Nature, frequency and duration of genital lesions after consensual sexual intercourse—Implications for legal proceedings

Role of Semen in Modulating the Female Genital Tract Microenvironment – Implications for HIV Transmission

“…While consensual intercourse does not appear to alter the number of vaginal epithelial layers or subepithelial lymphocytes, 40 mucosal microabrasions and lacerations have been observed in a majority of women by colposcopy up to 80 hrs after coitus. 22,41 Mucosal damage and inflammation are much more common after sexual assault and, among other factors, may underlie the reported increased transmission of HIV under these circumstances. 42,43 During sexual activity, the vagina undergoes anatomic and physiological changes.…”

Copulatory Wounding and Traumatic Insemination

“…If, in contrast, the proportion of CW is relatively stable, it may be the result of different individuals responding in different ways genetically to CW. This situation may lead Astrup et al 2012;Lincoln et al 2013 The proportion of copulations resulting in CW differs across species. The table is based only on examples resulting from systematic anatomical dissections or observations.…”

“…Including only the skin-breaching symptoms that obey our definition of CW (Box 1), such as mucus lesions, abrasions, or lacinations, CW was found in 10% -52% of the examined women (Astrup et al 2012;Lincoln et al 2013). However, a standard classification of genital injury after sexual intercourse was not available until recently (Kelly et al 2013).…”

“…In humans, post-CW healing can be inferred from the fact that fewer genital wounds have been found 36 h after injury than after 0-24 h (Anderson et al 2008;Berkowitz 2011;Astrup et al 2012). The time course of wound healing seems unknown in animal studies, but may be easily considered in arthropods, in which repaired wounds are visible as black melanin scars.…”

Semen-mediated Enhancement of HIV Infection Markedly Impairs the Antiviral Efficacy of Microbicides

“…In the first step of HIV-1 transmission, the virus needs to cross the mucosal epithelium to reach its target cells. This is facilitated by small lesions that occur via sexual intercourse or sexually transmitted diseases that affect the epithelial integrity [10]. After crossing the mucosal epithelium, the virus interacts with the major targets of HIV-1 infection: CD4 + T lymphocytes, macrophages and dendritic cells (DCs) that express the main receptor CD4 and the co-receptors CXCR4…”