Correlates of Anogenital Injuries in Adolescent Females

Objective: We sought to investigate correlates of anogenital injuries (AGIs) in adolescents. Methods: Our retrospective study included sexually assaulted female patients aged 12 to 17 reporting attempted or completed vaginal or anal penetration between 2002 and 2011. Forensic nurses performed anogenital examinations using colposcopy, digital macrovisualization, and toluidine blue dye application. We reviewed case files for AGIs and demographic and sexual assault characteristics. Results: Of the 1961 sexual assault examinations that met our inclusion criteria, 59.6% displayed AGIs. Our logistic regression model using 1752 examinations found the following variables associated with less injury: intercourse within 5 days prior to assault (OR 0.72, 95% CI = 0.55 to 0.95); post-coital interval of 49-72 (OR 0.50, 95% CI = 0.36 to 0.71), 73-96 (OR 0.41, 95% CI = 0.25 to 0.68), and 97-120 hours (OR 0.26, 95% CI = 0.13 to 0.51). Only lack of prior sexual experience was associated with increased injury (OR 2.01, 95% CI = 1.58 to 2.55). Conclusions: In our adolescent patient population, examination findings of AGIs correlate with variables related to time from assault and prior sexual experience.