Yaakobi-Zelnik Shani, Peled Raz Maya, Gewirtz-Meydan Ateret
Bnai Zion Medical Center, Haifa, Israel.
Hebrew University of Jerusalem, School of Social Work and Social Welfare, Jerusalem, Israel.
Isr J Health Policy Res. 2025 Jun 23;14(1):38. doi: 10.1186/s13584-025-00697-1.
One of the primary challenges faced by survivors of sexual abuse and assault is the fragmented nature of care. This begins immediately after the assault and continues throughout their recovery journey. To address this, specialized sexual assault referral centers (SARC) were established in Israel, providing comprehensive medical, legal, and emotional support. This study examines the association between these centers and survivors' consent to forensic examination and filing of police complaints.
This retrospective cohort study analyzed data from 616 cases of sexual abuse and assault reported at the SARC at Bnai Zion Medical Center between January 2016 and May 2022. Data included demographic information, assault characteristics, treatment details, and survivors' consent to forensic examination and police complaint filing.
Four distinct profiles of sexual assault survivors were identified. The first profile included survivors who consented to both forensic examination and police complaints. This group was characterized by shorter intervals between the assault and arrival at the center, being accompanied by friends or family, more often agreeing to receive medication and experiencing more incidents involving more than one attacker. The second profile included survivors who consented to forensic examination only, and it consisted mainly of young women who arrived unaccompanied, later after the assault, expressed more willingness to receive medications and often involved single perpetrator assaults with alcohol use. The third profile involved survivors who filed only a police complaint and were characterized by lower rates of alcohol use during the assault and less frequent receipt of medication. The fourth profile comprised survivors who refused both forensic examination and police complaint, primarily young females who arrived unaccompanied and often reported experiencing forced vaginal or anal penetration. Key predictors of group membership included time since the assault, biological sex, assault type, alcohol use, medication, presence of an informal escort, and multiple perpetrators.
The study underscores the importance of a victim-centered, trauma-informed approach to care, highlighting the need for tailored interventions to address the specific needs and barriers of each survivor profile. The findings suggest that timely access to medical care and supportive services is significantly associated with survivors' decisions to consent to forensic examinations and file police complaints.
性虐待和性侵犯幸存者面临的主要挑战之一是护理的碎片化。这种情况在袭击发生后立即开始，并在他们的整个康复过程中持续存在。为了解决这个问题，以色列设立了专门的性侵犯转介中心（SARC），提供全面的医疗、法律和情感支持。本研究探讨了这些中心与幸存者同意法医检查及向警方报案之间的关联。
这项回顾性队列研究分析了2016年1月至2022年5月期间在贝纳伊锡安医疗中心的SARC报告的616例性虐待和性侵犯案件的数据。数据包括人口统计学信息、袭击特征、治疗细节以及幸存者同意法医检查和向警方报案的情况。
确定了性侵犯幸存者的四种不同特征。第一种特征包括同意法医检查和向警方报案的幸存者。这一组的特点是袭击与到达中心之间的间隔时间较短，有朋友或家人陪同，更常同意接受药物治疗，并且更多地经历涉及多名袭击者的事件。第二种特征包括仅同意法医检查的幸存者，主要由无人陪同到达、在袭击后较晚到达、更愿意接受药物治疗且经常涉及单一犯罪者使用酒精的袭击的年轻女性组成。第三种特征涉及仅向警方报案的幸存者，其特点是袭击期间酒精使用率较低且较少接受药物治疗。第四种特征包括拒绝法医检查和警方报案的幸存者，主要是无人陪同到达且经常报告遭受强迫阴道或肛门插入的年轻女性。组成不同组别的关键预测因素包括袭击后的时间、生理性别、袭击类型、酒精使用、药物治疗、有无非正式陪同人员以及多名犯罪者。
该研究强调了以受害者为中心、注重创伤的护理方法的重要性，突出了需要采取量身定制的干预措施来满足每个幸存者特征的特定需求和障碍。研究结果表明，及时获得医疗护理和支持性服务与幸存者同意法医检查和向警方报案的决定显著相关。
