Factors Associated With Law Enforcement Reporting in Patients Presenting for Medical Forensic Examinations

Abstract

Law enforcement reporting following sexual assault is lower than for other violent crimes. Sexual assault nurse examiners (SANEs) provide care for patients in the acute period following sexual assault and are well-positioned to identify and address barriers to reporting. We examined data from medical forensic examination records documented by SANEs for a 5-year period (2011–2015). We examined 347 records of women 18 and older to identify factors associated with law enforcement reporting at the time of the exam using binomial logistic regression to construct odds ratios (OR). A total of 56.5% of patients in the sample reported to law enforcement. Patients who did not voluntarily consume alcohol were more likely to report than those who did (OR = 4.45; p = .001). Patients who were not students were more likely to report than students (OR = 3.24; p = .002). Patients who had a medical forensic exam within 32 hr of the assault were more likely to report than those having exams after 32 hr (OR = 2.68; p = .007). Patients who had anogenital and/or bodily injuries were more likely to report than those who had no injuries (OR = 2.50; p = .008). Patients who were penetrated (vaginally, orally, and/or anally) were more likely to report than those who were not penetrated (OR = 2.50; p = .056). Knowing the assailant, having multiple assailants, and patient and assailant race/ethnicity were not associated with different likelihood of reporting to law enforcement. SANEs and others who work with victims of sexual assault can use data to understand and address barriers to reporting.

Alcohol-involved rape: Limitations of the “rape exception” for abortion access.

“…Because of these concerns, rape is the least reported violent crime in the United States (Morgan & Oudekerk, 2019), and the majority of rape victims do not seek out medical care immediately following the assault (Zinzow et al, 2012). Victim intoxication exacerbates these already low rates; in a study of rape victims who had received medical forensic exams, voluntary victim alcohol consumption was the strongest predictor of not reporting the assault to law enforcement, resulting in 4 times lower odds of reporting (Downing et al, 2022). Among individuals who disclose their assaults, victims who were drinking at the time of the rape reported more negative social reactions than sober victims (Ullman, 2023).…”

Organizational Bias in Gender-Based Violence Research

“…Despite the increased availability of services, however, most victims still do not use them. Reporting to law enforcement, as with most forms of violence, is uncommon, with between 25% and 40% of sexual violence victims and about 28% of domestic violence victims filing reports (Downing et al 2020; Felson et al 2002; Morgan 2018). Estimates of social service utilization vary widely due to limited data availability.…”

The Link Between the SAMFE and Police Perceptions of Victim Credibility

“…Several studies have shown that sexual assault cases with forensic evidence proceed through more steps in case processing 4 and result in more arrests, charges, and convictions, particularly if that evidence was collected by trained SANEs (Campbell et al, 2009; Johnson et al, 2012; McGregor et al, 2002). In addition, there are other ways that SAMFEs can help cases progress beyond forensic evidence, primarily by corroborating events through photographs, documenting injuries and statements provided during the exam, and facilitating future victim participation with police through ensuring victim wellbeing and connection with a victim advocate (Campbell et al, 2015; Downing et al, 2020). The simple existence of forensic evidence, rather than what the forensic evidence may reveal, also may play a significant role in case outcomes: in one study, the existence of forensic evidence, not findings from the evidence testing, was associated with suspect identification.…”