Patterns of sexual assault in both men
and women have changed in the past decade, reports a new study, with attacks by
strangers less common and those by known assailants on the rise.
These changing patterns may reflect increased reporting of these crimes.
"Healthcare professionals should be aware that general body trauma is
common, that the assailant is often someone known to the victim, and that
evidence of semen is commonly found by the crime laboratory even when it is not
found in the emergency department analysis," writes a team of researchers led by
Dr. Debra Houry of the Denver Health Medical Center in Colorado.
The researchers reported on over 1,000 victims of sexual assault seen in a
Denver trauma center from 1992 to 1995. The patients were mostly female (96%),
and ranged in age from 1 year to 85 years. Over one quarter of the victims were
under 18.
Most patients (80%) reported a single assailant, but two attackers were
reported in 10% of cases. Men were more likely to be victims of more than one
assailant.
Overall, the attacker was someone the victim knew -- friend, significant
other, previous acquaintance, or former significant other -- in almost 40% of
cases. Over 40% of the attacks occurred in either the victim's or the attacker's
home, and in three quarters of these cases the victim knew the assailant.
Eighty percent of patients reported the use of physical force, including the
use of a weapon in one fifth of all attacks. Strangers were twice as likely to
use a weapon as known attackers.
Significantly, general body trauma was reported by physicians more often
than genital trauma. About two thirds of victims had cuts, bruises, and other
injuries. More than half the women and one third of the men also had genital or
anal injuries.
The authors report that while sperm was identified from emergency department
examination for only 13% of cases, crime lab analysis found evidence of semen in
almost half.
Writing in the April issue of the Annals of Emergency Medicine, the
researchers point out that percentage of sexual assaults by strangers has
decreased. This may be part explained by the fact that people are more aware of
interpersonal violence and more likely to report it.
The fact that about one third of victims didn't show body or genital injury
is important, note the authors. "Because many sexual assault victims may not
have physical trauma or genital trauma on examination, this does not mean that
an assault did not occur," they explain.
In a statement, Houry also noted that injuries such as contusions "may not
become visible for at least 48 hours" after an assault.
The researchers also found that almost 90% of sexual assault victims
accepted antibiotic treatment to prevent sexually transmitted disease. And 60%
of female victims chose pregnancy prophylaxis.
Because victims of sexual assault are often treated in emergency rooms, it
is important that emergency physicians be aware of the medical and psychological
needs of these patients, state the authors.
According to figures released by the FBI in 1994, in the US, about 1 in 3
women and 1 in 7 men will be raped at some point in their lifetime.
