There is increasing interest among forensic nurses to understand the differences in genital injury after rape as compared to consensual sex. With a colposcope an examiner is able to magnify and photograph microscopic ano-genital injuries that occur during either consensual sex or a sexual assault. Purpose: The specific aim of this study is to quantify the type and number of injuries identified in a controlled forensic exam following consensual sex. A secondary aim is to explore ethnic differences in injury rates and location. Theoretical Framework: The human sexual response as described by Masters and Johnson is used as the theoretical perspective for this study. Subjects: Fifty two female community volunteers were enrolled in the study. Mean age was 31.4 years (SD=6.53, range=21.3 to 44.8 years), 25 described their race/ethnicity as white/Caucasian, and 27 as black/African American. Methods: Following consensual intercourse, expert nurse examiners assessed nine ano-genital regions by using three different methods to identify injury (direct visualization, colposcopy, and toluidine blue staining). Results: The overall ano-genital injury rate for the entire sample was 54% (n=29), 41% for blacks (n=11), and 67% for whites (n=18). A Fisher’s exact test indicated that the proportion of whites with injuries was greater than the proportion of blacks with injuries (FI=3.63, p=.04). The most common injury sites were the posterior fourchette (47% of sample), labia minora (12%), anus (10%), and hymen (8%). Conclusions: More than half our sample of women experienced ano-genital injury following consensual sex. Further work is needed to determine how these injuries are different from or are similar to those injuries experienced by women who are sexually assaulted. Funded by the National Institute of Nursing Research, R01 NR05352.
Session #1177 - Womens' Health
The 29th Annual MNRS Research Conference (April 1-4, 2005)