Current issues in the use of colposcopy for examination of sexual assault victims
David J. Templeton A B C D G and Angela Williams E FA Sexual Health Service, Greater Western Area Health Service, 203 Brisbane St, Dubbo, NSW 2830, Australia.
B Sexual Health Service, Sydney South West Area Health Service, 182 Livingstone Rd, Marrickville, NSW 2204, Australia.
C Liverpool & Fairfield Sexual Assault Service, PO Box 3084, Liverpool, NSW 2170, Australia.
D School of Rural Health, University of Sydney, Dubbo Campus, PO Box 1043, Dubbo, NSW 2830, Australia.
E Division of Clinical Forensic Medicine, Victorian Institute of Forensic Medicine, Melbourne, VIC 3006, Australia.
F Department of Forensic Medicine, Monash University, Melbourne, VIC 3006, Australia.
G Corresponding author. Email: david.templeton@email.cs.nsw.gov.au
Sexual Health 3(1) 5-10 https://doi.org/10.1071/SH05028
Submitted: 10 May 2005 Accepted: 2 November 2005 Published: 20 February 2006
Abstract
Colposcopic examination is considered the gold standard in child sexual abuse evaluations in Australia. However, there remain contentious issues with its use, especially in adult victims, which we sought to address by a review of the literature. Colposcopy has been shown to be a sensitive and acceptable tool for detection of anogenital abnormalities in children. The significance of some genital findings remains controversial, especially when images are interpreted by inexperienced clinicians. Its use in adult assessments is hampered by a lack of comparative studies on colposcopically detected genital injuries in adults following consensual v. non-consensual sexual intercourse. Further research is urgently needed before the use of colposcopy can be routinely recommended for adult victims.
Additional keywords: child abuse, rape.
Acknowledgements
The authors would like to thank the doctors involved in sexual abuse examinations from around the world who responded to the email survey on availability of national and international guidelines for colposcopic sexual assault/abuse assessments. Special thanks to Associate Professor David Wells for use of his photograph and Dr Terence Donald, Dr Anne Smith, Dr Anne Piper, Dr Jane MacDonald and Mr Colin Borg for their comments and assistance with distribution of the email guideline enquiries.
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