Forensic sexual assault examination and genital injury: is skin color a source of health disparity?
Forensic sexual assault examination and genital injury: is skin color a source of health disparity?
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DOI：
10.1016/j.ajem.2007.11.025
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发表时间：
2008-10-01
影响因子：
3.6
通讯作者：
Fisher, Bonnie S.
中科院分区：
文献类型：
--
作者：
Sommers, Marilyn S.;Zink, Therese M.;Fisher, Bonnie S.
目的：本研究的目的是：(1)估计黑人和白人女性在双方同意的性行为后肛门生殖器损伤的频率、患病率、类型和位置；(2)调查在法医性侵犯检查中皮肤颜色在损伤检测中的作用。方法：采用横断面描述性设计对120名健康志愿者进行了控制良好的法医检查后，双方同意的性交。结果：55%的样本在双方同意的性交后至少有一次肛门生殖器损伤；百分比在白人（68%）和黑人（43%）参与者之间存在显著差异（P = 0.02）。种族/民族是外生殖器损伤患病率和频率的重要预测因子，而不是内生殖器或肛门损伤的预测因子。然而，肤色变量-浅/暗-、红/绿-和黄/蓝-混淆了种族/民族与外生殖器损伤发生和频率之间的原始关系，肤色变量-红/绿-与内生殖器损伤发生和频率显著相关。结论：尽管黑人和白人女性在肛门生殖器损伤的频率和患病率上存在差异，但这种差异可以更充分地解释为肤色的差异，而不是种族/民族的差异。临床建议和刑事司法影响进行了讨论。(c) 2008爱思唯尔公司版权所有。
Purpose: The study objectives were to (1) estimate the frequency, prevalence, type, and location of anogenital injury in black and white women after consensual sex and (2) investigate the role of skin color in the detection of injury during the forensic sexual assault examination.Methods: A cross-sectional descriptive design was used with 120 healthy volunteers who underwent a well-controlled forensic examination after consensual sexual intercourse.Results: Fifty-five percent of the sample had at least 1 anogenital injury after consensual intercourse; percentages significantly differed between white (68%) and black (43%) participants (P = .02). Race/ ethnicity was a significant predictor of injury prevalence and frequency in the external genitalia but not in the internal genitalia or anus. However, skin color variables-lightness/darkness-, redness/ greenness-, and yellowness/blueness-confounded the original relationship between race/ethnicity and injury occurrence and frequency in the external genitalia, and 1 skin color variable-redness/greenness -was significantly associated with injury occurrence and frequency in the internal genitalia.Conclusions: Although differences exist in anogenital injury frequency and prevalence between black and white women, such differences can be more fully explained by variations in skin color rather than race/ethnicity. Clinical recommendations and criminal justice implications are discussed. (c) 2008 Elsevier Inc. All rights reserved.