Comparative Study of Acute Anogenital Injury Between Consensual and Nonconsensual Postmenarche Adolescents.

ABSTRACT: In Thailand, sexual activity involving those under the legal age of consent may be legally and medically problematic, even if it is consensual. Thus, differentiating anogenital injury characteristics that occur during consensual versus nonconsensual acts with adolescent female subjects could aid legal advocates and improve health care and social support for these patients. Our study included postmenarche female patients having acute anogenital injuries after consensual and nonconsensual penetration. We found that nonconsenting patients had more cases of anogenital injury than consenting (69.8% vs 55.5%), with at least 1 abrasion, contusion, laceration, labia major or minor injury, and external or internal site injury. Both consensual and nonconsensual cases had the same common sites for injury type, reflecting the same injury mechanism; prior sexual intercourse was a significant protective factor against some anogenital injury prevalence, types, and sites for both groups. Adolescents forced into nonconsensual acts had more nonanogenital injuries. Looking at factors such as age, prior sexual activity history, and use of condom and/or contraceptive pills, it is very clear that early sexual education, particularly around consent, is critically needed in Thailand for the best interests of adolescents and children so that they and/or their guardians can access the health and legal resources required.

Detection of prostate specific antigen and semenogelin in specimens from female rape victims.

The presence of semen is generally accepted as evidence in sexual assault cases prosecution. Detection of sperm is confirmation of semen; however, sperm cannot always be detected. Prostate specific antigen (PSA) and semenogelin (Sg) are used as semen biomarkers. We compared the detection rate and persistence of sperm, PSA and Sg over a range of time intervals from the time of assault to specimen collection. The results show that sperm had the longest persistence and highest detection rate. The detection rate of the Sg test was significantly better than that of the PSA test overall, whether the sperm test was negative or positive. In conclusion, the detection of sperm should be the first test executed: if sperm is not detected, the Sg test is more suitable than the PSA test and could be used up to 72 h after assault.