Predictors of genital injury after nonconsensual intercourse

Understanding differences in genital injuries after nonconsensual and consensual intercourse is an important element of prosecuting sexual assault cases. In order to determine if the injury patterns and total surface area of genital injuries can differentiate between the types of intercourse (consensual or non-consensual), eighty women were examined after non-consensual (retrospective chart review, n = 40) and consensual (recruited, n = 40) intercourse within 48 hours using colposcopy, toluidine blue dye, and digital photography to document genital injuries. Differences between types of injuries found in the nonconsensual and consensual groups, based on the univariate analysis, were found with the number of sites (NoS) with ecchymosis (p < 0.01) and NoS with redness (p < 0.01). Based on the logistic hierarchical regression model, 85% of the nonconsensual group and 90% of the consensual group were classified correctly by using the NoS with tears, ecchymosis, abrasions, and redness and SA of injury when controlling for time from intercourse to examination. The NoS with redness (p = 0.017), NoS with ecchymosis, and SA of injury (p = 0.039) were individually predictive. The NoS with ecchymosis were also a significant finding when addressed as an individual block (p < 0.001). In this small sample, exploratory study, while controlling for time, the injury patterns and total SA of genital injuries were able to correctly classify the nonconsensual group 85% of the time. Replication of this study with a larger sample is essential.