Adolescent Sexual Assault

Adams, Joyce A.; Girardin, Barbara W.; Faugno, Diana K.

doi:10.1016/s1083-3188(01)00126-7

Cited by 93 publications

(10 citation statements)

References 4 publications

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“…This observation is consistent with previous studies reviewed by the RCPCH [4]. Of seven studies reporting any abnormal signs, two found these in 61-95% [5,35] and two in 46% and 57% [6,33], despite widely differing methodology and definitions. However a quarter had no signs, so the absence of physical signs could not be said to negate a child’s history or exclude the possibility of abuse.…”

Section: Discussionsupporting

confidence: 91%

Anal signs of child sexual abuse: a case–control study

Hobbs

Wright

2014

BMC Pediatr

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BackgroundThere is uncertainty about the nature and specificity of physical signs following anal child sexual abuse. The study investigates the extent to which physical findings discriminate between children with and without a history of anal abuse.MethodsRetrospective case note review in a paediatric forensic unit.Cases: all eligible cases from1990 to 2007 alleging anal abuse.Controls: all children examined anally from 1998 to 2007 with possible physical abuse or neglect with no identified concern regarding sexual abuse. Fisher’s exact test (two-tailed) was performed to ascertain the significance of differences for individual signs between cases and controls. To explore the potential role of confounding, logistic regression was used to produce odds ratios adjusted for age and gender.ResultsA total of 184 cases (105 boys, 79 girls), average age 98.5 months (range 26 to 179) were compared with 179 controls (94 boys, 85 girls) average age 83.7 months (range 35–193). Of the cases 136 (74%) had one or more signs described in anal abuse, compared to 29 (16%) controls. 79 (43%) cases and 2 (1.1%) controls had >1 sign. Reflex anal dilatation (RAD) and venous congestion were seen in 22% and 36% of cases but <1% of controls (likelihood ratios (LR) 40, 60 respectively), anal fissure in 14% cases and 1.1% controls (LR 13), anal laxity in 27% cases and 3% controls (LR 10).Novel signs seen significantly more commonly in cases were anal fold changes, swelling and twitching. Erythema, swelling and fold changes were seen most commonly within 7 days of last reported contact; RAD, laxity, venous congestion, fissure and twitching were observed up to 6 months after the alleged assault.ConclusionsAnal findings are more common in children alleging anal abuse than in those presenting with physical abuse or neglect with no concern about sexual abuse. Multiple signs are rare in controls and support disclosed anal abuse.

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Section: Discussionsupporting

confidence: 91%

Anal signs of child sexual abuse: a case–control study

Hobbs

Wright

2014

BMC Pediatr

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“…Consistent with findings from general populations [10-13], violence against FSWs is increasingly associated with HIV [14] as well as STI symptoms [15] and infection [6,7,14]. Condom non-use and other sexual risk behaviors [5,6,9,16], injection drug use [14], often undertaken as coping mechanism, as well as physiologic factors and genitoanal injury concomitant with sexual violence [17,18], are largely considered responsible for these patterns. The high burden of violence against FSWs, coupled with its observed impact on HIV risk and infection, has fueled growing international interest in preventing and responding to violence against FSWs.…”

Section: Introductionmentioning

confidence: 57%

Violence against women in sex work and HIV risk implications differ qualitatively by perpetrator

et al. 2013

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BackgroundPhysical and sexual violence heighten STI/HIV risk for women in sex work. Against this backdrop, we describe the nature of abuse against women in sex work, and its STI/HIV implications, across perpetrators.MethodsAdult women involved in sex work (n = 35) in Baltimore, MD participated in an in-depth interview and brief survey.ResultsPhysical and sexual violence were prevalent, with 43% reporting past-month abuse. Clients were the primary perpetrators; their violence was severe, compromised women’s condom and sexual negotiation, and included forced and coerced anal intercourse. Sex work was a factor in intimate partner violence. Police abuse was largely an exploitation of power imbalances for coerced sex.ConclusionsFindings affirm the need to address physical and sexual violence, particularly that perpetrated by clients, as a social determinant of health for women in sex work, as well as a threat to safety and wellbeing, and a contextual barrier to HIV risk reduction.

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“…Physical sequelae may include bodily and genital injury [3,6,7], pelvic pain, traumatic fistulas [8,9], unwanted pregnancy, increased risk of HIV [9,10] and sexually transmitted infections [11,12], and even death [13]. Adolescents and young women and those without prior sexual intercourse experiences are particularly vulnerable to physical trauma and genital-anal injury associated with sexual violence [6,9,14-16]. Physical injury may be worsened in cases in which there is a greater length of time to physical examination [16].…”

Section: Introductionmentioning

confidence: 99%

Development of a screening tool to identify female survivors of gender-based violence in a humanitarian setting: qualitative evidence from research among refugees in Ethiopia

et al. 2013

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BackgroundHigh levels of gender-based violence (GBV) persist among conflict-affected populations and within humanitarian settings and are paralleled by under-reporting and low service utilization. Novel and evidence-based approaches are necessary to change the current state of GBV amongst these populations. We present the findings of qualitative research, which were used to inform the development of a screening tool as one potential strategy to identify and respond to GBV for females in humanitarian settings.MethodsQualitative research methods were conducted from January-February 2011 to explore the range of experiences of GBV and barriers to reporting GBV among female refugees. Individual interview participants (n=37) included female refugees (≥15 years), who were survivors of GBV, living in urban or one of three camps settings in Ethiopia, and originating from six conflict countries. Focus group discussion participants (11 groups; 77 participants) included health, protection and community service staff working in the urban or camp settings. Interviews and discussions were conducted in the language of preference, with assistance by interpreters when needed, and transcribed for analysis by grounded-theory technique.ResultsSingle and multiple counts of GBV were reported and ranged from psychological and social violence; rape, gang rape, sexual coercion, and other sexual violence; abduction; and physical violence. Domestic violence was predominantly reported to occur when participants were living in the host country. Opportunistic violence, often manifested by rape, occurred during transit when women depended on others to reach their destination. Abduction within the host country, and often across borders, highlighted the constant state of vulnerability of refugees. Barriers to reporting included perceived and experienced stigma in health settings and in the wider community, lack of awareness of services, and inability to protect children while mothers sought services.ConclusionsFindings demonstrate that GBV persists across the span of the refugee experience, though there is a transition in the range of perpetrators and types of GBV that are experienced. Further, survivors experience significant individual and system barriers to disclosure and service utilization. The findings suggest that routine GBV screening by skilled service providers offers a strategy to confidentially identify and refer survivors to needed services within refugee settings, potentially enabling survivors to overcome existing barriers.

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Adolescent Sexual Assault

Cited by 93 publications

References 4 publications

Anal signs of child sexual abuse: a case–control study

Anal signs of child sexual abuse: a case–control study

Violence against women in sex work and HIV risk implications differ qualitatively by perpetrator

Development of a screening tool to identify female survivors of gender-based violence in a humanitarian setting: qualitative evidence from research among refugees in Ethiopia

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