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 exam	14
Hymen transection	6a
No exam	12
Acute SA (past 5 days)
Yes	4
Sexual assault specimen kit collected
No	27
Yes	4
Collected in ER other than Children's Hospital	1
Pregnant
No	29
Yes	1
Treated prophylatically	1
Not tested	1
Chlamydia
Yes	9
Other STI+
Yes	3

a

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 = 32	Other assaults, n = 534	χ2 (d.f.)
	%	%
PTSD screen
Likely	90.0	59.8	12.0 (1)**
Partial	–	29.1	–
Screen negative	10.0	11.1	0.1 (1)
Self-harm
Yes	60.0	50.2	1.1 (1)
Suicidal ideation
Yes	64.0	52.1	1.3 (1)
Suicide attempts
Yes	36.0	25.5	2.3 (1)
Ran away in past 12 months
Yes	64.3	41.1	5.7 (1)*
Drinking, in last 12 months
Yes	70.4	35.3	17.2 (1)**
Drinking, in past month
0	33.3	72.5	21.0 (1)**
1–2 days	33.3	13.4	10.5 (1)**
3–5 days	14.8	7.8	2.4 (1)
6–9 days	18.5	4.3	13.0 (1)**
10 or more	–	0.2	–
Binge drinking in past 2 weeks
Never	51.9	86.8	27.0 (1)**
Once	33.3	5.3	39.9 (1)**
Twice	14.8	4.8	6.3 (1)*
3 or more	–	2.4	–
Marijuana, in last 12 months
Yes	44.4	37.7	0.5 (1)
Marijuana use in past month
None	63.0	73.1	1.7 (1)
1–2	22.2	12.3	2.4 (1)
3 or more	14.8	14.6	0.1 (1)
Other drugs in last 12 months
Yes	15.4	13.9	0.1 (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

a

“age at first use” is only those youth who reported ever trying that behavior.

*

p < .05.

**

p < .01.

Full article at:   http://goo.gl/5cv5Qk

By:   Edinburgh L1, Pape-Blabolil J1, Harpin SB2, Saewyc E3.

• 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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