Geographies of Sexual Assault: A Spatial Analyses to Identify Neighborhoods Affected by Sexual and Gender-Based Violence.

Emergency departments are a common access point for survivors of sexual and gender-based violence (SGBV), but very little is known about where survivors live and the neighborhoods they return to. The objectives of this study were to describe the patient population that present for a sexual or partner-based assault and explore the geographic distribution of cases across the Ottawa-Gatineau area. Data for this study were extracted from the Sexual Assault and Partner Abuse Care Program (SAPACP) case registry (January 1 to December 31, 2015) at The Ottawa Hospital. Spatial analyses were conducted using six-digit postal codes converted into Canadian Census Tract units to identify geographic areas with concentrated cases of SGBV. Concentrated areas were defined as Census Tracts with seven or more SGBV cases within a single calendar year. In 2015, there were 406 patients seen at the SAPACP and 348 had valid postal codes and were included in the analyses. More than 90% of patients were female and 152 (43.68%) were below 24 years of age. More than 70% knew their assailant and the most common locations of the assault were at the survivors' home (31.03%), assailants' home (27.01%), or outdoors (10.92%). Eight concentrated areas were identified including three in the downtown entertainment district, three lower income areas, one high-income neighborhood, and one suburb more than 20 km from downtown. The findings from this study describe the typical clinical presentation of sexual and domestic assault survivors and also challenge geographic stereotypes of where survivors live and what areas of the city are most affected by SGBV. Using residential information provides a survivor-centric approach that highlights the widespread nature of SGBV and supports the need for population-based approaches to improve care for survivors.

Featured counter-trafficking program: H.E.A.L.T.H. Clinic of Ottawa.

This invited article is one of several comprising part of a special issue of Child Abuse and Neglect focused on child trafficking and health. The purpose of each invited article is to describe a specific program serving trafficked youth. Featuring these programs is intended to raise awareness of innovative counter-trafficking strategies emerging worldwide and facilitates collaboration on program development and outcomes research. This article describes the H.E.A.L.T.H. Clinic of Ottawa, Ontario, Canada, a primary health care clinic designed specifically for those who have experienced, are currently experiencing, or are at risk for sexual exploitation, coercion, or human trafficking.

Achieving just outcomes: forensic evidence collection in emergency department sexual assault cases.

BACKGROUND: Achieving just outcomes in sexual assault cases is one of the most serious and complex problems facing the healthcare and justice systems. This study was designed to determine the prevalence and correlates of Sexual Assault Evidence Kit (SAEK) completion and release to police among sexual assault cases presenting to the ED. METHODS: Data for this retrospective study come from the Sexual Assault and Partner Abuse Care Programme (SAPACP) case registry (1 January to 31 December, 2015) at The Ottawa Hospital, a unique medical-forensic access point and the only facility offering SAEK collection in Ottawa. Bivariable and multivariable logistic regression models were conducted using ORs, adjusted ORs (AORs) and 95% CIs. RESULTS: In 2015, 406 patients were seen by the SAPACP and 202 (77.1%) were eligible for a SAEK. Among eligible cases, 129 (63.9%) completed a SAEK and 60 (29.7%) released the SAEK to police for investigation. Youth cases (≤24 years) had the highest odds of completing a SAEK (AOR 2.23, 95% CI 1.18 to 4.23). Cases who were uncertain of the assailant (AOR 3.62, 95% CI 1.23 to 10.67) and assaults that occurred outdoors (AOR 3.14, 95% CI 1.08 to 9.09) were most likely to release the SAEK to police. CONCLUSION: Even with access to specialised forensic evidence collection, many sexual assault survivors do not complete a SAEK, and even fewer release the evidence to police for investigation. The ED is a common entry points into the healthcare system, and this study has highlighted the need to strengthen services and reduce attrition along the health-justice continuum.

Characteristics associated with sexual assaults at mass gatherings.

INTRODUCTION: Sexual assault is disturbingly common, yet little is known about those occurring at mass gatherings, defined as a group of people congregated for a common purpose. Our objectives were to examine patterns of variation in sexual assault associated with mass gatherings and to determine factors associated with assaults occurring at mass gatherings. METHODS: We performed a case series analysis from January to December, 2013. We included all patients >16 years presenting within 30 days of their sexual assault to the Ottawa Hospital Sexual Assault and Partner Abuse Care Program (SAPACP). Cases were stratified by whether or not they occurred at mass gatherings. We abstracted from the SAPACP records: patient and sexual assault characteristics, alcohol or drug consumption and medical and forensic care accepted. We performed descriptive analyses and multiple logistical regression to identify factors associated with mass gathering assaults. RESULTS: We found 204 cases of sexual assault, of which 53 (26%) occurred at mass gatherings. Relative frequencies of mass gathering sexual assaults peaked during New Year's Eve, Canada Day, university frosh week and Halloween. We found the following factors were statistically significantly associated with sexual assault at mass gatherings: younger age (OR=0.95, 95% CI 0.91 to 0.99); voluntary consumption of drugs and alcohol (3.88, 95% CI 1.34 to 11.23); assault occurring on a holiday (2.37, 95% CI 1.00 to 5.64) and the assailant unknown to the victim (2.43, 95% CI 1.15 to 5). INTERPRETATION: This study is the first to describe patterns of variation in sexual assault incidents associated with occurrence of mass gatherings as well as factors associated with such assaults. We will disseminate these results to key stakeholders in order to develop prevention-minded policies for future mass gatherings.