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Effect of menstrual bleeding on the detection of anogenital injuries in sexual assault victims

  • Author Footnotes
    1 25 Sheldon Blvd. SE, Grand Rapids MI 49503, United States of America.
    Linda Rossman
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    1 25 Sheldon Blvd. SE, Grand Rapids MI 49503, United States of America.
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    YWCA West Central Michigan Nurse Examiner Program, Grand Rapids, MI, United States
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    1 25 Sheldon Blvd. SE, Grand Rapids MI 49503, United States of America.
    Stephanie Solis
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    1 25 Sheldon Blvd. SE, Grand Rapids MI 49503, United States of America.
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    YWCA West Central Michigan Nurse Examiner Program, Grand Rapids, MI, United States
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  • Author Footnotes
    1 25 Sheldon Blvd. SE, Grand Rapids MI 49503, United States of America.
    Janda Stevens
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    1 25 Sheldon Blvd. SE, Grand Rapids MI 49503, United States of America.
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    YWCA West Central Michigan Nurse Examiner Program, Grand Rapids, MI, United States
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    1 25 Sheldon Blvd. SE, Grand Rapids MI 49503, United States of America.
    Barbara Wynn
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    1 25 Sheldon Blvd. SE, Grand Rapids MI 49503, United States of America.
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    YWCA West Central Michigan Nurse Examiner Program, Grand Rapids, MI, United States
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  • Jeffrey S. Jones
    Correspondence
    Corresponding author at: 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States.
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    Department of Emergency Medicine, Spectrum Health Hospitals, Grand Rapids, MI, United States
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    1 25 Sheldon Blvd. SE, Grand Rapids MI 49503, United States of America.
Published:November 06, 2018DOI:https://doi.org/10.1016/j.ajem.2018.11.005
      The physical examination of sexual assault victims is performed to identify and treat injuries, as well as collect forensic evidence for prosecution. The combination of colposcopy with digital imaging and staining with contrast media such as toluidine blue, has led to reports of genital injury prevalence approaching 90% following nonconsensual sexual intercourse [
      • Sommers M.S.
      Defining patterns of genital injury from sexual assault: a review.
      ]. Such forensic evidence of anogenital injury influences decision making and legal outcomes throughout the criminal justice process. Because the examination is based on scientific evidence, it may influence victims to report their experiences to police, encourage police to file a complaint, and persuade prosecutors to file rape charges and pursue a conviction [
      • Sommers M.S.
      • Fisher B.S.
      • Karjane H.M.
      Using colposcopy in the rape exam: health care, forensic, and criminal justice issues.
      ]. For example, McGregor et al. demonstrated that the presence of anogenital trauma was significantly related to filing of charges by the prosecutor as well as conviction [
      • McGregor M.
      • Du Mont J.
      • Myhr T.
      Sexual assault forensic medical examination: is evidence related to successful prosecution?.
      ].

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