Patterns of genital injury in female sexual assault victims

Slaughter, Laura; Brown, Carl R. V.; Crowley, Sharon; Peck, Roxy

doi:10.1016/s0002-9378(97)70556-8

Cited by 224 publications

(63 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sometimes the women were not sure whether vaginal penetration had occurred, nor could this be definitively ascertained by examination. Studies indicate that it can be difficult to discern between injuries sustained from recent consensual sex and non-consensual assault 16,31–33 . Forensic evidence kits were only processed if the victim decided to press charges, and for legal reasons we did not have access to the results that might have confirmed the presence of semen or foreign DNA.…”

Section: Resultsmentioning

confidence: 99%

Challenges in conducting research on sexual violence and HIV and approaches to overcome them

Aldous

Magnus

Roberts

et al. 2017

American J Rep Immunol

View full text Add to dashboard Cite

Studies have implicated sexual violence as a strong correlate of HIV acquisition in women. Characterizing how such violence affects the female immune system may provide insight into the biological mechanisms of HIV transmission and ultimately improve global HIV prevention strategies. Little research has been done in this domain, and the obstacles to investigation can be daunting. Here we describe methodological challenges encountered and solutions explored while implementing a study of dysregulation of immune biomarkers potentially indicative of increased HIV susceptibility in women following sexual assault. Challenges included accessing sexual assault survivors and defining sexual assault, promoting study participant well-being during research engagement, reducing selection and information bias, collecting and processing biological samples, and adjusting for confounders such as reproductive tract infections and emotional and physical abuse. We found that many survivors of sexual assault welcomed the attention from study staff and felt empowered by the opportunity to help other women at risk for violence. Well-trained research staff and well-articulated community and medical partnerships were key methods to overcoming challenges while promoting the safety and welfare of vulnerable study participants.

show abstract

Section: Resultsmentioning

confidence: 99%

Challenges in conducting research on sexual violence and HIV and approaches to overcome them

Aldous

Magnus

Roberts

et al. 2017

American J Rep Immunol

View full text Add to dashboard Cite

show abstract

“…Examiners identified genitoanal and oral injuries via visual inspection, magnification with colposcopy, and toluidine blue contrast application. They used the TEARS classification 4 to document injuries. 5 …”

Section: Methodsmentioning

confidence: 99%

“…3 Prevalence rates range from 5% to 70%, and differ for consensual and non-consensual intercourse; 4-8 injury prevalence in women varies by examination type, 5,9 skin color, 8 age, 10 and intercourse-related variables. 8 The TEARS classification— tears, ecchymosis, abrasions, redness , and swelling 4 —is commonly used to examine coital genitoanal injuries. Rough sex can alter the integrity of the epithelial barrier by causing TEARS, 8 and cervical swelling is noted with forced sex.…”

Section: Introductionmentioning

confidence: 99%

Exploring Genitoanal Injury and HIV Risk Among Women

Brawner

Sommers

Moore

et al. 2016

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background Genital, anal and oral injuries sustained from sexual intercourse may explain HIV transmission among women. We determined the variability in genitoanal injury frequency and prevalence in women following consensual sexual intercourse, exploring the role of menstrual phase and hormonal birth control. Methods We used a longitudinal, observational design with a convenience sample of 393 women aged 21 and older. Participants had a baseline interview with gynecologic examination, followed by consensual sexual intercourse with a male partner and a second gynecologic examination. We analyzed injury prevalence with logistic regression and injury frequency with negative binomial regression among women who were: a) menstrual, not using hormonal birth control, b) menstrual, using hormonal birth control, or c) menopausal. We also compared injury among menstrual women in the follicular, ovulatory and luteal phases. Findings Women using hormonal birth control had 38% more external genitalia injuries (adjusted rate ratio [ARR] = 1.38, p = 0.030) and more than twice the anal injuries (ARR = 2.67, p = 0.005) as the non-hormonal birth control menstruating group. Menopausal women had more than three times the anal injuries (ARR = 3.36, p = 0.020) than those in the non-hormonal menstrual group. Among menstrual women, those in the follicular phase had a greater prevalence and frequency of external genitalia injuries than those in other phases. Interpretation Increased rates of post-coital genitoanal injuries are noted among women using hormonal birth control and/or in the follicular phase of menstruation. Biological factors that influence women's risk for HIV warrant further investigation.

show abstract

“…While Slaughter et al developed a system that is based on injury type ( T (tears), E (ecchymosis), A (abrasions), R (redness) and S (swelling), or TEARS), 4 widespread acceptance of this typology has not occurred (see Tables 2 and 3). First, it is more appropriate to genital injury as compared to non-genital injury, which has a broader range of presentations such as fractures and ligature injury.…”

mentioning

confidence: 99%

“…7,8 Third, debate exists about the appropriateness of the terms: Should “ecchymosis” and bruising be used interchangeably 9 and are “tears” and lacerations the same phenomenon? 4 (see Table 1)_ENREF_10…”

mentioning

confidence: 99%

Injuries from intimate partner and sexual violence: Significance and classification systems

Sommers

Brown

Buschur³

et al. 2012

Journal of Forensic and Legal Medicine

View full text Add to dashboard Cite

While intimate partner violence (IPV) and sexual violence (SV) are highly associated with injury, the healthcare and legal significance of these injuries is controversial. Purpose: Herein we propose to explore the significance of injury in IPV and SV and examine the current status of injury classification systems from the perspectives of the healthcare and criminal justice systems. We will review current injury classification systems and suggest a typology of injury that could be tested empirically. Findings: Within the published literature, we found that no commonly-accepted injury typology exists. While nuanced and controversial issues surround the role of injury detection in the sexual assault forensic examination, enough evidence exists to support the continued pursuance of a scientific approach to injury classification. We propose an injury typology that is measureable, is applicable to the healthcare setting and criminal justice system, and allows us to use uses a matrix approach that includes a severity score, anatomic location, and injury type. We suggest a typology that might be used for further empirical testing on the validity and reliability of IPV and SV injury data. Conclusion: We recommend that the community of scientists concerned about IPV and SV develop a more rigorous injury classification system that will improve the quality of forensic evidence proffered and decisions made throughout the criminal justice process.

show abstract

Patterns of genital injury in female sexual assault victims

Cited by 224 publications

References 11 publications

Challenges in conducting research on sexual violence and HIV and approaches to overcome them

Challenges in conducting research on sexual violence and HIV and approaches to overcome them

Exploring Genitoanal Injury and HIV Risk Among Women

Injuries from intimate partner and sexual violence: Significance and classification systems

Contact Info

Product

Resources

About