperience would be associated with increased injury while alcohol use, consent, drug use, lapse of consciousness, child birth, increasing post-coital interval, and weapon involvement would be associated with less injury
Variables found to correlate with AGIs in bivariate analysis (Table 1) included alcohol (p = 0.047), intercourse 5 days prior (p < 0.001), post-coital interval (p < 0.001), vaginal penetration by penis (p = 0.004), vaginal penetration by finger (p = 0.039), penal-anal penetration (p < 0.001), patient position (p = 0.048), and sexual inexperience (p < 0.001)
Summary
Medical professionals are often the first contact for sexually assaulted minors, and relevant findings, physical injuries, including anogenital injuries (AGIs), may be available for a brief period of time [1,2]. In addition to administering appropriate medical care, focusing on specific factors that provide the greatest medicolegal yield should be a priority. We expanded on our prior study of AGIs in adult women by examining correlates in an adolescent population [3]. We hypothesized that intercourse 5 days prior, stranger assault, and sexual inexperience would be associated with increased injury while alcohol use, consent, drug use, lapse of consciousness, child birth, increasing post-coital interval, and weapon involvement would be associated with less injury
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