Caring for young adolescent sexual abuse victims in a hospital-based children's advocacy center.
OBJECTIVE
This study compared health care assessments, referrals, treatment, and outcomes for young adolescent sexual assault/sexual abuse victims seen at a hospital-based Child Advocacy Center (CAC), to that provided to similar victims evaluated by other community providers. A second purpose was to document how common DNA evidence is found among such cases.


METHODS
A retrospective matched case-comparison design matched index CAC cases diagnosed with extra-familial sexual assault to non-CAC cases referred for prosecution in the same county, matched by age and sex of victim, age and sex of perpetrator, and type of assault (N=128 pairs). Since the case-comparison design produces paired data, analyses used paired t-tests, McNemars test, and Wilcoxon signed-rank tests. Health care outcomes included whether victims received a health exam, indicated tests, findings of trauma on genital exams and counseling referrals; legal outcomes included whether cases were prosecuted, verdicts, and length of sentences.


RESULTS
CAC cases were significantly more likely to receive a physical exam, a genital exam when indicated, and referral for counseling (all p<.001). In the CAC group 26.7% vs. 4.8% had positive genital trauma findings, and only 6.3% of CAC cases failed to get indicated sexually transmitted infection (STI) tests or prophylactic treatment for STIs vs. 80% of the comparisons (p<.001). There were no differences in decisions to prosecute, convictions, or sentence lengths between the groups. DNA was documented in only 27.3% of acute cases, although evidence kits were completed.


CONCLUSIONS
Young adolescent sexual abuse victims received markedly different health care in a hospital-based CAC compared to elsewhere. DNA is not commonly found in acute cases.


CONCLUSIONS
Community health care providers and law enforcement should be encouraged to refer victims to hospital-based CACs for specialized examinations and treatment.
Edinburgh
Laurel
L
Midwest Children's Resource Center, Children's Hospital and Clinics of Minnesota, 347 N Smith Avenue, Suite 4001, St. Paul, MN 55102, USA.
Saewyc
Elizabeth
E
Levitt
Carolyn
C
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis* / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000628:therapy; D002651:Child Advocacy / Q000331:legislation & jurisprudence; D019548:Crime Victims / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D016172:DNA Fingerprinting / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008910:Minnesota; D010552:Personality Assessment; D012017:Referral and Consultation / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014600:Utilization Review