Victims of drug facilitated sexual assault aged 13-24: a cross sectional study on the pool of users of a sexual violence relief centre in Northern Italy.

This cross-sectional study aimed to assess the association between drugs and alcohol intake and sexual abuse in adolescents, otherwise defined as Drug Facilitated Sexual Assault (DFSA). We considered the survivors who accessed care at the Centre "Soccorso Violenza Sessuale" (SVS - Sexual Violence Relief Centre) in Turin (Italy), between May 2003 and May 2022. We found that 973 patients aged 13-24 among which 228 were victims of DFSA. Epidemiological and anamnestic aspects of the episode of sexual violence were examined, with a specific focus on investigating the alcohol and/or drug intake as reported by the victim, along with the results of the toxicological analysis. the study further accounts for the variations caused by the COVID-19 pandemic on DFSA-related accesses. Our findings show that 23% of adolescents accessing care at SVS were subjected to DFSA. Six out ten adolescents knew their aggressor, at times a partner (10%) oran acquaintance (43%). In 12% of cases violence was perpetrated by a group of people (12%). Almost 90% of young victims described alcohol consumption, while 37% reported drug use at the time of the assault. Alcohol taken alone or in combination with other substances was the most detected drug in our sample throughout the period considered. Given the large use of psychoactive substances among adolescents, it is imperative to implement harm reduction strategies alongside educational activities aimed at fostering awareness about consent. Health personnel should be trained to manage the needs of victims of DFSA clinically and forensically.

Sexual Violence and Alcohol Intake: A Population-Based Explorative Study in a Northwestern Italian Area.

Background and Objectives: Sexual violence (SV) is a major global public health concern. While socioeconomic factors and familial relationships have been widely reported to contribute to SV, the role of alcohol consumption should not be ignored. Indeed, alcohol can impair cognition, distort reality, increase aggression, and ease drug-facilitated sexual assault. This retrospective study aims to explore the relationship between alcohol consumption and SV by examining the prevalence, characteristics, and consequences of violence episodes. Materials and Methods: A total of 1481 women accessed the Rape Centre "Centro Soccorso Violenza Sessuale" in Turin, Italy between 2008 and 2019, with 223 reporting alcohol consumption before the assault. Results: The alcohol group had a younger age profile, predominantly within the 18-25-year-old category. SV incidents involving alcohol consumers were more likely to occur in public places or in someone else's home, while the non-alcohol-consuming group experienced more violence in their own homes. Acquaintances and unknown individuals were primarily responsible, whereas partners were the most common perpetrators of violence against non-alcohol-consuming women. Alcohol consumers sought medical attention sooner after the assault and exhibited more symptoms and injuries, particularly of neurological origin. Concurrent use of recreational drugs was higher among alcohol consumers. The logistic regression analysis revealed higher odds of injury for Italian women and those in the 18-35 age groups after consuming alcohol. Conclusions: This study contributes to the understanding of the relationship between alcohol consumption and SV. The prevalence of alcohol-related sexual aggression is lower compared to that shown in previous studies. Nationality, age, and assailant identity influence SV dynamics. These findings can guide well-targeted interventions and prevention strategies to address SV and inform communities facing similar challenges.

Sexual Harassments Related to Alcohol and Drugs Intake: The Experience of the Rape Centre of Turin.

A cross-sectional study was conducted that describes the characteristics of sexual violence episodes related to the intake of alcohol and drugs observed among women that turned to the "Centro Soccorso Violenza Sessuale" (SVS) of the Sant'Anna Hospital in Turin between 1 January 2008, and 31 December 2017. Two hundred twenty-two patients were enrolled, 25 of which were minors, 141 were Italians, and most of them knew their aggressor and were raped in a private home. One hundred and fifty-five of them declared to the healthcare personnel to have taken alcoholic substances and/or drugs in conjunction with the event (86 reported having drunk alcohol, 36 having taken drugs and 33 disclosed both alcohol and drug abuse). If the woman knew her abuser, alcohol consumption was described as voluntary in more than 80% of cases, while in relation to drugs the consumption was equally voluntary or fraudulent. About 73% of women who reported having drunk alcohol just had amnesia or amnesia related to other symptoms, while amnesia was present in about 63% of women who reported only drug use. Physicians observed physical injuries on 156 women. Patients who reported to have assumed alcohol presented a significantly higher risk to suffer any physical injury and have a significantly increased risk to suffer injuries to their head and/or neck. The results obtained underline how even in Northern Italy alcohol intake represents the most widespread psychoactive substance in case of drug-facilitated sexual assault. There is therefore a need to promote education and prevention campaigns among citizens, especially among the youngest.

Violence against pregnant women in the experience of the rape centre of Turin: Clinical and forensic evaluation.

Pregnant women can be victims of violence: as a matter of fact, far from being a protective factor, pregnancy can trigger or worsen episodes of abuse. Studies conducted by the WHO highlight that its incidence fluctuates between 1% and 28%. Therefore violence during pregnancy is endemic all over the world and involves all social strata. We analysed 113 medical records concerning pregnant women (average age 27.9 ± 6.0 years, 80 foreigners), who turned to the Centro Soccorso Violenza Sessuale, one of the two Italian Rape Centre, in Turin between January 1st, 2005 and December 31st, 2017. Fifty-three women were visited in the first trimester, 41 in the second, and 16 in the third, while 3 during the puerperium. The current partner was accused to be the abuser by the 84.4% of the Italian women and by the 69.2% of the foreigners. Sixty-eight women suffered multiple forms of violence, while 98 suffered only physical violence, and 3 reported only sexual abuse. According to 20 women, violent episodes increased during pregnancy. The clinical history of these women was characterized by some recurrent physical symptoms, such as pelvic pain, abdominal pain, facial pain and headache and 54 women presented injuries (abrasions and ecchymosis). Our results confirm that violence in pregnancy is a social and public health problem. Therefore it is important that the health personnel should be prepared not only to care for women seeking help, but above all its better preparation could also identify victims of violence, which do not report abuse.

Violence against African migrant women living in Turin: clinical and forensic evaluation.

The phenomenon of migration is often related to violence and exploitation. Data collection in conflict-affected countries is hard and complicated by the lack of literature, especially on the health of migrant female victims of violence. The aim of our study has been to realise a clinical and forensic evaluation on African female migrant's global health through their admissions to the Rape Centre "Soccorso Violenza Sessuale" at Sant'Anna Hospital in Turin. In our sample, we considered several aspects such as place where the violence occurred, number and the identity of the perpetrators, use of physical restraint instruments and/or substances, kidnapping, prostitution under duress, abuses, pregnancies and outcomes, injuries and complained symptoms, female genital mutilation, and sexually transmitted diseases. The sample consisted of 143 women, of which 136 were victims of violence. In 72.8% of the episodes, the perpetrator of violence was an unknown subject. Of the women, 58.8% reported being abused in Libya, 92.6% were victims of sexual violence, and 30.2% became pregnant after sexual abuse. The physical examination of the sample showed that 34.6% of women had at least a scar and that 12.5% reported a female genital mutilation. This is the first database on health of African female migrants in Turin area collecting data on migration, violence, and physical and psychological effects of abuse.

58 cases of sexual violence bearing forensic interest: congruence between the victim's report and the data from laboratory analyses.

The assistance provided by specialised healthcare personnel to victims of a sexual violence cannot focus just on the clinical intervention appropriate for the lesions suffered by the patient, but must also take legal and forensic needs into account. Anamnestic data represents a crucial step towards the finding of forensic evidence. Our retrospective study aims to analyse the congruence between verbal reports from abused women and the laboratory data to the end of identifying ways for enhancing the gathering of anamnestic data. We considered 960 medical records related to sexual violence that reached the Rape Centre "Soccorso Violenza Sessuale" of Turin between 2003 and 2013. Having consulted the register of evidence, we selected the cases for which the local judicial authority had asked for expert advice on biological material. The selected cases have been gathered in two different categories depending on whether the victim could or could not recall the events. Then, we looked at the results of the cytological analysis performed to identify the presence of sperm cells, at the results of the body fluid identification, and at the results of the DNA quantitation. Our findings strongly suggest that forensic investigations should be carried out independently from the presence of memories of the traumatic events on the victim's part. Moreover, they suggest that forensic investigations should also be pursued in the presence of a negative cytologic examination.