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Hill TD, Garcia-Alexander G, Sileo K, Fahmy C, Testa A, Luttinen R, Schroeder R. Male Sexual Dysfunction and the Perpetration of Intimate Partner Violence. Violence Against Women 2024; 30:3234-3250. [PMID: 37211748 PMCID: PMC11380368 DOI: 10.1177/10778012231174348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We contribute to our understanding of the social epidemiology of intimate partner violence (IPV) by developing a mediation model that frames IPV as an outcome of male sexual dysfunction (performance anxiety and erectile dysfunction) and the mechanisms of masculine discrepancy stress (the perceived failure to conform to internalized normative expectations of masculinity) and anger. Our mediation analyses of recently collected data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of 792 men, confirmed that sexual dysfunction was indirectly associated with the perpetration of any IPV, physical IPV, and sexual IPV through the compound path of masculine discrepancy stress and anger.
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Affiliation(s)
- Terrence D Hill
- Department of Sociology, One UTSA Circle, University of Texas at San Antonio, San Antonio, TX, USA
| | | | - Katelyn Sileo
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX, USA
| | - Chantal Fahmy
- Department of Criminology & Criminal Justice, University of Texas at San Antonio, San Antonio, TX, USA
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, San Antonio, TX, USA
| | - Rebecca Luttinen
- Department of Demography, University of Texas at San Antonio, San Antonio, TX, USA
| | - Ryan Schroeder
- Department of Criminal Justice and Criminology, Georgia Southern University, Statesboro, GA, USA
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Luong R, Parkin JA, Cunningham N. Acute concomitant injury and intoxication in complainants of recent sexual assault: A review. J Forensic Leg Med 2022; 92:102448. [DOI: 10.1016/j.jflm.2022.102448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
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Briken P, Turner D. Erectile Functioning as a Risk Factor for Committing a Sexual Offense? J Sex Med 2022; 19:1064-1066. [DOI: 10.1016/j.jsxm.2022.03.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 11/30/2022]
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Moreira B, Carvalho J, Nobre P. The Role of Dysfunctional Sexual Beliefs and Sexual Self-Esteem in Sexual Aggression: A Study with Male College Students. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 34:308-318. [PMID: 38596523 PMCID: PMC10903654 DOI: 10.1080/19317611.2021.2015036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/13/2021] [Accepted: 11/30/2021] [Indexed: 04/11/2024]
Abstract
This study aimed to understand how the endorsement of dysfunctional sexual beliefs is associated with sexual self-esteem and sexually aggressive behavior in male college students; it further tested the mediating role of sexual self-esteem in the relationship between sexual beliefs and sexual aggression. Results revealed significant relationships between dysfunctional sexual beliefs and sexual aggression; even so, no mediating effects were found. Findings suggest that students' beliefs about sexuality, namely, a conservative pattern of sexual beliefs, work as predisposing factors for sexual aggression. The current results add to the knowledge on the preventive targets regarding sexual offending behavior in community samples.
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Affiliation(s)
- Bárbara Moreira
- Faculty of Psychology and Educational Sciences, Porto University, Porto, Portugal
| | - Joana Carvalho
- Faculty of Psychology and Educational Sciences, CPUP: Center for Psychology of Porto University, Porto University, Porto, Portugal
| | - Pedro Nobre
- Faculty of Psychology and Educational Sciences, CPUP: Center for Psychology of Porto University, Porto University, Porto, Portugal
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Langevin S, Proulx J, Lacourse E. Sexual Aggressors Against Women's Sexual Lives: A Latent Class Analysis. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:1430-1451. [PMID: 29237318 DOI: 10.1177/0306624x17694374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study investigated the day-to-day deviant and nondeviant sexuality of a sample of Canadian sexual aggressors against women ( N = 160). Using latent class analysis, three latent classes were identified: internalized deviant (ID), low sexual problem (LSP), and hypersexual deviant (HD). Following the latent class analysis, the developmental, physiological, cognitive, and criminological correlates of these lifestyles were analyzed. ID ( n = 31) aggressors were characterized by sexual dissatisfaction, sexual deviance, and a bland sexual life. LSP ( n = 116) aggressors were characterized by the absence of sexual deviance or hypersexuality. HD ( n = 13) aggressors were characterized by hypersexuality and sexual deviance. Our exploratory study suggests that the day-to-day nondeviant and deviant sexual life of sexual aggressors against women appear to affect their modus operandi. Furthermore, the adult sexual lifestyles of sexual aggressors against women appear to be extensions of their adolescent sexual lifestyles. The results of this study thus suggest avenues for research-notably, the specific influence of sexual behaviours and internalized psychosexual problems on modus operandi-that could improve the clinical management of sexual aggressors against women.
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Kelly DL, Larkin HJ, Paolinetti LA. Intra- and inter-rater agreement of the Genital Injury Severity Scale. J Forensic Leg Med 2017; 52:172-180. [PMID: 28946081 DOI: 10.1016/j.jflm.2017.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 09/11/2017] [Accepted: 09/15/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The Genital Injury Severity Scale (GISS) is a clinimetrically-tested tool in use for quantifying and qualifying external genital injury after sexual intercourse. PURPOSE To evaluate inter- and intra-rater agreement of the GISS amongst examiner/raters in an urban, ethnically diverse, emergency department based sexual assault center. METHODS The study was conducted in three phases. Six examiners with various years of experience rated their own cases and each others' cases greater than one year after the initial exam. They rated the photographs and documentation of each case at least one year apart. Another six raters utilized a combination of the photos and documentation simultaneously from the same cases. The evaluation method was the completion of the GISS for each phase. RESULTS Based on the experience level of the rater, the differences in overall agreement were not significant. Strength of agreement was highest with the combination of photos and documentation with W ranging from 0.60501 (substantial) to 0.91056 (almost perfect). The GISS variables with the highest level of agreement were tissue break type and toluidine blue uptake type, both with photo evaluation alone and combination of documentation and photos (W = 0.72051 and 0.74599, respectively). CONCLUSION The Genital Injury Severity Scale is a reliable tool to quantify and qualify the severity of external genital injury when used to evaluate a combination of photos and documentation utilizing midlevel providers trained as sexual assault forensic examiners with various years of experience.
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Affiliation(s)
- Dana L Kelly
- Alameda Health System, Highland, Department of Emergency Medicine, 1411 E. 31st St, Oakland, CA 94602 USA.
| | - Hillary J Larkin
- Alameda Health System, Highland, Department of Emergency Medicine, 1411 E. 31st St, Oakland, CA 94602 USA.
| | - Lauri A Paolinetti
- Alameda Health System, Highland, Department of Emergency Medicine, 1411 E. 31st St, Oakland, CA 94602 USA; Samuel Merritt University, 3100 Summit Street, Oakland, CA 94609 USA.
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Abstract
This article examines one kind of conscientious refusal: the refusal of healthcare professionals to treat sexual dysfunction in individuals with a history of sexual offending. According to what I call the orthodoxy, such refusal is invariably impermissible, whereas at least one other kind of conscientious refusal—refusal to offer abortion services—is not. I seek to put pressure on the orthodoxy by (1) motivating the view that either both kinds of conscientious refusal are permissible or neither is, and (2) critiquing two attempts to buttress it.
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Dang SS, Gorzalka BB. Insecure Attachment Style and Dysfunctional Sexual Beliefs Predict Sexual Coercion Proclivity in University Men. Sex Med 2015; 3:99-108. [PMID: 26185675 PMCID: PMC4498827 DOI: 10.1002/sm2.60] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Past studies have shown an association between low sexual functioning and engaging in sexually coercive behaviors among men. The mechanism of this relationship is not well understood. Moreover, most studies in this area have been done in incarcerated sex offenders. AIMS The aim of the current study was to investigate the role of potential distal predictors of sexual coercion, including insecure attachment style and dysfunctional sexual beliefs, in mediating the relationship between sexual functioning and sexual coercion. The study also seeks to extend past findings to a novel non-forensic population. METHODS Male university students (N = 367) anonymously completed online questionnaires. MAIN OUTCOME MEASURES Participants completed the Sexual Experiences Survey, Improved Illinois Rape Myth Acceptance Scale, Hostility Towards Women Scale, Likelihood of Rape Item, Experiences in Close Relationships Scale, Dysfunctional Sexual Beliefs Scale, and Brief Sexual Functioning Questionnaire. RESULTS Sexual functioning was not significantly associated with sexually coercive behaviors in our sample (r = 0.08, P = 0.247), though a significant correlation between sexual functioning and rape myth acceptance was found (r = 0.18, P = 0.007). Path analysis of all variables showed that the likelihood of rape item was the strongest correlate of sexually coercive behaviors (β = 0.34, P < 0.001), while dysfunctional sexual beliefs appeared to mediate the association between anxious attachment and likelihood of rape item score. Anxious (r = -0.27, P = 0.001) and avoidant (r = -0.19, P = 0.004) attachment also correlated significantly with lower sexual functioning. CONCLUSIONS These findings suggest the relationship between sexual functioning and sexual coercion may be less robust than previously reported, and may be due to a shared association with other factors. The results elaborate on the interrelation between attachment style and dysfunctional sexual beliefs as predictors of sexual coercion proclivity, suggesting avenues for further research.
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Affiliation(s)
- Silvain S Dang
- Department of Psychology, University of British ColumbiaVancouver, BC, Canada
- Corresponding Author: Silvain S. Dang, MA, Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada. Tel: 604-822-2952; Fax: 604-822-6923; E-mail:
| | - Boris B Gorzalka
- Department of Psychology, University of British ColumbiaVancouver, BC, Canada
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Walker G. The (in)significance of genital injury in rape and sexual assault. J Forensic Leg Med 2015; 34:173-8. [PMID: 26165680 DOI: 10.1016/j.jflm.2015.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/08/2015] [Accepted: 06/09/2015] [Indexed: 11/24/2022]
Abstract
The forensic significance of genital injury following rape and sexual assault has been the subject of considerable academic and research interest, in terms of the contribution it may provide to the body of evidence in criminal proceedings. This essay takes a critical look at such research, in the context of modern understandings of what actually constitutes rape and sexual assault. Written from the author's perspective as a forensic physician practising in Scotland, it illustrates the fascinating interface between medical evidence and the legal system.
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Affiliation(s)
- Graeme Walker
- NHS Highland Forensic Medical Service, c/o Medical Room, Burnett Road Police Station, Inverness IV1 1RL, Scotland, United Kingdom.
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Phillips EA, Rajender A, Douglas T, Brandon AF, Munarriz R. Sex Offenders Seeking Treatment for Sexual Dysfunction--Ethics, Medicine, and the Law. J Sex Med 2015; 12:1591-600. [PMID: 26060942 DOI: 10.1111/jsm.12920] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The treatment of sexual dysfunction in patients with prior sexual offenses poses ethical and legal dilemmas. Sex offenders are not obligated by law to disclose this history to medical professionals. Over 20% of sex offenders experience sexual dysfunction; however, the number of sex offenders seeking evaluation for sexual dysfunction is unknown. AIMS The aims of this study were to determine the incidence and characteristics of sex offenders seeking treatment in our clinic; and to review data regarding sex offender recidivism and ethics pertaining to the issue as it relates to treating physicians. METHODS Sex offenders were identified via three methods: new patient screening in a dedicated sexual medicine clinic, chart review of those on intracavernosal injection (ICI) therapy for erectile dysfunction (ED), and review of patient's status-post placement of penile prosthesis. Charts were cross-referenced with the U.S. Department of Justice National Sex Offender Public Website. Patient characteristics and details of offenses were collected. MAIN OUTCOME MEASURES The main outcome measures used were a self-reported sexual offense and national registry data. RESULTS Eighteen male sex offenders were identified: 13 via new patient screening; 3 by review of ICI patients; 1 by review of penile prosthesis data; and 1 prior to penile prosthesis placement. All were primarily referred for ED. Of those with known offenses, 64% were level 3 offenders (most likely to re-offend). The same number had committed crimes against children. All those with complete data had multiple counts of misconduct (average 3.6). Ninety-four percent (17/18) had publicly funded health care. Twelve (67%) were previously treated for sexual dysfunction. CONCLUSIONS Registered sex offenders are seeking and receiving treatment for sexual dysfunction. It is unknown whether treatment of sexual dysfunction increases the risk of recidivism of sexual offenses. Physicians currently face a difficult choice in deciding whether to treat sexual dysfunction in sex offenders.
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Affiliation(s)
| | | | - Thomas Douglas
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
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Genito-anal injury patterns and associated factors in rape survivors in an urban province of South Africa: a cross-sectional study. BMC WOMENS HEALTH 2015; 15:29. [PMID: 25887051 PMCID: PMC4396864 DOI: 10.1186/s12905-015-0187-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 03/11/2015] [Indexed: 11/10/2022]
Abstract
Background The prevalence of genito-anal injuries in rape survivors varies significantly and the factors associated with the absence of injuries are not well understood. This plays a major role in the conviction of cases as the absence of injury is equated with a lack of assault. In such cases, health care providers face major challenges in presenting and defending their findings. The aim of this paper is to describe the absence of genito-anal injuries by site in a group of rape survivors and to identify factors associated with the absence of these injuries. Methods In a cross-sectional study rape cases reported to the police in one province in South Africa were randomly sampled using a two stage sampling procedure. Data were obtained on the survivor, the circumstances of the rape and the findings of the medicolegal examination. Descriptive statistics were conducted for the prevalence of genito-anal injuries by site and logistic regression models were built to identify factors associated with the absence of genito-anal injuries for all survivors and those reported to be virgins. Results In the sample of 1472 women injuries ranged from 1% to 36%. No significant injuries were reported for 749 (51%) survivors. In the multivariable model there was a significantly lower odds of having no injuries in survivors who were virgins, those raped by multiple perpetrators and those examined by a doctor with additional qualifications. In the model for survivors who were virgins, those with disabilities had a greater odds of having no injuries while those between the ages of 8 and 17 years had a lower odds of having no injuries compared to survivors below four years of age. Conclusions This study found that being a virgin, multiple perpetration rape and the examiner’s qualifications were significantly associated with the absence of genito-anal injuries. Health providers should thus be aware that in all other respects there was no difference in survivors who had injuries and those who did not. It is important to reiterate the message that the presence of injuries does not necessarily prove that rape occurred nor does the absence disprove the fact.
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Carvalho J, Nobre PJ. Early maladaptive schemas in convicted sexual offenders: preliminary findings. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2014; 37:210-216. [PMID: 24268826 DOI: 10.1016/j.ijlp.2013.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Core cognitive schemas may play a role in the vulnerability for sexual offending. Identifying these schemas could help to conceptualize sexual crimes and rehabilitate convicted sexual offenders. The aim of this preliminary study was to explore the relationship between early maladaptive schemas (EMSs) and sexual offending, as well as how rapists and child sex molesters differ in terms of these schemas. Thirty-two men convicted for rape, 33 convicted for child sexual abuse, and 30 non-offenders were evaluated using the Young Schema Questionnaire (YSQ-S3) and the Brief Symptom Inventory (BSI). Results showed that participants convicted for child sexual abuse presented significantly more schemas from the disconnection/rejection, impaired autonomy/performance, other directness, and over vigilance/inhibition domains than non-offenders, whereas rapists presented more schemas from the impaired autonomy/performance domain than non-offenders. Differences between sex offenders showed that child molesters presented more schemas of pessimism than rapists. Preliminary findings suggested that EMSs may impact sex offender's perceptions about themselves and about the world. Schema-focused therapy (Young, 1990, 1999) may thus be an acceptable approach to sex offender's psychological assessment and intervention.
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Affiliation(s)
- Joana Carvalho
- Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal.
| | - Pedro J Nobre
- Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal
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Answer to the comments made by Prof Chariot to our original paper 'patterned genital injury in cases of rape - a case-control study'. J Forensic Leg Med 2013; 20:1147-8. [PMID: 24237841 DOI: 10.1016/j.jflm.2013.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 09/13/2013] [Indexed: 11/22/2022]
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Sánchez-Sánchez F, González-Correales R, Jurado-López AR, San Martín-Blanco C, Montaña-Hernández RM, Tijeras-Úbeda MJ, Benitez-Moreno JM, Brenes-Bermúdez F, Mir Pizà J, Villalba-Quintana E. [The medical history taking in sexual health: skills and attitudes]. Semergen 2013; 39:433-9. [PMID: 23953149 DOI: 10.1016/j.semerg.2013.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 05/22/2013] [Accepted: 06/09/2013] [Indexed: 01/03/2023]
Abstract
A sexual satisfactory life favourably affects quality of life, there being evidence that shows there are multiple organic processes of which sexual dysfunction is often a precocious sign of underlying organic disease (cardiovascular, endocrinological or neurological). Difficulties exist in recording the sexual anamnesis on the part of the professional, the patient, or by the health system. Nevertheless, given its importance, it is necessary for the doctor to adopt an attitude of active search, especially among the population of risk. To do this, it is necessary that the situation is propitious (sense of the opportunity), preserving the confidentiality of the meeting, and it will be carried out naturally and with empathy, adopting a listening attitude, taking into account the non-verbal language, without issuing valued judgments, and resorting to assertivity to overcome the resistances. This article proposes guidelines to perform an anamnesis adequately.
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Affiliation(s)
- F Sánchez-Sánchez
- Medicina de Familia y Comunitaria, Centro de Salud Xátiva, Valencia, España.
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Astrup BS, Ravn P, Thomsen JL, Lauritsen J. Patterned genital injury in cases of rape – A case–control study. J Forensic Leg Med 2013; 20:525-9. [DOI: 10.1016/j.jflm.2013.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 11/12/2012] [Accepted: 03/02/2013] [Indexed: 10/27/2022]
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Carvalho J, Quinta‐Gomes A, Nobre PJ. The Sexual Functioning Profile of a Nonforensic Sample of Individuals Reporting Sexual Aggression Against Women. J Sex Med 2013; 10:1744-54. [DOI: 10.1111/jsm.12188] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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White C. Genital injuries in adults. Best Pract Res Clin Obstet Gynaecol 2013; 27:113-30. [DOI: 10.1016/j.bpobgyn.2012.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 08/03/2012] [Accepted: 08/16/2012] [Indexed: 11/28/2022]
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Abstract
Sexual assault and HIV are coexisting public health problems. Sexual assault may increase HIV transmission risk through diverse mechanisms, such as infliction of anal, oral, and genital injuries by penile, digital, or object penetration, extragenital trauma, concurrent sexually transmitted infections, condom use, and whether the perpetrator was circumcised.
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Abstract
PURPOSE OF REVIEW To look critically at recent research articles that pertain to children and adolescents who present with genital injuries. RECENT FINDINGS Emerging evidence supports links to long-term psychological sequelae of child sexual abuse. Parents should be educated to instruct their children regarding types of child abuse and prevention. 'Medicalization' of female genital mutilation (FGM) by health providers, including 'cutting or pricking', is condemned by international organizations. SUMMARY Genital injuries whether accidental or intentional need to be reported with standardized terminology to allow for comparisons between reported outcomes. Motor vehicle accidents associated with pelvic fractures may result in bladder or urethral trauma. Adverse long-term psychosocial behaviors may be sequelae of child sexual abuse. FGM is willful damage to healthy organs for nontherapeutic reasons, and a form of violence against girls and women. Healthcare providers should counsel women suffering from the consequences of FGM, advise them to seek care, counsel them to resist reinfibulation, and prevent this procedure from being performed on their daughters.
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