Ensuring Equitable Access: An evaluation of forensic and clinical care for adolescent survivors of sexual assault

Objective: The Ottawa Hospital Sexual Assault and Partner Abuse Care Program (SAPACP) is the sole referral centre for medical and forensic care for sexually assaulted adolescents and adults in Ottawa. As adolescents are... [ view full abstract ]

Objective: The Ottawa Hospital Sexual Assault and Partner Abuse Care Program (SAPACP) is the sole referral centre for medical and forensic care for sexually assaulted adolescents and adults in Ottawa. As adolescents are commonly an under-serviced risk group, especially at hospitals, we sought to investigate all adolescent sexual assault cases and evaluate access to clinical and forensic care.

Methods:  A patient chart review was conducted in 2013 and contextual information on the sexual assault (e.g. assailant and environmental characteristics) and service provision (e.g. diagnostics, treatment, forensic evidence collection) was abstracted. We used an inclusive age definition of 16-24 years to compare the adolescent and adult patient populations. We conducted logistic regression modelling to assess proportional differences in service uptake between adolescents and adults using odds ratios (OR) and 95% confidence intervals (CI).

Results: In 2013, there were 204 new cases of sexual assault and 115 (56.37%) were adolescent cases. Among adolescents, 54 (46.96%) involved an unknown assailant, 50 (43.48%) suspected drug facilitated sexual assault, 40 (34.78%) took place at mass gatherings (e.g. music festivals, university frosh week etc.), and 13 (11.30%) involved multiple assailants. Consent and uptake of SAPACP services was high among adolescents, 96 (83.48%) received standard diagnostic blood work, 95 (82.61%) received STI treatment and emergency contraceptives, and 78 (67.83%) completed a forensic sexual assault kit. Compared to adult patients, adolescents had equally high levels of service uptake with no significant differences detected for diagnostic blood work (OR:0.78, 95% CI:0.36-1.72), STI treatment and emergency contraceptives (OR:1.65, 95% CI:0.84-3.26) or forensic sexual assault kit (OR:1.02, 95% CI:0.56-1.84).

  Conclusion: Ensuring quality care for adolescents following sexual assault is a critical component of comprehensive service provision. In a predominantly adult general hospital, our program has demonstrated that adolescents are successfully receiving safe and accessible sexual assault care.