Analysis of 1,076 cases of sexual assault

Rates of sexual assault are increasing, and evidence exists that its demographics and characteristics are changing. The purpose of our study was to describe victim, assailant, assault, and treatment characteristics for sexual assault victims and to provide descriptive data on the evidentiary examination.

Prospective data were collected on all sexual assault victims presenting to an urban Level I trauma center from January 1992 to December 1995 for treatment and evidentiary examination. Data from crime laboratory records were retrospectively reviewed.

One thousand one hundred twelve patients presented after a sexual assault. A total of 1,076 (97%) patients consented to the medical and evidentiary examination and were enrolled in the study. Age ranged from 1 to 85 years (mean, 25 years; median, 23 years), with 96% (1,036/1,076) female and 4% (41/1,076) male victims. The number of assailants was greater than 1 in 20% (208/1,044) of cases, and the assailant was a stranger only 39% (409/1,094) of the time. Force was used in 80% (817/1,027) of reported assaults, and in 27% (275/1,014) of cases a weapon was present. Vaginal intercourse was involved in 83% (851/1,023) of female victims. Oral assault was involved in 25% (271/1,053) of all cases, and anal penetration was involved in 17% (178/1,058) of all cases. Overall, general body trauma was seen 67% (621/927) of the time, and genital trauma occurred in 53% (388/736) of cases. Twenty percent (147/1,712) of patients had no trauma noted on examination. Sperm were noted on the emergency department wet mount in only 13% (93/716) of the victims, and of the 612 cases with both ED sperm data and crime laboratory semen data available, evidence of sperm and semen were found 48% (296/612) of the time by either.

Health care 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 ED analysis of a wet mount.