Sexual Health & Offences

Question 1

What legal document is used to define sexual offences?

Answer 1

Sexual Offences Act 2009

Question 2

What is the legal definition of rape?

Answer 2

It is defined as penetration of the vagina, anus or mouth to any extent without consent

In a case where penetration is initially consented to but at some point of time, the consent is withdrawn

Question 3

What is the legal definition of sexual assault by penetration?

Answer 3

This is when a person with any part of their body or anything else without consent penetrates the vagina or anus

This includes penetration by a penis

Question 4

What is the legal definition of sexual assault?

Answer 4

It includes sexual penetration of the vagina, anus or mouth

It includes any form of sexual activity with semen ejaculation into or onto a person

It includes the emission of urine or saliva in a sexual manner

Question 5

What is the legal definition of sexual coercion?

Answer 5

This is when a person is coerced into participating in a sexual activity

This is deemed as an offence

Question 6

What is the legal definition of coercing someone into being present during a sexual activity?

Answer 6

When a person person intentionally causes an individual to be present while a third person engages in such an activity

Question 7

What is the legal definition of coercing someone into looking at a sexual image?

Answer 7

When an individual is coerced into looking at a sexual image, sexual activity or genital for the purpose of obtaining sexual gratification, humiliation or cause distress

Question 8

What is the legal definition of communicating indecently?

Answer 8

When a person sends, by whatever means, a sexual verbal communication or sexual written communication (including sounds of sexual activity or using sign language)

Question 9

What is the legal definition of sexual exposure?

Answer 9

This is exposing the genitals in a sexual manner with the intention that they will be seen and for the purposes of sexual gratification, humiliation or distress

Question 10

What is the legal definition of voyeurism?

Answer 10

This is installation of equipment for live viewing or recording with the intention of enabling the individual or others to observe an individual doing a private act in a place which reasonable by expected to provide privacy - bedroom, hotel room, toilet, changing room

This is installation of equipment for live viewing or recording beneath clothing with the intention of enabling the individual to observe their genitals or buttocks

Question 11

In terms of sexual offences, in what eight circumstances can consent be withheld?

Answer 11

When the individual has incapacity due to alcohol or any other substance

When the individual has mental or physical incapacity

When the individual is below or 16 years old

When there is evidence of acts of violence or threat of violence

When there is evidence of unlawful detention

When the consent was given based on a person known to the victim

When a third party has given consent

When the victim is asleep or unconscious

Question 12

What is the purpose of examining victims of sexual assault?

Answer 12

This is to establish whether the clinical finding support the history of the incident

To identify clinical evidence that supports the alleged acts have taken place

Question 13

What is important to remember when conducting intimate examinations?

Answer 13

To always have a chaperone present

Question 14

How do we conduct external examination of sexual assault victims - seven steps?

Answer 14

We retain clothing from the incident

We establish points of contact and order of contact

We swab for saliva, DNA, semen and blood

We comb head hear and pubic hair

We swab the fingernails and take fingernail clippings

We document injuries - bruises, love bits, fingernail marks

We conduct toxicology samples (drugs, alcohol)

Question 15

How do we conduct internal examination of sexual assault victims - three steps?

Answer 15

We examine the skin around genitalia and anus for injuries document and photograph

We conduct sexual swabs prior to internal examination

We conduct colposcopy, speculum and colonoscopy examinations

Question 16

What eight forensic samples are obtained from sexual assault victims? In what time frames should these be taken?

Answer 16

DNA from fingers in the vagina - up to 12 hours

DNA from a penis - up to 12 hours

Fingernail scrapping - up to 2 days

Oral swabs - up to 30 hours

Lubricant from a condom - up to 3 days

Ano-rectum swab - up to 3 days

Vaginal swab - up to 7 days

Question 17

In cases where sexual assault is proven, how do we clinically manage these patients?

Answer 17

We offer prophylaxis for pregnancy and STIs

We treat any new medical conditions or pre-existing conditions exacerbated by the incident

We provide psychiatric support

Question 18

What documentation do we refer to in regards to ethical issues surrounding STIs?

Answer 18

GMC Confidentiality Guidance on Serious Communicable Diseases 2017

Question 19

What does the ‘GMC Confidentiality Guidance on Serious Communicable Diseases 2017’ state?

Answer 19

You may disclose information to a person who has close contact with a patient who has a serious communicable disease if you have reason to think that…

• The person is at risk of infection that is likely to result in serious harm
• The patient has not informed them and cannot be persuaded to do so

Question 20

How do we protect a patients confidentiality when they test positive for an STI?

Answer 20

We don’t give their name to the contacts

Question 21

How do we manage patients who are healthcare professionals who contract HIV?

Answer 21

In order to protect their wellbeing, we start them on treatment

In order to protect the wellbeing of their patients, we review their patient list and look for known HIV infected patients

In some cases, we conduct a look back exercise, which is when we write to all their previous patients and invite them for HIV testing

In terms of employment, they can resume to work if they have undetectable viral loads < 200 copies per mL and agree to 3 monthly monitoring