The Forensic Nurse

In most cases the EIA (enzyme immunoassay), used on blood drawn from a vein, is the most common screening test used to look for antibodies to HIV. A positive (reactive) EIA must be used with a follow-up (confirmatory) test such as the Western blot to make a positive diagnosis. There are EIA tests that use other body fluids to look for antibodies to HIV. These include:

• Oral Fluid Tests – use oral fluid (not saliva) that is collected from the mouth using a special collection device. This is an EIA antibody test similar to the standard blood EIA test. A follow-up confirmatory Western Blot uses the same oral fluid sample.
• Urine Tests – use urine instead of blood. The sensitivity and specificity (accuracy) are somewhat less than that of the blood and oral fluid tests. This is also an EIA antibody test similar to blood EIA tests and requires a follow-up confirmatory Western Blot using the same urine sample.

Rapid Tests:

A rapid test is a screening test that produces very quick results, in approximately 20 minutes. Rapid tests use blood from a vein or from a finger stick, or oral fluid to look for the presence of antibodies to HIV. As is true for all screening tests, a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be made. These tests have similar accuracy rates as traditional EIA screening tests. Please visit the rapid HIV testing section for details.

Sexual assualt knows no boundries. No matter what race, what nationality, what socio-economic status you hail from can spare you from the potential turmoil. 

 So is the case of Lawrence Taylor, the former NFL linebacker great for the New York Giants. Thursday morning the Hall of Fame linebacker was arrested in his hotel in Rockland County for soliciting sex from a 16 year old girl.

 Taylor was arrested when police were told that the minor had been delivered to his hotel room by another man, Rasheed Davis. Taylor stated at a news conference that he had paid $300 to the man for delivering her. He claims not to have engaged in sex with the minor girl. His Attorney Arthur Aidala state that Taylor is “a loving and family man” and that “My Client did not have sex with anybody. ”

The girl, who has not been identified because she is a minor, was reported missing back in march as a suspected runaway. ESPN.com reported “Early Thursday morning, Davis punched and kicked her, drove her to the hotel against her will and told her she had to have sex with Taylor, police said. When she refused, Davis handed her over to Taylor, who sexually assaulted her, they said. Taylor paid her $300, which she gave to Davis”.

After the alleged incident, she was somehow able to use a cell phone to get a message out. Her uncle received a text message from her with an address and contacted New York Police department to investigate. Officers found the girl along with Rasheed Davis at an address in the Bronx. Davis was charged with unlawful imprisonment, assault and endangering the welfare of a child. It was then when police were directed to Lawrence Taylors whereabouts. The hotel is located  about a half mile from the Spook Rock Golf Course, where Taylor frequently plays.

Mr. Taylor was released after posting a $75,000 bond and subsequently driven away from the courthouse by Mark Lepselter, a friend and business associate.

Ramapo Chief of Police Peter Brower said Taylor was cooperative when police took him into custody at around 4:00AM. Brower would not comment on if Lawrence Taylor knew the age of the girl, but did state that “Ignorance is not an excuse to an individual’s age”. In New York, third-degree rape is a charge levied when the victim is under the age of consent, which is 17 years of age.

For well over two hours outside a school gymnasium in Richmond, a 15 year old california girl was allegedly beaten and gang raped while a a crowd of approximately 20 people stood by and watched. The crowd managed to stand by and watch, snicker, and even “tweet” about the incident on twitter, the popular social networking site. Not one of them intervened or called the authorities to report the crime.

The reasoning behind why no one got involved gets a little more complex. Some say there was fear of repercussions from the gang conducting the rape and beating. Others say the crowd was overcome with what is known as the bystander effect. The bystander effect is when individuals in a crowd see that everyone else in the crowd is doing or not doing something, and that behavior becomes the accepted social norm. In essense, because no one else was doing anything, it must be ok for me to do nothing.

Some of you may remember the story of Kitty Genovese who was brutally raped, beaten, robbed, and eventually stabbed to death in Queens New York back in 1964. The story gained national attention when it was later revealed that several witnesses heard her scream during the attack during the night, and no one notified the police. One man shouted from his window to leave the girl alone, and the attacker fled, only to return a few minutes later when the police never arrived, and dragged her into a stairwell and stabbed her again leaving her to bleed out in a stairwell.

California has a law that makes it illegal to witness a crime against a child and not report it to police. But in this case technically the crowd did not violate the law which specifies that age of the minor child is 14 or less. The victim in the California gang-rape case was 15 years old.

  “This just gets worse and worse the more you dig into it,” Lt. Mark Gagan of the Richmond Police Department. “It was like a horror movie. I can’t believe not one person felt compelled to help her.”

To date the AP is reporting that five people have been arrested so far in connection with the crime. Three juveniles and two adults.  Richmond police spokesman, Lt. Mark Gagan said that  the three juveniles will be charged as adults. While the complete list of charges is not final yet, the suspects will be facing felony charges like “rape in concert” which can carry a life sentance.

The police were eventually notified when a person called in who had overheard others who were at the scene of the assault talking about the incident. The girl was found unconscious and “brutally assaulted” under a bench shortly before midnight Saturday 

Police have posted a $20,000 reward for anyone who comes to them with information that helps arrest and convict those involved in the attack.

Ben Roethlisberger, the two time NFL superbowl winner with the Pittsburgh Steelers was named as a defendant in a lawsuit filed by a woman in Nevada.

According to court records, the woman, Andrea McNulty, has filed a civil suit against Roethlisberger. An attorney for Roethlisberger ,  David Cornwell denied Roethlisberger sexually assaulted McNulty. He issued the following statement:

“This weekend Andrea McNulty served Ben Roethlisberger with a civil complaint accusing him of sexually assaulting her in July 2008. Ben has never sexually assaulted anyone; especially Andrea McNulty. The timing of the lawsuit and the absence of a criminal complaint and a criminal investigation are the most compelling evidence of the absence of any criminal conduct. If an investigation is commenced, Ben will cooperate fully and Ben will be fully exonerated,” Cornwell said.

* State only pays for abortions when necessary to protect the woman’s life.

Source: Guttmacher Institute 2009

Source: http://www.ncsl.org/programs/health/aborlaws.htm

Trying to

Often SANE programs go unnoticed and unpraised for their efforts. Most people would tell you that its not really polite conversation to talk about the needs for such programs.  

But the Chicago Tribune recently published an article about a SANE program in cook county. There is a phenominal qoute in the article by Tom Fleming Jr of the Park Forest Police department:

“We know that a SANE nurse who is trained in evidence collection has done the correct work for us,” he said. “Our goal is to not have a trial. Our goal is to get a confession from that offender. And we’re best equipped to do that with medical evidence. If we can do that, if we can get an offender to take a plea and not go to trial, then we’ve served that victim right at that very moment.”

Read the Full Article here:

http://www.chicagotribune.com/news/local/chi-sex-assault-treatment-sw-zon.ar0apr08,0,7944054.story

I was recently asked about a case in which an adult male was raped and during the sexual assault had an ejaculation. Often the topic of male rape is forgotten when we talk about sexual assaults.

While rarely reported, male rapes do actually occur.  Perhaps it is male pride or ego, but reporting statistics for survivors of male sexual assault are even lower than that of women. One FBI statistic estimated that close to 3% of adult males will be raped at some point in their lives.

As for why the reporting statistics are so low, it may be due to the fact that this type of event may be even more shameful and traumatic to men than it is to women. Society in general tells men that in order to be respected and seen as desirable that they must be seen as strong, tough, and powerful.

All the experts agree that rape is almost never about the sex. Its about power and control. Excercising your will over someone elses. Essentially proving that you are the one in control. That you are stronger than the other person.

Bringing this type of shame to a man can be exceptionally devastating to their emotional self concienience. By not being able to fend off an attackers the victim may view himself as weak, undesireable, or even homosexual. 

These feelings of homosexuality can be even more confusing if the victim experiences an erection or even ejaculates. Both of these situations are very common and are often used as tools of shame by an attacker to make the victim think that they wanted or enjoyed being raped. In reality these types of reactions are more physiological than anything.

Often people believe that an erection equals sexual arousal. There are many reasons why a man may experience an erection during a sexual assault. The simple friction of touching the millions of tiny nerve endings on the penis could cause an erection, even if the touch was unwanted or unpleasant.

Being penetrated anally can also cause an involuntary erection. The application of pressure on to the prostate gland from digital, penile, or foreign object insertion to the anus can often cause an erection. Any proctologist will tell you that this type of reaction is very typical while performing a Digital Rectal Exam for prostate screening.  

Bringing the victim to the point of ejaculation is also quite common. Rapists will often make every effort possible to ensure that the victim does ejaculate to add the the feelings of guilt, shame, and homosexuality. This can add another layer of power, and dominance, and even increased pleasure for the rapist for having such control over the other person. Remember in most cases its about power not the actual sex.