Genital injuries in women reporting sexual assault

Abstract

Background: The likelihood of genital injury following sexual assault remains unclear. Genital injury related to sexual assault is often an issue in court proceedings, with the expectation that injuries will be found in 'genuine' cases. Conviction rates are higher when the complainant has genital injuries. Objectives: To determine the type, frequency and severity of genital and non-genital injuries of women following alleged sexual assault and, in addition, to determine factors associated with the presence of injuries. Methods: The assault records and forensic examination findings of 153 consecutive women who attended a sexual assault service in Newcastle, Australia, between 1997 and 1999 were reviewed. All of the women were examined within 72 hours of the assault. Associations were sought between victim and reported assault variables and the presence of injury using multiple logistic regression analysis. Results: Of the women, 111 (73%) were aged under 30 years and only 4% were over 50 years. Penile–vaginal penetration was the most common type of sexual assault (86%). Non-genital injuries were found in 46% of the women examined (mostly minor) and genital injury in only 22%. Genital injury in the absence of non-genital injury was rare (3%). Independent risk factors for the detection of non-genital injuries were reported threats of violence (OR 5.7, 95% CI; 2.2–14.6). Risk factors for genital injury were the presence of non-genital injury (OR 19, 95% CI; 6.0–63.0), threats of violence (OR 3.7, 95% CI; 1.5–8.9) and being over the age of 40 years (OR 5.6, 95% CI; 1.6–20.3). If the alleged assailant was known to the woman this was protective for both non-genital (OR 0.3, 95% CI; 0.1–0.5) and genital (OR 0.4, 95% CI; 0.2–0.9) injury. Conclusions: The presence of genital injury should not be required to validate an allegation of sexual assault, particularly in the absence of non-genital injuries.