Sunday, December 27, 2015

Multiple Perpetrator Rape among Girls Evaluated at a Hospital-Based Child Advocacy Center: Seven Years of Reviewed Cases

The aim of this study was to describe contextual events, abuse experiences, and disclosure processes of adolescents who presented to a hospital-based Child Advocacy Center for medical evaluation and evidentiary collection as indicated after experiencing multiple perpetrator rape during a single event (n=32) and to compare these findings to a group of single perpetrator sexual assaults (n=534). 

This study used a retrospective mixed-methods design with in-depth, forensic interviews and complete physical examinations of gang-raped adolescents. Patients ranged from 12 to 17 years (M=14 years). Girls who experienced multiple perpetrator rape during a single event were more likely to have run away, to have drunk alcohol in the past month, and to have participated in binge drinking in the past 2 weeks. 

Acute presentation of these victims were rare but 30% had hymenal transections and 38% had sexually transmitted infections (STIs). Forensic interviews revealed alcohol was a common weapon used by offenders, and its use resulted in victims experiencing difficulty in remembering and reporting details for police investigation or physical and mental health care. 

Most victims were raped at parties they attended with people they thought they could trust, and they felt let down by witnesses who could have helped but did not intervene. Although relatively rare, multiple perpetrator rape during a single event is a type of severe sexual assault experience and has significant risks for deleterious health outcomes. 

These victims require health care by trained providers to diagnose physical findings, treat STIs, screen for trauma, and support victims.

Table 2.
Physical examination findings for gang-raped girls only (n= 32).
Gang-raped, n = 32
Genital injury findings (post-SA)
Normal exam14
Hymen transection6a
No exam12
Acute SA (past 5 days)
Sexual assault specimen kit collected
Collected in ER other than Children's Hospital1
Treated prophylatically1
Not tested1
Other STI+
Of these six hymen transections, 2 were acute in nature and 4 were not.

Table 3.
Comparisons of risk behaviors, girls who were gang-raped compared to other types of sexual abuse (N= 566).
Gang-raped, n = 32Other assaults, n = 534χ2 (d.f.)
PTSD screen
Likely90.059.812.0 (1)**
Screen negative10.011.10.1 (1)
Yes60.050.21.1 (1)
Suicidal ideation
Yes64.052.11.3 (1)
Suicide attempts
Yes36.025.52.3 (1)
Ran away in past 12 months
Yes64.341.15.7 (1)*
Drinking, in last 12 months
Yes70.435.317.2 (1)**
Drinking, in past month
033.372.521.0 (1)**
1–2 days33.313.410.5 (1)**
3–5 days14.87.82.4 (1)
6–9 days18.54.313.0 (1)**
10 or more0.2
Binge drinking in past 2 weeks
Never51.986.827.0 (1)**
Once33.35.339.9 (1)**
Twice14.84.86.3 (1)*
3 or more2.4
Marijuana, in last 12 months
Yes44.437.70.5 (1)
Marijuana use in past month
None63.073.11.7 (1)
1– (1)
3 or more14.814.60.1 (1)
Other drugs in last 12 months
Yes15.413.90.1 (1)
M (SD)M (SD)t-test
Age at first use, alcohola
(range 11–17 yrs)13.2 (1.22)12.68 (1.62)1.78
Age at first use, marijuanaa
(range 11–17 yrs)12.8 (1.70)12.8 (1.40)0.07
Age of first use, ‘other drugs’a
(range 11–17 yrs)12.7 (0.82)13.2 (1.64)1.48
Emotional distress, past 30 days
(range 0–4)2.4 (1.12)2.2 (1.15)1.13
“age at first use” is only those youth who reported ever trying that behavior.
p < .05.
p < .01.

Full article at:

  • 1Midwest Children's Resource Center, Children's Hospital and Clinics of Minnesota, St. Paul, MN, USA.
  • 2University of Colorado College of Nursing, Aurora, CO, USA.
  • 3University of British Columbia School of Nursing, Vancouver, Canada. 

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