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2015 ; 15
(ä): 29
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Genito-anal injury patterns and associated factors in rape survivors in an urban
province of South Africa: a cross-sectional study
#MMPMID25887051
Jina R
; Jewkes R
; Vetten L
; Christofides N
; Sigsworth R
; Loots L
BMC Womens Health
2015[Mar]; 15
(ä): 29
PMID25887051
show ga
BACKGROUND: The prevalence of genito-anal injuries in rape survivors varies
significantly and the factors associated with the absence of injuries are not
well understood. This plays a major role in the conviction of cases as the
absence of injury is equated with a lack of assault. In such cases, health care
providers face major challenges in presenting and defending their findings. The
aim of this paper is to describe the absence of genito-anal injuries by site in a
group of rape survivors and to identify factors associated with the absence of
these injuries. METHODS: In a cross-sectional study rape cases reported to the
police in one province in South Africa were randomly sampled using a two stage
sampling procedure. Data were obtained on the survivor, the circumstances of the
rape and the findings of the medicolegal examination. Descriptive statistics were
conducted for the prevalence of genito-anal injuries by site and logistic
regression models were built to identify factors associated with the absence of
genito-anal injuries for all survivors and those reported to be virgins. RESULTS:
In the sample of 1472 women injuries ranged from 1% to 36%. No significant
injuries were reported for 749 (51%) survivors. In the multivariable model there
was a significantly lower odds of having no injuries in survivors who were
virgins, those raped by multiple perpetrators and those examined by a doctor with
additional qualifications. In the model for survivors who were virgins, those
with disabilities had a greater odds of having no injuries while those between
the ages of 8 and 17 years had a lower odds of having no injuries compared to
survivors below four years of age. CONCLUSIONS: This study found that being a
virgin, multiple perpetration rape and the examiner's qualifications were
significantly associated with the absence of genito-anal injuries. Health
providers should thus be aware that in all other respects there was no difference
in survivors who had injuries and those who did not. It is important to reiterate
the message that the presence of injuries does not necessarily prove that rape
occurred nor does the absence disprove the fact.
|*Rape/diagnosis/statistics & numerical data
[MESH]
|*Wounds and Injuries/diagnosis/epidemiology/etiology
[MESH]