Sommers Marilyn S, Fargo Jamison D, Baker Rachel B, Fisher Bonnie S, Buschur Carol, Zink Therese M
University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA.
J Forensic Nurs. 2009;5(4):191-200. doi: 10.1111/j.1939-3938.2009.01054.x.
Little is known about the role of skin color in the forensic sexual assault examination. The purpose of this study was to determine whether anogenital injury prevalence and frequency vary by skin color in women after consensual sexual intercourse. The sample consisted of 120 healthy (63 Black, 57 White) women who underwent a forensic sexual assault examination following consensual sexual intercourse. Experienced sexual assault forensic examiners using visual inspection, colposcopy technique with digital imaging, and toluidine blue application documented the number, type, and location of anogenital injuries. Although 55% of the total sample was observed to have at least one anogenital injury of any type following consensual intercourse, the percentages significantly differed for White (68%) and Black (43%) participants (p= 0.02). When the presence of anogenital injury was analyzed by specific anatomical region, a significant difference between White and Black participants was only evident for the external genitalia (White = 56%, Black = 24%, p= .003), but not for the internal genitalia (White = 28%, Black = 19%, p= .20) or anus (White = 9%, Black = 10%, p= 0.99). A one standard deviation-unit increase in L* values (lightness) was related to a 150% to 250% increase in the odds of external genitalia injury prevalence (p < 0.001). While Black and White participants had a significantly different genital injury prevalence, dark skin color rather than race was a strong predictor for decreased injury prevalence. Sexual assault forensic examiners, therefore, may not be able to detect injury in women with dark skin as readily as women with light skin, leading to health disparities for women with dark skin.
关于肤色在法医性侵犯检查中的作用，人们知之甚少。本研究的目的是确定在自愿性交后，女性肛门生殖器损伤的患病率和发生率是否因肤色而异。样本包括120名健康女性（63名黑人，57名白人），她们在自愿性交后接受了法医性侵犯检查。经验丰富的性侵犯法医检查人员通过目视检查、数码成像的阴道镜检查技术和应用甲苯胺蓝记录了肛门生殖器损伤的数量、类型和位置。虽然在自愿性交后，总样本中有55%的人被观察到至少有一处任何类型的肛门生殖器损伤，但白种人（68%）和黑种人（43%）参与者的这一比例存在显著差异（p = 0.02）。当按特定解剖区域分析肛门生殖器损伤的存在情况时，白种人和黑种人参与者之间的显著差异仅在外部生殖器方面明显（白种人 = 56%，黑种人 = 24%，p = 0.003），而在内部生殖器方面（白种人 = 28%，黑种人 = 19%，p = 0.20）或肛门方面（白种人 = 9%，黑种人 = 10%，p = 0.99）并不明显。L*值（亮度）每增加一个标准差单位，外部生殖器损伤患病率的几率就增加150%至250%（p < 0.001）。虽然黑种人和白种人参与者的生殖器损伤患病率有显著差异，但深色皮肤而非种族是损伤患病率降低的有力预测因素。因此，性侵犯法医检查人员可能无法像浅色皮肤女性那样容易地检测出深色皮肤女性的损伤，这导致了深色皮肤女性的健康差异。
