Post-exposure prophylaxis, STI testing and factors associated with follow-up attendance: a review of 4159 cases of acute post-sexual assault medical care

Storage of evidence and delayed reporting after sexual assault: Rates and impact factors on subsequent reporting

BACKGROUND

Sexual assault (SA) is alarmingly prevalent, yet reporting rates remain disproportionately low. Forensic examinations (FE) play a crucial role in both immediate medical care and evidence collection, yet many victims/survivors may not report the crime initially, leading to the loss of vital forensic evidence. The storage of evidence "Option 3″ care alternative provides post-SA care including FE without initial police involvement.

METHODS

This is a cross-sectional study analysing the attendances of people who chose to store evidence at the Dublin Sexual assault Treatment Unit (SATU) between January 1, 2017 and December 31, 2023.

RESULTS

There were 238 storage of evidence FEs ('Option 3') performed during the study period, which represented 12.8 % of all FEs. The majority identified as female (89.1 %), with an average age of 26.6 years. 31.9 % attended within 24 h of the incident, and 51.3 % self-referred. Most assaults occurred over weekends (64.7 %), with alcohol consumption reported in 82.2 % of cases and drug-facilitated SA concerns in 20.2 %. Genital injuries were present in 17.9 % of females and 19 % of males. Those that availed of storage of evidence (compared with those who initially reported to the police) were significantly more likely to have consumed alcohol (p < 0.001) and the assault was more likely to have occurred indoors (p = 0.002). There was no significant difference in care option choice for those 'unsure' of the assault occurrence (p = 0.353). Among storage of evidence cases, 20.2 % subsequently reported to the police, with females more likely to report (p = 0.02), while people who were uncertain whether an assault had occurred were less likely to report (p = 0.04). Genital injury (p = 0.822), victim-assailant relationship (p = 0.465), assault location (p = 0.487), and substance consumption (p = 0.332) did not significantly affect subsequent reporting rates.

CONCLUSIONS

The availability of storage of evidence has afforded people the opportunity to access prompt, responsive SATU care including collection of forensic evidence which may have significant evidential value. This approach provides further opportunity for comprehensive detection of a crime, even if reporting to the police is delayed.

An Observational Study of Sexual Assaults in French Guiana During 2019-2020

Introduction

Sexual violence is a major public health issue, including in French Guiana. The feeling of insecurity is significant in this part of France. Sexual violence is an important reason for consultation in forensic and emergency medicine. The challenge is to provide care within the first 72 hours, particularly in medicolegal terms and for infectious disease management. The objectives of our study were, firstly, to establish the epidemiology of sexual assaults at Cayenne General Hospital (CGH), and secondly, to evaluate the management of these victims.

Materials and Methods

From January 1st, 2019 to December 31st, 2020, we conducted a single-center retrospective descriptive study including patients who were consulted for sexual assaults in the Forensic medicine and the Emergency departments of CGH.

Results

Over this period, 400 sexual assault victims were consulted. Most of them, were women (87%) with a median age of 13 years-old [8; 17.5]. The aggressor was mostly male (99%) frequently known by the victim (87%) and from her family (39%). Suspected assaults represented 19% of consultations. The most frequent assault on women was penile-vaginal penetration (82%) and penile-anal penetration (77%) on men. The delay of consultation was superior to 72 hours in 60% of the cases. A psychological follow-up was recommended for 62% of these victims.

Conclusion

This work allowed to identify a young and female population at risk, most often assaulted by a male known to her. Most of the patients consulted more than 72 hours after the assault. Our study highlights the need for prevention actions in French Guiana focusing on this population at risk.

Female perpetrated sexual assault: a review of attendances to the national sexual assault treatment units in the Republic of Ireland

BACKGROUND

Female perpetrated sexual assault is under-represented in sexual assault research, and indeed possibly an underreported crime. The aim of this study is to address the lack of comprehensive data in relation to female perpetrated sexual assault attendances to the national sexual assault treatment unit network in the Republic of Ireland.

METHODS

This is a cross-sectional study analysing the attendances of female perpetrated sexual assault attendances at the six sexual assault treatment units in the Republic of Ireland between 1 January 2017 and 31 December 2022.

RESULTS

There were 95 attendances where the assailant (or one of the assailants) was identified as female. 62% (n=59) of these attendances involved a solo female assailant, 3.2% (n=3) where it was a multiple assailant assault with only female assailants and 34.7% (n=33) cases with male and female assailants. 74.7% (n=71) of victims identified as female, 24.2% (n=23) as male and 1.1% (n=1) as 'other'. The average age of attenders was 27.0 ± 10.7 years old. 54.7% (n=52) of attendances were within 72 hours of the assault. 52.6% (n=50) of these underwent a forensic examination. 30.5% (n=29) of incidents occurred in the assailant's home. 23% of assailants were described as a friend of the victim/survivor. 34.7% (n=33) sustained bodily injuries (genital and/or extra-genital).

CONCLUSION

Female perpetrated sexual assault is a distinct entity when analysing attendances to the national sexual assault treatment unit network, representing just under 2% of all attendances. We have shown that those who experience these assaults are likely to be female, be assaulted by a single female perpetrator who is known to them and attend a sexual assault treatment unit within 72 hours of the assault. Awareness of the characteristics of these attendances will ultimately allow us to develop appropriate supports for these victims/survivors and to raise awareness of this type of crime.

Female adolescent sexual assault; a national review of 1014 consecutive cases

BACKGROUND

Sexual violence is common in contemporary society and disproportionally affects adolescents. In order to develop effective treatment, awareness and prevention strategies it is vital that we understand the epidemiology of adolescent sexual assault (SA). The aim of this study is to evaluate attendances by female adolescents to the national sexual assault treatment unit (SATU) network in the Republic of Ireland and compare these attendances with adult women accessing the service.

METHODS

This is a cross-sectional study analysing the attendances of all adolescent female attendances at the 6 SATUs in the Republic of Ireland and comparing them with all adult female attendances between 1/1/2017 and 31/12/2022.

RESULTS

There were 1014 female adolescent attendances and 3951 female adult attendances over the timeframe studied. Adult attenders were more likely to attend within 7-days of the alleged assault compared with adolescent attenders (80.3% V 70.2% OR1.513 CI 1.35-1.697 p < 0.001). When compared with adult attenders, adolescent attenders were significantly more likely to disclose being assaulted outdoors (40.9% V 15.7% OR2.607 CI 2.346-2.898 p < 0.01), during the day (58.4% V 34.4% OR1.673 CI 1.565-1.790 p < 0.01), assaulted by a friend/family member (28.9% V 16% OR 1.812 CI1.603-2.049 p < 0.01) and less likely to have consumed alcohol prior to the incident (45.6% V 25.3% OR1.807 CI 1.653-1.975 p < 0.001). Physical injuries were less likely in adolescent attenders (30% V 35.5% OR0.845 CI 0.758-0.942 p = 0.02).

CONCLUSION

A comparison of the characteristics of adolescent and adult female sexual assault disclosures identifies differences regarding location of the incident, relationship to perpetrator and prevalence of alcohol consumption. Knowledge of these factors support appropriate tailoring of treatment, prevention and awareness strategies to help modify the impact and reduce the incidence of SA in the vulnerable adolescent cohort.