title: Sexual exploitation of very young Hmong girls.
abstract: OBJECTIVE
  Recent increases in Hmong girls referred to a Midwest hospital-based child advocacy center prompted this comparison of abuse experiences for Hmong extra-familial sexual abuse cases versus peers.
  
  
  METHODS
  Retrospective chart review of all girls, aged 10 to 14 years, with extra-familial sexual abuse 1998-2003 (n = 226). Fourteen percent of cases were Hmong (n = 32). Demographics, risk behaviors, abuse experiences, physical findings and legal outcomes were compared for Hmong (H) and Other (O) girls using chi-square. Multivariate logistic regressions explored differences in gynecologic findings and sexually transmitted disease (STD) results.
  
  
  RESULTS
  Hmong girls were more likely to be runaways (90% H vs. 8% O), truant (97% H vs. 13% O), self-mutilating (38% H vs. 10% O), and suicidal (41% H vs. 21% O). Seventy-seven percent of Hmong reported gang rape, prostitution, or multiple assaults versus 16% Others; most had 5+ perpetrators (69% H vs. 2% O) and 5+ assaults (75% H vs. 24% O, both p < .001). Gynecologic findings were more prevalent among Hmong girls (63% H vs. 21% O). Controlling for penetration, number of partners/assaults, and acuity at examination, Hmong ethnicity predicted gynecologic findings (adjusted odds ration [AOR] = 6.57). Hmong girls were more likely to have a positive chlamydia screen (36% H vs. 4% O, p < .001), but only number of perpetrators was an independent predictor (AOR = 15.09). Most cases were prosecuted, but Hmong had higher prosecution rates (83% H vs. 57% O, p < .001).
  
  
  CONCLUSIONS
  Hmong girl assault experiences were markedly more severe than peers. Health care providers need appropriate knowledge of Hmong culture to conduct forensic examinations. Abused Hmong girls need culturally sensitive, developmentally appropriate after-care that helps connect them back with families and school.
authors.affiliation: Midwest Children's Resource Center, Children's Hospital, St. Paul, Minnesota 55102, USA. laurel.edinburgh@childrenshc.org
authors.forename: Laurel
authors.initials: L
authors.lastname: Edinburgh
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Saewyc
authors.forename: Tru
authors.initials: T
authors.lastname: Thao
authors.forename: Carolyn
authors.initials: C
authors.lastname: Levitt
mesh_terms: D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000208:ethnology* / Q000706:statistics & numerical data; D003466:Cultural Characteristics; D005260:Female; D018453:Homeless Youth; D006801:Humans; D015994:Incidence; D007812:Laos / Q000208:ethnology; D008910:Minnesota / Q000453:epidemiology; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology; D011477:Sex Work; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000208:ethnology; D013405:Suicide