@article{ref1,
title="Discriminating between consensual intercourse and sexual assault: genital-anal injury pattern in females",
journal="Journal of forensic and legal medicine",
year="2021",
author="Sommers, Marilyn S. and Fargo, Jamison D.",
volume="79",
number="",
pages="e102138-e102138",
abstract="BACKGROUND: Assessment of genital-anal (GA) injuries following sexual assault promotes health and assists prosecutors to build a case. The pattern of injuries may help differentiate between consensual and non-consensual intercourse, bolster the survivors' credibility, and increase prosecutions in sexual assault cases. <br><br>OBJECTIVES: To identify the constellation of G-A injury-related characteristics that most effectively discriminated between consensual sexual intercourse and sexual assault in females when controlling for intercourse-related variables. <br><br>METHODS: We employed a comparative study with two groups: a prospective cohort group with consensual participants and a group derived from an existing sexual assault registry. In the prospective cohort, we performed a sexual assault forensic examination at baseline and following consensual sexual intercourse with females ≥21 years. We compared their injury patterns to the injury records of females ≥21 years who were sexual assaulted. <br><br>RESULTS: We enrolled a sample of 834 females: 528 consensual (63.3%) participants and 306 non-consensual (36.7%) registry cases. After controlling for race/ethnicity, age, and time between intercourse and examination, logistic regression analyses showed that the presence of an external genital tear increased the odds of non-consensual intercourse more than two times (adjusted odds ratio [AOR] = 2.70, 95% CI = 1.28-5.56). Logistic regression analyses also showed that the odds of non-consensual sexual intercourse were significantly greater with a lower prevalence and frequency of external and internal genital redness, lack of condom use and lubrication, and presence of anal penetration. Latent class analysis identified high and low G-A injury prevalence subgroups among both consensual and non-consensual samples. One subset of results emerged that may be indicative of non-consensual as compared to consensual intercourse: a higher prevalence of external genital and anal tears. <br><br>CONCLUSION: External genital tears occurred more frequently in the non-consensual sample and increased the odds of non-consensual intercourse more than two times. Anal tears, swelling, and ecchymosis and anal penetration were markers for non-consensual intercourse and should increase suspicion for lack of consent.<p /> <p>Language: en</p>",
language="en",
issn="1752-928X",
doi="10.1016/j.jflm.2021.102138",
url="http://dx.doi.org/10.1016/j.jflm.2021.102138"
}