Objectives: This paper presents the development of a local sexual assault investigation kit (SAK) that doctors in the Philippines could use to collect biological samples from victims of sexual abuse, including child patients, that would be used for DNA testing. The study also reports on a management system via courier service to protect the integrity of the samples that could be eventually used as evidence in court from the collection site to the laboratory with sufficient backup measures. Methods: Women and Child Protection Units (WCPU) from Manila, Baguio, Cebu, and Davao partnered with the DNA Analysis Laboratory, Natural Sciences Research Institute of UP Diliman (NSRI-UPD) DNA Analysis Laboratory in testing the utility of a prototype SAK for the collection of biological samples from child patients. From January 2002 to March 2006, samples were collected from patients who went to WCPU within 72 hours post-contact and consented to participate in the study. WCPU doctors collected biological samples guided by the patient’s narratives and packaged the samples while following detailed documentation and chain of custody procedures. SAKs were then sent via a designated courier service from WCPU to the NSRI-UPD DNA Analysis Laboratory for DNA testing. The WCPU kept half of the samples collected, following recommendations made during sectoral consultations that included members of the Research Group of the Philippine Judicial Academy, prosecutors, and defense counsels. Case samples were packed well by the WCPU and received at the NSRI-UPD DNA Analysis Laboratory. Due to budget limitations, only the internal genitalia and patients’ reference buccal swabs were subjected to DNA tests as reported by Maiquilla et al.1 The remaining SAK components and case records were kept in a dedicated and secure storage facility. DNA testing reports were sent to the WCPU, which released them to the child patients and their legal guardians. Results: One hundred fifty-four female children aged 2-18 years old and their legal guardians agreed to participate in the study. Based on the initial interviews of the social workers who conducted the evaluation, all the participants came from families with very low socioeconomic status. The WCPU doctors then complied with prescribed procedures. To date, NSRI-UPD DNA Analysis Laboratory records show that a subpoena for expert testimony had been issued in only one case out of the 63 cases (1.6%) that were positive for male DNA. No further information was available on the final decision in this case due to the absence of any order from the judge granting the laboratory access to court records. Likewise, WCPUs did not have any information on the remaining 62 cases that could have used the DNA test results as evidence if a case had been filed in court. Conclusion This study is the first to report the development and validation of a sexual assault investigation kit in the Philippines aimed at helping medical doctors in collecting and preserving critical biological samples for DNA testing. Using a dedicated courier service to send SAK from collecting agencies to the laboratory for DNA testing was successfully tested and resulted in faster delivery and significantly reduced overall cost. While DNA testing remains the most powerful tool for human identification and the technology has been available in the Philippines since 1997, certain factors have prevented it from being used routinely in sexual assault investigations, including those involving children.
Women and child protection units ; Sex Offenses

Objectives: Suicidal ideation is a serious concern even among the pediatric population. This study aimed to determine its prevalence among victims of child sexual abuse and the factors that may contribute to its occurrence. Methods: A cross-sectional analytic study was done using medical records of 393 victims of child sexual abuse seen at the PGH CPU from 2017–2019. A logistic regression analysis was performed to assess the associations of age, sex, closest relation to perpetrator, mode, and chronicity of sexual abuse to the presence of suicidal ideation. Results: The prevalence of suicidal ideation among victims of child sexual abuse is 28%. The factors that were found to have a statistically significant association with suicidal ideation were age and closest relation to perpetrator. For each additional year from 6 to 17 years of age, the odds of having suicidal ideation increased by a factor of 1.33 (95% CI 1.19, 1.49; p<0.001). Victims who were abused by an immediate family member had increased odds of suicidal ideation by a factor of 2.12 (95% CI 1.12, 4.03; p=0.021). Conclusion Suicide is prevalent among victims of child sexual abuse. A high index of suspicion should be given to older adolescents and those whose perpetrators are immediate family members.
Suicidal Ideation ; Child Abuse ; Sex Offenses ; Mental Health

Background: Child sexual assault has been underreported, more so, those who minor perpetrators have assaulted. Surveillance for these children, victims and perpetrators alike, must be established. Objective: The objective was to describe the characteristic profile of the minor perpetrators who committed child sexual abuse seen in Philippine General Hospital - Child Protection Unit (PGH-CPU) from January 2013 to December 2018. Methodology: This retrospective cohort study was conducted using chart review and data retrieval from the Child Protection Management Information System (CPMIS) of the PGH-CPU. Results: There were 931 minor perpetrators. 55.9% were 15-19 years old and were predominantly male. 12.7% came from Cavite and 9.5% from Manila. Most were neighbors, acquaintances, and cousins of the victims. 39.4% were still students. 14.4% engaged in alcohol consumption. 7.7% have repeatedly abused children. 6.1% already had police blotter records. 7.3% were exposed to pornography. 7.5% are currently in jail, and 4.1% are in the same household as the victim. Conclusion A child’s environment is potentially contributory to their actions. The minor perpetrators reported were observed to have adverse childhood experiences like violence in their families. Although sexual abuse cases focus on the victims, it is equally vital that authorities give attention to minor perpetrators because they are also children. Programs and interventions should be provided for them to grow up to be better individuals in society.
Sex Offenses ; Child

In 1998, biological samples were collected from the body of a 17-year old female rape-homicide victim within 24 hours post-contact. In the absence of a sexual assault investigation kit, locally available medical supplies were used to collect biological samples. The victim’s family filed a case naming the victim’s uncle as the assailant. More than a year into the trial, samples from the victim and the accused were tested for DNA. The vaginal smears yielded DNA profiles originating from at least two persons, with one DNA source being male. Upon discovery, the victim’s age, the state of her body, and medicolegal examination results supported the allegation of sexual assault rather than consensual sex. This paper described the DNA testing conducted for this rape with homicide case. The prosecution used the DNA test results to support the charges against the accused, who was eventually convicted and sentenced to death in 2001. Upon automatic review in 2004, the Philippine Supreme Court affirmed the conviction and dismissed the defense’s claim that DNA testing violated the defendant’s right against self-incrimination. The defendant’s death conviction was commuted to life imprisonment when the Death Penalty was suspended via Republic Act No. 9346 in 2006. The case described here is considered one of the DNA landmark cases cited in the Philippine Rule on DNA Evidence of 2007.
Sex Offenses ; Microsatellite Repeats

In recent years, sexual assault cases have been on the rise, seriously infringing the legitimate rights and interests of women and children, causing widespread concern in society. DNA evidence has become the key evidence to prove the facts in sexual assault cases, but lack of DNA evidence or only DNA evidence in some sexual assault cases leads to unclear facts and insufficient evidence. With the emergence of high-throughput sequencing technology and the development of bioinformatics and artificial intelligence, new progress has been made in the study of human microbiome. Researchers have begun to use human microbiome for difficult sexual assault cases indentification. This paper reviews the characteristics of human microbiome, and its application value in the inferences of the body fluid stain origin, the sexual assault method, the crime time, etc. In addition, the challenges faced by the application of the human microbiome in practical case handling, the solutions and future development potential are analyzed and prospected.
Child ; Humans ; Female ; Artificial Intelligence ; Forensic Medicine/methods* ; Sex Offenses ; DNA ; Microbiota ; Crime Victims

BACKGROUND: This study aimed to develop an education system using DVD video-based teaching materials or web-based learning to reduce sexual violence among teens in Japan. METHODS: During the first stage, June 2018 to March 2019, an education program using DVD video teaching materials was carried out at three high schools and four universities with research consent from the director of the facility. From 1337 high school students and first- and second-year university students, subjects in their teen years were targeted for analysis. A survey was conducted at baseline and after the DVD video teaching. During the second stage, November 2019 to March 2020, web-based learning using improved video teaching materials was developed and carried out. From the adolescents who participated in the web-based learning, subjects in their teen years were targeted for analysis. A survey was conducted at baseline and after the web-based learning. RESULTS: In the first stage, 876 students consented to and participated in the education using DVD video teaching materials and baseline and after surveys (collection rate 65.5%). Among these, the number of respondents in their teens both baseline and after education was 705 persons (valid response rate 80.4%). In the second stage, the number of respondents in their teens both baseline and after education was 250 respondents in their teens who received web-based learning using the improved video teaching materials (valid response rate 87.1%). The improvement effect of the two programs was observed in attitudes that lead to physical violence, attitudes that lead to mental violence, attitudes that promote healthy conflict resolution, and dangerous attitudes that lead to sexual violence from persons in the community or through the Internet. The web-based learning program achieved an improvement of preventive attitudes toward sexual violence. CONCLUSIONS The education program using DVD video teaching materials or web-based learning may help prevent sexual violence among teens in Japan.
Adolescent ; Compact Disks ; Female ; Humans ; Internet ; Japan ; Male ; Sex Offenses/statistics & numerical data* ; Students ; Teaching Materials ; Video Recording

Background: There has been an increasing trend in reported sexual abuse patients in the Philippines in the past 20 years. Patient evaluation is critical from health care providers and it is imperative to have an acute care protocol that heath care providers can use in managing these patients. Objective: To assess the adherence to the acute care protocol as applied to adult female sexual abuse patients who consulted at the Philippine General Hospital OB Admitting Section from March to August 2019 Methods: The study design used was an observational, cross-sectional study via descriptive analysis using a designed questionnaire. Relevant data regarding compliance to the acute care protocol was assessed from patient experience via the questionnaire after undergoing the standard services of the hospital. Data was then documented, tabulated and processed via Microsoft Excel data sheets. Results: In terms of patient perspective, 96.2 % of all cases (n=27) were provided service by OBGYNs and psychiatrists and 100% were assessed by social workers. Although stated in the protocol, legal and/or police assistance was not provided by the hospital during patient consult. Conclusion The institution was able to adhere to the acute care protocol services of patients in terms of obstetric and gynecologic, psychiatric and social worker services but not legal and/or police assistance.
Humans ; Sex Offenses ; Patient Compliance

Sadomasochism is the sexual interest, psychosexual deviance or sexual crimes that are sexually aroused by suffering or causing others to suffer. This study summarizes the concept, assessment and diagnosis, categories and symptoms, psychological and biological mechanisms, judicial disposition and clinical intervention strategies of sadomasochism from the perspectives of clinical medicine, law, criminology and psychology, suggests that further research should take local people with sadomasochism preference and local patients as research objects, pay attention to different types of sadomasochists, conduct bottom-up research, explore the core elements and manifestations of sadomasochism, and accurately define and classify sadomasochism, construct an effective scale, a erectile measurement sexual stimulation system and a diagnostic criteria; discuss evaluation methods combined with crime scene data; discuss the validity of masochists' consent combined with diagnosis; establish targeted criminal correction programs and a treatment and rehabilitation system to provide reference for the improvement of medical, judicial and mental health services.
Criminals ; Humans ; Male ; Masochism ; Sadism ; Sex Offenses ; Sexual Behavior

PURPOSE: The purpose of this study was to review sexual abuse prevention education program for Korean elementary school students.METHODS: Whittemore and Knafl's integrative review methods were used and Gough's weight of evidence was employed as a quality appraisal tool. Articles published in Korean or English were identified through electronic search engines and scholarly web sites using three keywords: “elementary school student”, “sexual abuse”, and “prevention education”. Peer-reviewed articles published between 2000 and 2018 were included in this review.RESULTS: Twelve articles met the inclusion criteria and were appraised as being high-quality. Among the 12 selected studies, seven were descriptive, while five were intervention studies. Sexual abuse prevention education programs were effective in improving perceptions, knowledge, attitudes, and preventive behaviors among elementary school students. However, deficiencies were found in the variety of educational methods, utilization of experts, and standardization of the content of sexual abuse prevention education.CONCLUSION: We need to provide various educational methods that are appropriate for specific developmental stages, and the sexual abuse prevention content should draw upon the current sexual education program administered to this population. Furthermore, parents and trained teachers or school health teachers should be included to provide effective education programs for elementary students.
Child ; Child Abuse, Sexual ; Education ; Humans ; Korea ; Parents ; School Health Services ; Search Engine ; Sex Offenses

The purpose of this study was to develop a brief rating scale of post-traumatic stress disorder (PTSD) symptoms among sexual violence victims. We analyzed the data from 195 victims and 220 non-victims to select meaningful items from the original PTSD rating scales. We also examined the validity of the brief scale by assessing internal consistency and ROC curves. The optimal cutoff scores for each brief scales were obtained. The results showed that a different approach may be required for early intervention in different age groups.
Early Intervention (Education) ; Humans ; ROC Curve ; Sex Offenses ; Stress Disorders, Post-Traumatic ; Weights and Measures