Sensitivity of the Colposcopy Exam After Sexual Assault

University Of Cincinnati, Cincinnati OH

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Abstract

The National Violence Against Women survey reported that 1 of 6 US women have experienced an attempted or completed rape. Each year almost three million women are injured during rape and sexual assault. Because of the success in identifying microscopic genital injury in sexual assaulted children, more practitioners are using a colposcope during the exam of adult females. Colposcopic photos are then used in court testimony to document non-consensual vs. consensual sex. The specific aim of this study is to determine whether experts can accurately predict consensual vs. non-consensual sex from colposcopic photographs. Research questions include: 1) Can experts differentiate between colposcopic photos of women groups of women: those who have experienced consensual vs. non-consensual sex? 2) When viewed as colposcopic photons, what is the difference in number, type and location of injury to the female genitalia and/or anus after consensual versus non-consensual sex? 3) What are the differences in the sensitivity and specificity of colposcopic photos in detecting injury to the female genitalia and/or anus in African-American and White women? The study will involve prospective enrollment of control subjects who will undergo a colposcopic exam following consensual sex. The photographs derived from the exam will be compared to a retrospective review of photographs from unidentified sexual assault survivors. 100 control subjects who are examined after consensual sexual intercourse will be enrolled over the three years of the study. Chart records and colposcopic photos of sexual assault survivors will be reviewed retrospectively and matched to control subjects by ethnicity, age, and time from assault to exam. A panel of five gynecologic and forensic experts will attempt to differentiate between the photographs of women with consensual (n=100) and non-consensual (n=100) attempt to differentiate between the photographs of women with consensual (n=100) and non-consensual (n=100) sex. They will also determine the frequency, type and location of injury to the female genitalia and/or anus after consensual versus non- consensual sex. Sensitivity, specificity, and other statistics describing the raters' ability to differentiate between the two sets of photographs will be calculated. Findings will also support or refute statements by experts that they can differentiate consensual versus non-consensual sex from colposcopy photos. Ultimately the study has the potential to improve evidence-based practice and enhance conviction rates for rape.