Short Report
Sexual assault of adolescent girls: Examining acute care service use Janice Du Mont EdD1,2*, Sheila Macdonald MN3, Daisy Kosa MSc1,3, Rebecca Brown MD4
A
ccording to the Canadian Centre for Justice Statistics 2008 survey data, female adolescents experience rates of sexual assault that are more than double that of female young adults (1). In the most recent clinical paediatric guidelines on adolescent sexual assault, it was emphasized that adolescent victims have specific treatment and management needs (2). However, little is known about their use of services in the acute post-sexual assault period. The purpose of the present study was to examine adolescents’ use of specialized acute care violence services, and to determine whether, compared with young adults, there are important differences in the types of sexual assaults experienced and their service utilization.
Methods
Ontario has 35 hospital-based sexual assault/domestic violence treatment centres (SA/DVTCs) staffed by nurses with specialized training in sexual assault that includes paediatric and adolescent care. These centres provide emergency services 24 h/day, seven days per week to women, children and men who present within approximately seven days (72 h at the time of study) of a sexual assault or physical assault by an intimate partner. SA/DVTC nurses are trained to offer all relevant services to all clients, with clients free to accept or decline (eg, crisis counselling, referral for on-site medical follow-up care and services in the community). The goal of addressing the immediate emotional, medical, forensic and social needs of victims of sexual assault, through on-site care and referral to appropriate services in the community, is to reduce the occurrence of longer-term physical and psychological morbidity and re-victimization. As part of a larger project, information was collected prospectively from victims who presented at one of 30 SA/DVTCs between April 1, 2009 and June 30, 2011, and
consented (or their guardians) to participate in a province-wide study investigating service use and satisfaction (3). Ethics board approval was obtained at all participating centres, with five programs not able to participate because of organizational restructuring, difficulty ensuring round-the-clock nursing coverage and/or significant modifications to the study design requested by their research ethics boards. In the present analysis, female adolescent (12 to 18 years of age) were compared with female young adult (19 to 24 years of age) sexual assault victims on sociodemographic-, assault- and care-related variables using χ2 and, where appropriate, Fisher’s exact tests. Analyses for the assault-related variables included a ‘doesn’t know/doesn’t remember’ category.
Results
During the study period, 1082 female sexual assault victims were seen, of whom 665 (61.5%) were included in the sample: 347 (32.1%) were adolescents and 318 (29.4%) were young adults. Compared with young adult sexual assault victims, adolescent victims differed on ethnicity and race (P=0.004). Adolescents were more likely to identify as Aboriginal (16.3% versus 7.5%), Black (8.1% versus 6.1%) and biracial (2.0% versus 0.7%), and less likely to describe themselves as Caucasian (71.0% versus 82.6%) or Asian (2.6% versus 3.1%). They were also more likely than young adult victims to report sexual assaults that included cunnilingus (13.1% versus 8.2%; P
Sexual assault of adolescent girls: Examining acute care service use Janice Du Mont EdD1,2*, Sheila Macdonald MN3, Daisy Kosa MSc1,3, Rebecca Brown MD4
A
ccording to the Canadian Centre for Justice Statistics 2008 survey data, female adolescents experience rates of sexual assault that are more than double that of female young adults (1). In the most recent clinical paediatric guidelines on adolescent sexual assault, it was emphasized that adolescent victims have specific treatment and management needs (2). However, little is known about their use of services in the acute post-sexual assault period. The purpose of the present study was to examine adolescents’ use of specialized acute care violence services, and to determine whether, compared with young adults, there are important differences in the types of sexual assaults experienced and their service utilization.
Methods
Ontario has 35 hospital-based sexual assault/domestic violence treatment centres (SA/DVTCs) staffed by nurses with specialized training in sexual assault that includes paediatric and adolescent care. These centres provide emergency services 24 h/day, seven days per week to women, children and men who present within approximately seven days (72 h at the time of study) of a sexual assault or physical assault by an intimate partner. SA/DVTC nurses are trained to offer all relevant services to all clients, with clients free to accept or decline (eg, crisis counselling, referral for on-site medical follow-up care and services in the community). The goal of addressing the immediate emotional, medical, forensic and social needs of victims of sexual assault, through on-site care and referral to appropriate services in the community, is to reduce the occurrence of longer-term physical and psychological morbidity and re-victimization. As part of a larger project, information was collected prospectively from victims who presented at one of 30 SA/DVTCs between April 1, 2009 and June 30, 2011, and
consented (or their guardians) to participate in a province-wide study investigating service use and satisfaction (3). Ethics board approval was obtained at all participating centres, with five programs not able to participate because of organizational restructuring, difficulty ensuring round-the-clock nursing coverage and/or significant modifications to the study design requested by their research ethics boards. In the present analysis, female adolescent (12 to 18 years of age) were compared with female young adult (19 to 24 years of age) sexual assault victims on sociodemographic-, assault- and care-related variables using χ2 and, where appropriate, Fisher’s exact tests. Analyses for the assault-related variables included a ‘doesn’t know/doesn’t remember’ category.
Results
During the study period, 1082 female sexual assault victims were seen, of whom 665 (61.5%) were included in the sample: 347 (32.1%) were adolescents and 318 (29.4%) were young adults. Compared with young adult sexual assault victims, adolescent victims differed on ethnicity and race (P=0.004). Adolescents were more likely to identify as Aboriginal (16.3% versus 7.5%), Black (8.1% versus 6.1%) and biracial (2.0% versus 0.7%), and less likely to describe themselves as Caucasian (71.0% versus 82.6%) or Asian (2.6% versus 3.1%). They were also more likely than young adult victims to report sexual assaults that included cunnilingus (13.1% versus 8.2%; P
