ࡱ > I K @ A B C D E F G H b Z z w G 1 bjbjWW X 5 5 o U C#
M# Y# Y# Y# 4 # # # # h # ( # m0 h G ( G G G EI D T EX ( Y# %Z EI EI %Z )Z ] Y# Y# G G H Ӕ ] ] ] -Z Y# G Y# G ԇ ] %Z ] ] $m x Y# Y# o eGW1 # G\ N n $ p 0 n ߜ ] ߜ H o ] o L Y# o %Z %Z %Z " :
Sexual Assault Victims in Honolulu: A 2001 2010 Statistical Profile
Dawna Nelson, MSW
Evelyn Yanagida, Ph.D.
Carol Plummer, Ph.D.
Copyright 2012 by the Sex Abuse Treatment Center, Kapiolani Medical Center for Women and Children, an affiliate of Hawaii Pacific Health. All rights reserved. No portion of this report may be reproduced, in whole or in part, in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system now known or hereafter invented, without prior written permission from the Sex Abuse Treatment Center.
Funds for this report were provided by the Hawaii State Department of the Attorney General, Crime Prevention and Justice Assistance Division. ACKNOWLEDGMENTS
We acknowledge and thank Annie Hollis, B.A., MSW candidate (2013) for help with editing/formatting. We would also like to thank the staff of the Sex Abuse Treatment Center for their support and donation of time, assistance, and valuable input towards completing this report. This material was approved by the Institutional Review Boards of the Kapiolani Medical Center for Women and Children and the University of Hawaii at Manoa. The opinions, findings and conclusions expressed in this publication are those of the authors and do not necessarily reflect the views of Kapiolani Medical Center for Women and Children or the University of Hawaii. The authors have no conflicts of interest relevant to this study.
TABLE OF CONTENTS
TOC \o "1-3" \h \z \u HYPERLINK \l "_Toc340570393" LIST OF FIGURES PAGEREF _Toc340570393 \h ii
HYPERLINK \l "_Toc340570394" LIST OF TABLES PAGEREF _Toc340570394 \h ii
HYPERLINK \l "_Toc340570395" EXECUTIVE SUMMARY PAGEREF _Toc340570395 \h 1
HYPERLINK \l "_Toc340570396" SECTION 1: BACKGROUND PAGEREF _Toc340570396 \h 6
HYPERLINK \l "_Toc340570397" Current Study PAGEREF _Toc340570397 \h 6
HYPERLINK \l "_Toc340570398" The Sex Abuse Treatment Center PAGEREF _Toc340570398 \h 7
HYPERLINK \l "_Toc340570399" Victim Characteristics PAGEREF _Toc340570399 \h 10
HYPERLINK \l "_Toc340570400" Assault Characteristics PAGEREF _Toc340570400 \h 14
HYPERLINK \l "_Toc340570401" Prevalence of Sexual Assault Nationally and in Hawaii PAGEREF _Toc340570401 \h 16
HYPERLINK \l "_Toc340570402" SECTION 2: DEMOGRAPHIC PROFILE PAGEREF _Toc340570402 \h 19
HYPERLINK \l "_Toc340570403" Victim Profile Hawaii PAGEREF _Toc340570403 \h 19
HYPERLINK \l "_Toc340570404" Assault Characteristics Hawaii PAGEREF _Toc340570404 \h 22
HYPERLINK \l "_Toc340570405" SECTION 3: TRENDS PAGEREF _Toc340570405 \h 32
HYPERLINK \l "_Toc340570406" Introduction PAGEREF _Toc340570406 \h 32
HYPERLINK \l "_Toc340570407" SECTION 4: VICTIM POLICE REPORTING PAGEREF _Toc340570407 \h 38
HYPERLINK \l "_Toc340570408" Background PAGEREF _Toc340570408 \h 38
HYPERLINK \l "_Toc340570409" Predictors for Reporting to Police: Adults PAGEREF _Toc340570409 \h 41
HYPERLINK \l "_Toc340570410" Predictors for Reporting to Police-Juveniles PAGEREF _Toc340570410 \h 43
HYPERLINK \l "_Toc340570411" Predictors for Reporting-Males PAGEREF _Toc340570411 \h 45
HYPERLINK \l "_Toc340570412" Predictors of Reporting to Police- Females PAGEREF _Toc340570412 \h 47
HYPERLINK \l "_Toc340570413" SECTION 5: ALCOHOL AND LEVEL OF ASSAULT RISK PAGEREF _Toc340570413 \h 50
HYPERLINK \l "_Toc340570414" SECTION 6: DISCUSSION AND IMPLICATIONS PAGEREF _Toc340570414 \h 58
HYPERLINK \l "_Toc340570415" REFERENCES PAGEREF _Toc340570415 \h 66
HYPERLINK \l "_Toc340570416" APPENDIX A: SEX ABUSE TREATMENT CENTER ACTIVITIES PAGEREF _Toc340570416 \h 71
HYPERLINK \l "_Toc340570417" APPENDIX B: FREQUENCY OF VARIABLES USED IN REPORT PAGEREF _Toc340570417 \h 73
HYPERLINK \l "_Toc340570418" APPENDIX C: COLLAPSING OF VARIABLES PAGEREF _Toc340570418 \h 75
HYPERLINK \l "_Toc340570419" Definitions of variable code/categories PAGEREF _Toc340570419 \h 75
LIST OF FIGURES
TOC \h \z \c "Figure" HYPERLINK \l "_Toc340570619" Figure 1: Flowchart of Common SATC Access Points PAGEREF _Toc340570619 \h 9
HYPERLINK \l "_Toc340570620" Figure 2: Comparison of Hawaiis Forcible Rape Rate with the National Forcible Rape Rate PAGEREF _Toc340570620 \h 17
HYPERLINK \l "_Toc340570621" Figure 3: Age Distribution of Female and Male Sexual Assault Victims PAGEREF _Toc340570621 \h 19
HYPERLINK \l "_Toc340570622" Figure 4: Sex of Victim by Intake Year PAGEREF _Toc340570622 \h 21
HYPERLINK \l "_Toc340570623" Figure 5: Time of Assault by Gender PAGEREF _Toc340570623 \h 25
HYPERLINK \l "_Toc340570624" Figure 6: Time of Assault by Offender-Victim Relationship PAGEREF _Toc340570624 \h 26
HYPERLINK \l "_Toc340570625" Figure 7: Percent of Victims Exposed to Assailant Strategies by Gender PAGEREF _Toc340570625 \h 29
HYPERLINK \l "_Toc340570626" Figure 8: Percent of Victims by Gender PAGEREF _Toc340570626 \h 32
HYPERLINK \l "_Toc340570627" Figure 9: Victim Age at Assault by Gender 2001-2010 PAGEREF _Toc340570627 \h 33
HYPERLINK \l "_Toc340570628" Figure 10: Ethnicity of Victims 2001-2010 PAGEREF _Toc340570628 \h 34
HYPERLINK \l "_Toc340570629" Figure 11: Female Victim-Assailant Relationship 2001-2010 (n=4226) PAGEREF _Toc340570629 \h 34
HYPERLINK \l "_Toc340570630" Figure 12: Male Victim-Assailant Relationship 2001-2010 (n=353) PAGEREF _Toc340570630 \h 35
HYPERLINK \l "_Toc340570631" Figure 13: Time of Assault for Adult Victims 2001-2010 PAGEREF _Toc340570631 \h 36
HYPERLINK \l "_Toc340570632" Figure 14: Time of Assault for Minor Victims 2001-2010 PAGEREF _Toc340570632 \h 36
HYPERLINK \l "_Toc340570633" Figure 15: Reports to Police by Gender 2001-2010 PAGEREF _Toc340570633 \h 37
HYPERLINK \l "_Toc340570634" Figure 16: Percent of Victims Reporting to the Police by Age Status, 2001-2010 PAGEREF _Toc340570634 \h 37
HYPERLINK \l "_Toc340570635" Figure 17: Number of Victims Served by Gender 1990-2010 PAGEREF _Toc340570635 \h 59
HYPERLINK \l "_Toc340570636" Figure 18: Percentage of Victims Served by Age Group PAGEREF _Toc340570636 \h 59
LIST OF TABLES TOC \h \z \c "Table"
HYPERLINK \l "_Toc340570162" Table 1: Demographic Characteristics of Sexual Assault Victims Seeking Treatment at SATC, 2001-2010 (Percentages) PAGEREF _Toc340570162 \h 20
HYPERLINK \l "_Toc340570163" Table 2: Relationship of Offender to Victim by Age and Gender PAGEREF _Toc340570163 \h 23
HYPERLINK \l "_Toc340570164" Table 3: Relationship of Assailant to Victim by Age Categories (Percentages) PAGEREF _Toc340570164 \h 24
HYPERLINK \l "_Toc340570165" Table 4: Location of Assault, by Age and Gender (Percentages) PAGEREF _Toc340570165 \h 27
HYPERLINK \l "_Toc340570166" Table 5: Assailant Assault Strategies by Age at Assault (Percentages) PAGEREF _Toc340570166 \h 30
HYPERLINK \l "_Toc340570167" Table 6: Referral to SATC by Age and Gender (Percentages) PAGEREF _Toc340570167 \h 31
HYPERLINK \l "_Toc340570168" Table 7: Location of Assault by Gender and Age PAGEREF _Toc340570168 \h 36
HYPERLINK \l "_Toc340570169" Table 8: Percentage of Victims Reporting to the Police by Age and Gender PAGEREF _Toc340570169 \h 40
HYPERLINK \l "_Toc340570170" Table 9: Police Reporting by Age and Case Type PAGEREF _Toc340570170 \h 40
HYPERLINK \l "_Toc340570171" Table 10: Adult Victim Reporting Behavior (Percentages) n=1724 PAGEREF _Toc340570171 \h 42
HYPERLINK \l "_Toc340570172" Table 11: Juvenile Victim Reporting Behavior (Percentages) N=2493 PAGEREF _Toc340570172 \h 44
HYPERLINK \l "_Toc340570173" Table 12: Male Victim Reporting Behavior (Percentages) N=533 PAGEREF _Toc340570173 \h 46
HYPERLINK \l "_Toc340570174" Table 13: Female Victim Reporting Behavior (Percentages) n=3696 PAGEREF _Toc340570174 \h 48
HYPERLINK \l "_Toc340570175" Table 14: Use of Alcohol and Drug Use Prior to Assault (Percentages) PAGEREF _Toc340570175 \h 53
HYPERLINK \l "_Toc340570176" Table 15: Characteristics of Adult Sexual Assault Victims and Assailant Use of Alcohol (Percentages) PAGEREF _Toc340570176 \h 55
HYPERLINK \l "_Toc340570177" Table 16: Characteristics of Juvenile Sexual Assault Victims and Assailant Use of Alcohol (Percentages) PAGEREF _Toc340570177 \h 56
HYPERLINK \l "_Toc340570178" Table 17: Percentages of Clients by Ethnicity, 1990-2001 compared to 2001-2010 PAGEREF _Toc340570178 \h 60
EXECUTIVE SUMMARY
This report provides a descriptive analysis of 4,834 sexual assault victims who received services through the Sex Abuse Treatment Center (SATC) in Honolulu, Hawaii from mid-2001 through 2010. It also examines trends over the past twenty years across 9,929 victims, comparing these findings with those from the prior decade. Survivors of recent assaults as well as adults who were sexually assaulted as children were represented in this study. Furthermore, the type of assaults spanned the entire spectrum of sexual violence (i.e., fondling, penetration, harassment, etc.). These data represent a limited sample of sexual assault survivors in Hawaii as many victims do not disclose or report their assault, do not seek treatment at SATC or may receive treatment elsewhere (see Figure 1). Additionally, the findings and conclusions of this study do not necessarily represent the views of Kapiolani Medical Center for Women and Children. Nonetheless, this report provides useful information on a sample of sexual assault victims in Honolulu over a twenty year span, and one which can be compared against national trends.
Key Findings
Honolulu data on sexual assault has been remarkably consistent over time and closely aligns with national statistics. It is alarming to realize that children and youth compromised a significant majority of sexual assault victims that were seen through SATC. In the first ten years examined, 56% of victims were under age 18 and in the second decade, 57% were minors. In fact, a 34% increase in 12-15 year old victims was seen over this 20 year time frame. Victims in Honolulu were most often females (88% across the current 10 year period) and offenders most often males (97.4%). Weapons were used in less than 10% of the cases, although injuries were evident about 25% of the time. The average victim during this reporting period was 18 years old when assaulted. However, males were an average of 13 years old. Over the past ten years, victims 11 years and younger were most likely to be assaulted by family members. Eighty-three percent of victims knew their assailant with 13.3% of the victims reporting they were assaulted by a stranger. In 2001-2010, about 16% of victims were assaulted by strangers. Twenty percent of adult assaults were perpetrated by strangers while only 7.5% of assaults of minors were committed by strangers. For both sexes during the past ten years, assaults were most likely to occur in the victims (44.7%) or assailants (31.6%) home, hotel, or workplace. The levels of sexual assault and abuse in Honolulu neither increased nor decreased significantly over the twenty year period and were consistent with national trends.
People of Hawaiian ancestry continue to be the largest group of survivors seeking services at SATC. The largest ethnic categories of victims served were: Hawaiian/part-Hawaiian (28.2%), Caucasian (22.7%), and mixed ethnic heritage, not including Hawaiian (22.4%). Over the entire 20 years surveyed, this trend was consistent. It is unclear from the data if this indicates higher rates of sexual violence for Hawaiians or a greater willingness to utilize SATC services due to proximity, convenience, experience or other factors.
Referrals to SATC have changed significantly over time with more referrals now coming from schools, workplaces, and agencies other than the police. While positive relationships continue between law enforcement and SATC, awareness of SATC services by these other referral sources is very beneficial for connecting victims with assistance.
There have been some changes regarding reporting sexual assault cases to the police. SATC rates of victims reporting their assault to the police (71.1%) is higher than national numbers (16-20%), primarily because a large number of referrals to SATC initially come from the police, where victims first sought assistance or had the opportunity or knowledge to file a police report. This reporting rate is essentially the same relative to the previous 10 year period in which 68% of victims reported the assault to the police. As a whole, adult victims were more likely to report their assault if the assailant was a stranger, if there was only one perpetrator (as opposed to multiple perpetrators), if threats were involved and if the assault occurred within the past 72 hours. A further breakdown shows increased reporting of cases of juvenile victims regardless if the case was a recent or past assault. This change may indicate that professionals are aware of and complying with mandatory reporting laws with greater frequency.
Alcohol use plays a significant role in sexual assaults of both children and adults. In this study, on average, over half of all offenders had been or were using alcohol at the time of the assault, according to the victims. In particular, assailants were significantly more likely to have used alcohol if there were multiple offenders (66% in cases of one offender versus 84%) and if the victim was female (69% versus 51% with male victims). If the offender was a stranger or acquaintance, he was more likely to be using alcohol than if the assailant was an intimate partner or related to the victim. Caucasian victims were significantly more likely to be assaulted by an offender under the influence (81% versus 58% for Hawaiian or part-Hawaiian victims). Offenders use of alcohol also appeared to increase the level of violence against the victim. In addition, female victims were more likely to have consumed alcohol prior to the assault than males (28% versus 8%), although this difference is partially related to the older average age of females (19 years) versus males (13 years). The use of alcohol by assailants has remained relatively stable over the past 20 years while victim use of alcohol increased in this reporting period for both genders. Assailant drug use, while possibly harder to detect, was reported by victims in 10% of male assaults and 22% of female assaults over the past ten years. While this figure was relatively stable for females across 20 years, assailant drug use with male victims doubled in the last 10 years.
It is discouraging to see higher rates of Hawaiian/part Hawaiian victims, although the meaning of this increase is unclear. It may be that cultural trauma and its concomitant consequences have contributed to higher rates of sexual assault in this population. It may also mean that SATC efforts to develop culturally specific educational and outreach materials for the local population have worked to attract more Hawaiian/part Hawaiian victims to the Center. Given lower rates of service use by other racial and ethnic groups, adapting prevention approaches and materials may result in an increase in service use by more diverse populations.
We believe that the trend of significantly more referrals coming from sources other than the police is a good one. While the relationship between police and SATC is very strong, the movement towards more referrals from schools, colleges and workplaces suggest more awareness of SATC as a resource in the broader community. This increased support provides multiple pathways for victims to access information and services.
Reporting cases to law enforcement also showed some interesting trends. The clearest trend shows that official police reports are increasing in cases of sexual assault of children and youth. This may be partly due to mandatory reporting laws encouraging reports, but also due to adult concern and compliance with reporting mandates. Fewer adult reports emerged for victims who were assaulted in the past. Although adult reports for recent assaults were roughly at the same levels as previous findings, this still leaves a sizable percentage of victims who do not report. Nonetheless, recent trends suggest that victim referrals are coming from a wider range of agencies or individuals than the police. Additionally, there may be increased public awareness that police reports are optional and one can seek confidential services at SATC for symptoms post-assault without involving law enforcement. Thus, more victims may be accessing treatment services even if they do not wish to pursue criminal remedies.
This report also underlines the importance of alcohol as a factor in sexual assaults in Honolulu. While victim use of alcohol does not cause sexual assault, education on risk management, especially among young adult women where alcohol use peaks, may help to augment behaviors that promote safety. Additionally, joint efforts between community groups could begin to address the dangers posed by alcohol use by offenders and strategies for reducing these risks can be explored. For example, involvement of owners of bars, increased awareness that impaired judgment is not an excuse for rape, and increased bystander involvement with potential offenders could lead to innovative ways to address this concern.
This report revealed both similarities and differences in victim trends compared to the prior 10 year period. Despite prevention efforts, sex assault continues to be a safety concern in our community and resources need to be committed to assure that victims receive the services they deserve.
Disclaimer: The majority of victims of sexual violence are female and most sex offenders are male. While we strive to be gender neutral, in this report we often refer to a victim as she/her and an offender as he/him. This does not mean that a man or boy cannot be a victim of sexual assault or that a woman cannot be an offender.
The terms victim and survivor are used in this handbook. We are aware that some may take issue with the term victim but we use it to highlight the fact that you are forced to be a victim, but can choose to be a survivor.
Thank you for understanding these editorial decisions.
SECTION 1: BACKGROUND
Current Study
The purpose of this report is to provide updated information on victims receiving services from the Sex Abuse Treatment Center (SATC) and to compare and contrast this information to victims seen in the previous 10 years ADDIN EN.CITE Davidson200420(Davidson, Perrone, Haro, Yanagida, & Choi-Misailidis, 2004)202027Davidson, J.Perrone, P.Haro, F.Yanagida, E.Choi-Misailidis, S.J. Sexual assault victims in Honolulu: a statistical profile.2004 Report by the State of Hawaii Department of the Attorney General Crime Prevention & Justice Assistance Division in partnership with the Sex Abuse Treatment Center(HYPERLINK \l "_ENREF_10" \o "Davidson, 2004 #20"Davidson, Perrone, Haro, Yanagida, & Choi-Misailidis, 2004). This report presents descriptions and analyses from the time period between 2001 and 2010 as well as compares and contrasts trends from the previous ten year period between 1990 and 2001. The previous report analyzed data from the first six months of 2001, while this report includes the remainder of the year. Thus, this report actually reflects a 9.5 year time frame. All descriptive data and analyses were generated from a data set created from demographics and service profiles of sexual assault survivors presenting for services on the island of Oahu at the SATC. The dataset includes all sexual assault victims, regardless of whether they reported to the police and is inclusive of all assault types. Therefore the report captures additional victims that may not be included in law enforcement data. However, SATC does not service every case that is reported to the police and some survivors may seek private or informal resources. Additionally, the data presented represents only those who sought services on the island of Oahu.
SATC is not a research facility and its primary mission is to provide direct services to victims of sexual assault. Therefore, there were several limitations to the data. First, missing information in some data fields limited the generalizability of the findings (see Appendix B). Clients who were classified as Domestic Violence referrals were more likely to be missing demographic information and may have artificially inflated estimates of sexual violence as some were not victims of sexual assault. Thus, clients residing in domestic violence shelters were excluded from the analysis. Among the remaining clients, information was most likely to be missing on assault characteristics rather than victim demographics or assault type. Second, much of the available information was provided by victim self-report. Information regarding assault and assailant characteristics may therefore be speculative due to the victim not knowing or being unable to recall details. This was especially true in cases of stranger assault. For this reason, we have excluded variables relating to the assailant demographics. Finally, data on assault characteristics was limited to assault type and excluded information on victim response (i.e., resistance). Empirical research commonly uses victim response as an independent variable to predict long term impacts of sexual assault on individual functioning. Though victim information should not be used to represent the impact of sexual assault, it is important to understand the profile of victims seeking services as it informs both intervention and prevention efforts at the SATC.
The sample was obtained by importing variables relating to assault, victim and assailant characteristics into a database for each year between the periods of 2001-2010. Some variables were collapsed to make usable information (e.g., assault locations were collapsed from specific locations to five broad categories). Classification of categories was based on the previous decennial report as well as the current authors identifying how the information could be most interpretable and useful (see Appendix C). Descriptive analyses were conducted for the entire sample. Bivariate and multivariate analyses were conducted to evaluate within and between group variance on sexual assault characteristics. Chi-square tests were conducted to identify statistically significant relationships. Relationships between variables were considered significant if they had a p-value of .05 or less.
The Sex Abuse Treatment Center
The Sex Abuse Treatment Center is a community-based treatment and prevention program of the Kapiolani Medical Center for Women and Children, an affiliate of Hawaii Pacific Health. The SATCs mission is to support the emotional healing process for all children and adults sexually assaulted on the island of Oahu in Hawaii, to increase community awareness about the needs and concerns of sexual assault victims and, ultimately, to eliminate sexual violence. Created in 1976 due to community concern about the lack of adequate and appropriate care for victims of sexual violence, the SATC has provided a comprehensive array of crisis intervention, treatment, and prevention education services for sexual assault survivors, their families, and the general public for over 35 years.
SATC provides the full array of crisis intervention services including: a 24-hour hotline, a forensic examination to provide the victim the necessary medical assessment and treatment, the collection and preservation of forensic evidence should the victim decide to take criminal action, and in-person crisis counseling and follow-up. Short and long term therapy is also available to assist victims in their recovery from the assault. Finally, SATC provides community outreach and education activities to increase public awareness about sexual assault.
The SATC assists victims of recent and past assaults, women as well as men, and both adults and minors. Cases under the jurisdiction of Child Welfare Services (CWS) are not typically referred to SATC unless there are no plans for reunification with the offender (usually a family member). Thus, intra-familial abuse of minor children was under-represented in this sample of sexual assault victims. The SATC does not work with offenders, so CWS refers cases to SATC where the offending parent or adult figure has been removed from the home and there is no goal for reunification. SATC sees child cases in which the offender is outside of the family system (e.g., teacher, coach) or adult cases where typically the assailant is an acquaintance, friend or intimate partner.
Sexual violence covers a range of unwanted behaviors involving both contact and non-contact activities (e.g., penetration, fondling, exposure and harassment). The SATC services victims across the whole spectrum of sexual violence, delivering crisis, medical and therapy services for the island of Oahu. It is important to note that many victims do not access such services. Some victims initiate counseling services through other agencies or with various private providers in the community. Figure 1 illustrates the multiple points of entry for sexual assault victims into the various service and law enforcement sectors. There are a significant number of victims who choose not to report their assault to police or to seek services. Thus, the individuals who seek SATC services represent a unique subset of sexual assault victims and do not necessarily reflect the entire population of victims who have been sexually assaulted and reside on Oahu. Figure 1 illustrates the various places victims can exit services, either voluntarily or due to no follow-up.
Figure SEQ Figure \* ARABIC 1: Flowchart of Common SATC Access Points
Introduction
According to the National Center for Victims of Crime (NCVC), sexual violence takes many forms (e.g., attacks such as rape or attempted rape or any unwanted sexual contact or threats) and a sexual assault occurs when someone touches any part of another person's body in a sexual way, even through clothes, without that person's consent ADDIN EN.CITE The National Center for Victims of Crime201219(The National Center for Victims of Crime, 2012)191912The National Center for Victims of Crime, Sexual Violence2012http://www.victimsofcrime.org/library/crime-information-and-statistics/sexual-violence(HYPERLINK \l "_ENREF_41" \o "The National Center for Victims of Crime, 2012 #19"The National Center for Victims of Crime, 2012). The Centers for Disease Control (CDC) take a broader view in defining sexual violence as:
any sexual act that is perpetrated against someone's will. Sexual violence encompasses a range of offenses, including a completed nonconsensual sex act (i.e., rape), an attempted nonconsensual sex act, abusive sexual contact (i.e., unwanted touching), and non-contact sexual abuse ADDIN EN.CITE Black201121e.g.`, threatened sexual violence`, exhibitionism`, verbal sexual harassment`; (e.g., threatened sexual violence, exhibitionism, verbal sexual harassment; Black et al., 2011)212146Black, M.C.Basile, K.C.Breiding, M.J.Smith, S.G.Walters, M.L.Merrick, M.T.Chen, J.Stevens, M.R. National intimate partner and sexual violence survey (NISVS): 2010 summary report2011Atlanta, GANational Center for Injury Prevention and Control, Centers for Disease Control and Prevention(HYPERLINK \l "_ENREF_4" \o "Black, 2011 #21"e.g., threatened sexual violence, exhibitionism, verbal sexual harassment) (Black et al., 2011).
Additionally, digital technology has extended the spectrum of sexual violence (e.g., sexting).
The definition of sexual violence varies widely across individual state jurisdictions. The lack of consensus has often hampered efforts to examine factors related to both victims and assailants. The FBIs Uniform Crime Reports ADDIN EN.CITE 201121UCR`; (UCR; 2011)212146Black, M.C.Basile, K.C.Breiding, M.J.Smith, S.G.Walters, M.L.Merrick, M.T.Chen, J.Stevens, M.R. National intimate partner and sexual violence survey (NISVS): 2010 summary report2011Atlanta, GANational Center for Injury Prevention and Control, Centers for Disease Control and Prevention(UCR, HYPERLINK \l "_ENREF_4" \o "Black, 2011 #21"U.S. Department of Justice, 2011) previously defined forcible rape as the carnal knowledge of a female, forcibly and against her will. In 2011, the definition was revised as follows: the penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim ADDIN EN.CITE U.S. Department of Justice2012104(U.S. Department of Justice, 2012 )10410412U.S. Department of Justice,Attorney General Eric Holder announces revisions to the uniform crime reports definition of rape [press release]Press Release2012January 62012 Washington, D.C.Press Releasewww.fbi.gov/news/pressrel/press-releases/attorney-general-eric-holder-announces-revisions-to-the-uniform-crime-reports-definition-of-rape(HYPERLINK \l "_ENREF_48" \o "U.S. Department of Justice, 2012 #104"U.S. Department of Justice, 2012). This definition corrects some of the shortcomings of the previous definition in that it includes any gender of victim and perpetrator, not just women being assaulted by men. The updated definition also acknowledges that sexual assault with an object can be as traumatic as penile/vaginal rape and that victims may be unable to give consent because of mental or physical incapacity, the use of drugs or alcohol or because of age.
As a result of this more inclusive definition, it is anticipated that reported crimes of rape are likely to increase. Past studies which relied upon the FBI UCR statistics consistently showed that male on female forcible rape was one of the most underreported offenses to law enforcement. Recent information from the National Crime Victim Survey (NCVS) revealed a police reporting rate of nearly 50%, which is substantially higher than what has been reported in the past ADDIN EN.CITE U.S. Department of Justice201122(U.S. Department of Justice, 2011)222227U.S. Department of Justice, Bureau of Justice Statistics, Criminal victimization, 2010National Crime Victimization Survey2011Washington D.C.(HYPERLINK \l "_ENREF_46" \o "U.S. Department of Justice, 2011 #22"U.S. Department of Justice, 2011). The NCVS data included rape as well as other sexual assaults and victims of both genders. Additionally, extant research has found the incidence of sexual assault varies by both victim and assault characteristics. Therefore, findings from studies may vary depending on the source of the data (e.g., community samples, law enforcement data, etc.) and variables assessed (e.g., child sexual abuse, forcible rape, sexual assault, etc.). It should be noted that this study includes a sexual assault definition which is broader than forcible rape or definitions of some of the studies cited. Therefore, in interpreting our findings, it is important to do so cautiously, particularly in regards to comparisons with other studies which may be using different inclusion criteria.
Victim Characteristics
Age
Since the mid-1990s the rate of violent crime including sexual assault has declined, but based on the most recent crime statistics from the U.S. Department of Justice ADDIN EN.CITE Truman201123(Truman, 2011)232346Truman, J.L.Criminal victimization, 20102011Washington, DCDepartment of Justice, Bureau of Justice StatisticsNCJ 235508(HYPERLINK \l "_ENREF_44" \o "Truman, 2011 #23"Truman, 2011), teens and young adults continue to be the most vulnerable. According to the 2010 Criminal Victimization Report, the annual incidence of sexual victimization per 1,000 persons aged 12 and over is: 2.7 for 12-14 age group; 1.7 for 15-17 age group; 1.1 for 18-20 age group; 1.5 for 20-24 age group and 1.3 for 25-34 age group. Thereafter the rates dropped significantly (e.g., 0.6 for 35-49 age group). This data was supported by studies ADDIN EN.CITE Finkelhor200424(Finkelhor, Hammer, & Sedlak, 2004; Finkelhor, Ormrod, Turner, & Hamby, 2005)242427Finkelhor, D.Hammer, H.Sedlak, A. J.Sexually assaulted children: National estimates and characteristics, in OJJDPJuvenile Justice Bulletin2004U.S. Department of JusticeFinkelhor200525252517Finkelhor, D.Ormrod, R.Turner, H. Hamby, S. Victimization of children and youth: A comprehensive, national surveyChild Maltreatment: Journal of the American Professional Society on the Abuse of ChildrenChild Maltreatment: Journal of the American Professional Society on the Abuse of Children5-251012005(HYPERLINK \l "_ENREF_13" \o "Finkelhor, 2004 #24"Finkelhor, Hammer, & Sedlak, 2004; HYPERLINK \l "_ENREF_15" \o "Finkelhor, 2005 #25"Finkelhor, Ormrod, Turner, & Hamby, 2005) finding that older children were more likely to be sexually victimized, particularly between the ages of 5 -17 years. Similarly, in a 10 year review, Putnam ADDIN EN.CITE 200326(2003)262617Putnam, Frank W.Ten year research update review: Child sexual abuseJournal of the American Academy of Child and Adolescent PsychiatryJournal of the American Academy of Child and Adolescent Psychiatry269-2784232003(HYPERLINK \l "_ENREF_31" \o "Putnam, 2003 #26"2003){, 2003 #26;, 2003 #26;Putnam, 2003 #26} reported that the incidence of child sexual abuse increases with age as follows: 0-3 years old: 10% of victims; 4-7 years old: 28.4% of victims; 8-11 years old: 25% of victims and 12 and older: 35.9% of victims.
According to CDCs 2010 National Intimate Partner and Sexual Violence Survey ADDIN EN.CITE 201121NISVS`; (NISVS; 2011)212146Black, M.C.Basile, K.C.Breiding, M.J.Smith, S.G.Walters, M.L.Merrick, M.T.Chen, J.Stevens, M.R. National intimate partner and sexual violence survey (NISVS): 2010 summary report2011Atlanta, GANational Center for Injury Prevention and Control, Centers for Disease Control and Prevention(HYPERLINK \l "_ENREF_4" \o "Black, 2011 #21"NISVS, 2011), nearly 80% of female victims of completed rape were first raped before the age of 25 and 42% were first raped before the age of 18 years. Additionally, nearly 28% of male victims of completed rape were first raped when they were 10 years of age or younger. These data support studies that show that older children may be at greater risk for sexual assault, although this increased risk may be due to varying reporting definitions (i.e., the age at which the child was assaulted versus the age at which the child reported the assault). Thus, the higher incidence of reporting among older children may not necessarily mean they are more vulnerable.
Gender
It is well established that females, especially among adult victims, are sexually assaulted more frequently than males. For example, Elliott and colleagues ADDIN EN.CITE 200449(2004)494917Elliott, D.Mok, D. Briere, J.Adult sexual assault: Prevalence, symptomatology and sex differences in the general populationJournal of Traumatic StressJournal of Traumatic Stress203-2111732004(HYPERLINK \l "_ENREF_12" \o "Elliott, 2004 #49"2004) examined the prevalence of adult sexual assault in a stratified random sample of the general population. Of the 941 participants, adult sexual assault was reported by 22% of women and 3.8% of men.
Recent statistics ADDIN EN.CITE Truman201123(Truman, 2011)232346Truman, J.L.Criminal victimization, 20102011Washington, DCDepartment of Justice, Bureau of Justice StatisticsNCJ 235508(HYPERLINK \l "_ENREF_44" \o "Truman, 2011 #23"Truman, 2011) revealed that 8% of self-reported sexual assault victims ages 12 and older were male. The discrepancy in these reported prevalence rates has to be tempered against the likelihood that socio-cultural barriers make it more difficult for males, particularly teens and adult men, to report their assaults.
While adult males are assaulted less frequently than females, the frequency of male assaults among minors is higher relative to adults. According to Putnams10 year review ADDIN EN.CITE 20037(2003)7717Fisher, B. S. Daigle, L. E. Cullen, F. T.Turner, M.Reporting sexual victimization to the police and others: Results from a national-level study of college womenCriminal Justice and Behavior,Criminal Justice and Behavior,6-38312003(HYPERLINK \l "_ENREF_17" \o "Fisher, 2003 #7"2003), 25% of sexual assault child victims were male. This finding was supported by a recent study which used data from the 2001-2005 National Incident Based Reporting System (NIBRS) to construct an epidemiological profile of male sexual assault ADDIN EN.CITE Choudhary201212(Choudhary, Gunzler, Tu, & Bossarte, 2012)121217Choudhary, E.Gunzler, D.Tu, X.Bossarte, R.Epidemiological characteristics of male sexual assault in a criminological databaseJournal of Interpersonal ViolenceJournal of Interpersonal Violence523-5462732012(HYPERLINK \l "_ENREF_7" \o "Choudhary, 2012 #12"Choudhary, Gunzler, Tu, & Bossarte, 2012). Results revealed that the incidence of sexual assault was higher among young males (less than 19 years of age) than older males with approximately 90% of all cases being reported among members of this age group. However, these higher reporting percentages may be linked to mandated reporting requirements for suspicions of child sex abuse.
Marital Status
Victims who were not married had significantly higher rates of sexual violence than victims who were married, widowed, divorced or separated ADDIN EN.CITE Truman201123(Truman, 2011)232346Truman, J.L.Criminal victimization, 20102011Washington, DCDepartment of Justice, Bureau of Justice StatisticsNCJ 235508(HYPERLINK \l "_ENREF_44" \o "Truman, 2011 #23"Truman, 2011). This finding is probably confounded with age. For all personal crimes, unmarried, divorced and separated victims were equally at risk. This is supported by research findings that divorced and separated men and women experienced similar overall rates of violent victimization ADDIN EN.CITE Rennison200227(Rennison, 2002)272746Rennison, C.MRape and sexual assault: Reporting to police and medical attention, 1992-20002002Washington, DCBureau of Justice StatisticsNJS 194530(HYPERLINK \l "_ENREF_32" \o "Rennison, 2002 #27"Rennison, 2002).
Race and Ethnicity
The findings about race and ethnicity as risk factors for sexual assault victimization have historically been based on Caucasian samples. Studies that include more racially and ethnically diverse samples appear inconclusive. In some instances, apparent differences in ethnicity or culture in reporting or reactions may be more related to differences in abuse characteristics among or between groups, or to levels of acculturation than to cultural differences per se ADDIN EN.CITE Katerndahl200518(Fontes & Plummer, 2010; Katerndahl, Burge, Kellogg, & Parra, 2005)181817Katerndahl, D.A. Burge, S.K. Kellogg, N.D. Parra, J.M. Differences in childhood sexual abuse experience between adult Hispanic and Anglo women in a primary care settingJournal of Child Sexual AbuseJournal of Child Sexual Abuse85-951422005Fontes201017171717Fontes, L.Plummer, C. Cultural Issues in disclosures of child sexual abuse1-28Journal of Child Sexual Abuse192010(HYPERLINK \l "_ENREF_18" \o "Fontes, 2010 #17"Fontes & Plummer, 2010; HYPERLINK \l "_ENREF_23" \o "Katerndahl, 2005 #18"Katerndahl, Burge, Kellogg, & Parra, 2005).
Rickert and associates ADDIN EN.CITE 200428(2004)282817Rickert, V.I.Wiemann, C.M.Vaughan, R.D.White, J.W. Rates and risk factors for sexual violence among an ethnically diverse sample of adolescentsArchives of Pediatric and Adolescent MedicineArchives of Pediatric and Adolescent Medicine1132-11391582004(HYPERLINK \l "_ENREF_33" \o "Rickert, 2004 #28"2004) reported higher proportions of forced sexual assault among African Americans whereas Maxwell and colleagues ADDIN EN.CITE 200329(2003)292917Maxwell, C.D.Robinson, A.L.Post, L.A.The nature and predictors of sexual victimization and offending among adolescentsJournal of Youth and AdolescenceJournal of Youth and Adolescence465-477322003(HYPERLINK \l "_ENREF_26" \o "Maxwell, 2003 #29"2003) reported no differences. For minors, Finkelhor, Hammer & Sedlack ADDIN EN.CITE 200424(2004)242427Finkelhor, D.Hammer, H.Sedlak, A. J.Sexually assaulted children: National estimates and characteristics, in OJJDPJuvenile Justice Bulletin2004U.S. Department of Justice(HYPERLINK \l "_ENREF_13" \o "Finkelhor, 2004 #24"2004) found that black and white children experienced near-equal levels of sexual abuse while other studies have reported that both blacks and Latinos have an increased risk for sexual victimization.
More recently, Freeman and Temple ADDIN EN.CITE 201030(2010)303017Freeman, D.H.Temple, J.R.Social factors associated with history of sexual assault among ethically diverse adolescentsJournal of Family ViolenceJournal of Family Violence349-3562532010(HYPERLINK \l "_ENREF_19" \o "Freeman, 2010 #30"2010) found that adolescents of multi-ethnic descent (primarily African American and Hispanic) were substantially more likely to report sexual assault than their counterparts, but factors related to reporting of sexual violence may be very different from its actual prevalence. Furthermore, these findings may be confounded by other factors known to be related to increased risk of child sexual assault such as parental impairment (e.g., inadequacy, unavailability, conflict, use of substances, etc.). Race and ethnicity alone may not necessarily increase vulnerability specific to sexual assault but may influence trauma symptom expression.
In a study more relevant to Hawaiis population, Crisanti and colleagues ADDIN EN.CITE 201113(2011)131317Crisanti, A.Frueh, B.C.Gundaya, D.Salvail, F.Triffleman, E.Ethnoracial disparities in sexual asault among Asian Americans and Native Hawaiians/Other Pacific IslandersJournal of Clinical PsychaitryJournal of Clinical Psychaitry820-8267262011(HYPERLINK \l "_ENREF_9" \o "Crisanti, 2011 #13"2011) examined data on unwanted sexual experiences from the 2006-2007 Hawaii Behavioral Risk Factor Surveillance System (N=12,573 of an adult, community-based sample). Participants were 44% Caucasian, 41% Asian and 15% Native Hawaiian/Other Pacific Islander (NHOPI). Data revealed that NHOPIs had a higher 12 month period prevalence for unwanted sexual experiences (prevalence of 2.24 per 100) but a lower prevalence estimate for any lifetime unwanted sexual experience (prevalence 9.38 per 100). In contrast, Asian Americans had lower prevalence estimates for 12 month and lifetime period prevalence (0.78 and 3.91 per 100, respectively). The 12 month and lifetime prevalence estimates for Caucasians was 0.71 per 100 and 12.01 per 100, respectively). The authors concluded that there were ethnic and racial differences in sexual assault prevalence across these groups, with the relative risk contingent upon the time period ADDIN EN.CITE Crisanti201113(Crisanti et al., 2011)131317Crisanti, A.Frueh, B.C.Gundaya, D.Salvail, F.Triffleman, E.Ethnoracial disparities in sexual asault among Asian Americans and Native Hawaiians/Other Pacific IslandersJournal of Clinical PsychaitryJournal of Clinical Psychaitry820-8267262011(HYPERLINK \l "_ENREF_9" \o "Crisanti, 2011 #13"Crisanti et al., 2011). In order to fully interpret these findings, one also has to weigh the inter-relationship between socio-economic and ethnoracial status as factors that influence prevalence.
Assault Characteristics
Victim / Assailant Relationship
Recent information continues to support the well-established finding that the majority of sexual assault victims know their assailant regardless of the age or gender of the victim. The 2010 U.S. Department of Justice report reflects that for males 12 and above, 78% were assaulted by a friend or acquaintance as compared to 8% who were assaulted by a stranger. For females ages 12 and above, 48% were assaulted by a friend or acquaintance followed by 17% who were assaulted by intimate partner, and 9% who were assaulted by another relative. 25% of female victims reported that the perpetrator was a stranger.
The CDCs 2010 survey (NISVS) revealed that across all forms of violence (sexual violence, stalking, intimate partner violence), the vast majority of victims knew their assailant, who was most often an intimate partner or acquaintance and seldom a stranger. In this study, 51.1% of female victims of rape reported being raped by an intimate partner and 40.8% by an acquaintance. For male victims, 52.4% reported being raped by an acquaintance and 15.1% by a stranger.
These national findings that the victim most often knows the perpetrators of violence are supported by SATC statistics. Based on 2011 data from SATC, 21% of adult victims and 8% of victims ages 12 through 17 were assaulted by strangers. Similarly, 98% of victims below the age of 10 years and 85% of adult victims knew their perpetrators. This information is unique to the population that receives SATC services and does not reflect all sexual assault victims in Hawaii. However, it does support the findings that although stranger assaults tend to increase with age, they occur less frequently than assaults by assailants known to victims. This does not discount the impact of stranger assaults since Ullman, Filipas, Townsend and Starzynski ADDIN EN.CITE 200631(2006)313117Ullman, S. E.Filipas, H. H.Townsend, S. M.Starzynski, L. L.The role of victim-offender relationship in womens sexual assault experiencesJournal Of Interpersonal ViolenceJournal of Interpersonal Violence798-8192162006(HYPERLINK \l "_ENREF_49" \o "Ullman, 2006 #31"2006) found that stranger assailants were associated with a greater victim perceived life threat, more severe sexual assaults and ethnic minority victims. Additionally, assaults by both strangers and relatives resulted in greater post-traumatic stress disorder (PTSD) symptoms than assaults by acquaintances and romantic partners ADDIN EN.CITE Ullman200631(Ullman et al., 2006)313117Ullman, S. E.Filipas, H. H.Townsend, S. M.Starzynski, L. L.The role of victim-offender relationship in womens sexual assault experiencesJournal Of Interpersonal ViolenceJournal of Interpersonal Violence798-8192162006(HYPERLINK \l "_ENREF_49" \o "Ullman, 2006 #31"Ullman et al., 2006).
Despite these cumulative findings, there is a continued misperception among the general public that most sexual assaults are perpetrated by strangers. This is unfortunate, as prevention efforts are sometimes directed at the perceived threat of strangers as opposed to family members or friends, neighbors, acquaintances and other individuals within the victims lives.
Time and Location
The time that a sexual assault occurs is primarily related to the age of the victim. For example, a report by the Bureau of Justice Statistics ADDIN EN.CITE Snyder200032(Snyder, 2000)323246Snyder, H.J.Sexual assault of young children as reported to law enforcement: Victim, incident and offender characteristics2000National Center for Juvenile Justice, Bureau of Justice StatisticsNCJ 182990(HYPERLINK \l "_ENREF_37" \o "Snyder, 2000 #32"Snyder, 2000) revealed that adults were sexually assaulted most frequently between midnight and 2 a.m. For children under the age of 6 years, sexual assaults reached a peak in the 3 p.m. hour (around the release of children from school) with spikes at 8 a.m., noon and 6 p.m. (traditional meal times). For youth ages 6 through 17, the report indicated that the temporal patterns of sexual assault of youth ages 6 through 11, and juveniles ages 12 through 17, appear to be a combination of the patterns of the very young, and the adult victims (Snyder, 2000, p. 7).
This same report further stated that 70% of the sexual assaults reported to law enforcement occurred in the residence of the victim, the offender, or the residence of another individual. As with the time of assault, the location of assault was significantly related to the age of the victim. 77% of sexual assaults with juvenile victims occurred in a residence compared with 55% of adult victimizations.
The most common non-resident locations for sexual assaults of juveniles were roadways, fields/woods, schools, and hotels/motels. For adults the most likely locations after a residence included roadways, fields/woods, hotels/motels, parking lots, and commercial/office buildings (Snyder, 2000, p. 6).
Weapon Use
The U.S. Department of Justice ADDIN EN.CITE Truman201123(Truman, 2011)232346Truman, J.L.Criminal victimization, 20102011Washington, DCDepartment of Justice, Bureau of Justice StatisticsNCJ 235508(HYPERLINK \l "_ENREF_44" \o "Truman, 2011 #23"Truman, 2011) reported that for victims 12 and older, 12% reported that their assailant had used a weapon such as a firearm or knife. The majority of the time, however, weapons were not used with sexual assault victims.
This was consistent with previous findings from the Bureau of Justice Statistics ADDIN EN.CITE Snyder200032(Snyder, 2000)323246Snyder, H.J.Sexual assault of young children as reported to law enforcement: Victim, incident and offender characteristics2000National Center for Juvenile Justice, Bureau of Justice StatisticsNCJ 182990(HYPERLINK \l "_ENREF_37" \o "Snyder, 2000 #32"Snyder, 2000) which revealed that in 77% of sexual assaults (where the weapon information was available), the only weapon involved included hands, feet, or fists. A firearm was used or shown in 2% of sexual assault victimizations while other weapons such as a knife or club, were used in 6% of sexual assaults. The use of weapons increased with the age of the victim and child sexual assaults rarely involved firearms.
Injury and Treatment
The unwanted and forced acts that take place during a sexual assault may not result in visible injuries. According to Rennison ADDIN EN.CITE 200227(2002)272746Rennison, C.MRape and sexual assault: Reporting to police and medical attention, 1992-20002002Washington, DCBureau of Justice StatisticsNJS 194530(HYPERLINK \l "_ENREF_32" \o "Rennison, 2002 #27"2002), 5% of forcible rape victims had serious physical injuries and 33% had minor injuries. Early studies of rape examinations found genital injury rates between 5 and 40% ADDIN EN.CITE Sommers200733(Sommers, 2007)333317Sommers, M.S.Defining patterns of genital injury from sexual assault: A reviewTrauma, Violence & AbuseTrauma, Violence & Abuse270-280832007(HYPERLINK \l "_ENREF_38" \o "Sommers, 2007 #33"Sommers, 2007). Sugar, Fine and Eckert ADDIN EN.CITE 200434(2004)343417Sugar, N.F.Fine, D.N.Eckert, L.O.Physical injury after sexual assault: findings of a large case seriesAmerican Journal of Obstetrics and GynecologyAmerican Journal of Obstetrics and Gynecology71-7619012004(HYPERLINK \l "_ENREF_39" \o "Sugar, 2004 #34"2004) found that across 819 women 15 years and older presenting to an emergency department after a sexual assault, 52% had general body injuries, 20% had genital-anal trauma and 41% were without injury.
However, use of the latest examination techniques, including direct visualization, colposcopy and digital imaging, allow for documentation of more minor injuries and recent studies indicate the occurrence of genital injury after rape to be between 50 and 90 percent ADDIN EN.CITE Sommers200733(Sommers, 2007)333317Sommers, M.S.Defining patterns of genital injury from sexual assault: A reviewTrauma, Violence & AbuseTrauma, Violence & Abuse270-280832007(HYPERLINK \l "_ENREF_38" \o "Sommers, 2007 #33"Sommers, 2007). This statistic may, however, be inflated given that those with physical injury may be more likely to seek medical treatment, and thus be identified. Given that a significant number of victims do not report their assault, many may not receive prompt medical treatment for their injuries. This is concerning as victims of intimate partner and sexual violence have a significantly higher prevalence of long term health problems such as diabetes, frequent headaches, chronic pain and sleeping difficulties ADDIN EN.CITE Black201121(Black et al., 2011)212146Black, M.C.Basile, K.C.Breiding, M.J.Smith, S.G.Walters, M.L.Merrick, M.T.Chen, J.Stevens, M.R. National intimate partner and sexual violence survey (NISVS): 2010 summary report2011Atlanta, GANational Center for Injury Prevention and Control, Centers for Disease Control and Prevention(HYPERLINK \l "_ENREF_4" \o "Black, 2011 #21"Black et al., 2011).
Prevalence of Sexual Assault Nationally and in Hawaii
In 2010, the forcible rape rate in the United States was 27.5 per 100,000 residents as compared to 27.7 in Hawaii (based on the FBI Uniform Crime Report for 2010). Historically, Hawaiis forcible rape rate has been lower than national rates, but as indicated by Figure 2, for the past two years, it has been slightly higher. According to Fuatagavi and Perrone ADDIN EN.CITE 201235(2012)353546Fuatagavi, L.Perrone, P. Crime in Hawaii 2010: A Review of Uniform Crime Reports, State of Hawaii2012Department of the Attorney General, Crime Prevention & Justice Assistance Division(HYPERLINK \l "_ENREF_20" \o "Fuatagavi, 2012 #35"2012), from 2009 to 2010, reported forcible rapes decreased 7.3% in Hawaii. Decreases in the counties of Honolulu (14.4%) and Maui (27.9%) were offset by increases on Kauai (16.2%) and Hawaii Island (19.8%). Forcible rape was previously defined by the FBI as the carnal knowledge of a female forcibly and against her will ADDIN EN.CITE U.S. Department of Justice2011105(U.S. Department of Justice, 2011)10510546U.S. Department of Justice,Federal Bureau of InvestigationUniform Crime Report: Forcible rape2011Washington D.C.U.S. Department of Justicewww.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2010/crime-in-the-u.s.-2010/violent-crime/rapemain(HYPERLINK \l "_ENREF_47" \o "U.S. Department of Justice, 2011 #105"U.S. Department of Justice, 2011). However, the exclusion of minors and male adult victims in these statistics give a limited perspective on the prevalence of the full spectrum of sexual violence. Therefore in this report, all assaults or attempts to commit rape by force or threat of force are included.
Figure SEQ Figure \* ARABIC 2: Comparison of Hawaiis Forcible Rape Rate with the National Forcible Rape Rate
Year
National
Hawaii
2001
31.8
33.4
2002
33.1
29.9
2003
32.3
29.2
2004
32.4
28.6
2005
31.8
24.3
2006
31.0
28.3
2007
30.0
29.4
2008
29.3
28.2
2009
29.8
29.9
2010
27.5
27.7
The CDCs 2010 survey (NISVS) provides both national and state-level prevalence estimates of sexual violence. The study reported that nationally, one in five women (18.3%) and one in 71 men (1.4%) have been raped in their lifetime. Lifetime estimates for women ranged from 11.4% to 29.2% for rape and 28.9% to 58% for sexual violence other than rape. For men, lifetime estimates ranged from 10.8% to 33.7% for sexual violence other than rape; and 17.4% to 41.2% for rape, physical violence, and/or stalking by an intimate partner. For Hawaii, lifetime prevalence of sexual violence other than rape for women was 41.9% and for 17.1% for men. There was no available data on lifetime prevalence for rape ADDIN EN.CITE Black201121(Black et al., 2011)212146Black, M.C.Basile, K.C.Breiding, M.J.Smith, S.G.Walters, M.L.Merrick, M.T.Chen, J.Stevens, M.R. National intimate partner and sexual violence survey (NISVS): 2010 summary report2011Atlanta, GANational Center for Injury Prevention and Control, Centers for Disease Control and Prevention(HYPERLINK \l "_ENREF_4" \o "Black, 2011 #21"Black et al., 2011). However, Ruggiero and Kilpatrick ADDIN EN.CITE 200336(2003)363627Ruggiero, K.J.,Kilpatrick, D.G.Rape in Hawaii: A Report to the State2003Charleston, SCNational Violence Against Women Prevention Research Center, Medical University of South Carolina(HYPERLINK \l "_ENREF_35" \o "Ruggiero, 2003 #36"2003), drawing on a model using national factors predictive of female forcible rape, projected 14.5% of adult women in Hawaii have been subject to a completed forcible rape in their lifetime. This appears within the range of national statistics.
The prevalence of child sexual assault varies due to differences in definitions and methodology, but a conservative estimate of child sexual abuse prevalence is 20% in females and 5-10% in males. A recent meta-analysis of over 65 articles covering 22 countries revealed that approximately 8% of males and 20% of females suffered some type of sexual assault prior to the age of 18 ADDIN EN.CITE Pereda200937(Pereda, Guilera, Forns, & Gomez-Benito, 2009)373717Pereda, N.Guilera, G.Forns, M.Gomez-Benito, J. The prevalence of child sexual abuse in community and student samples: A meta-analysisJournal of Clinical PsychologyJournal of Clinical Psychology328-3382942009(HYPERLINK \l "_ENREF_29" \o "Pereda, 2009 #37"Pereda, Guilera, Forns, & Gomez-Benito, 2009). Finkelhor, Jones and Shattuck ADDIN EN.CITE 200938(2009)383827Finkelhor, D.Jones, L.M.Shattuck, A. Updated trends in child maltreatment, 20092009Durham, NCCrimes Against Children Research Center(HYPERLINK \l "_ENREF_14" \o "Finkelhor, 2009 #38"2009) have tracked the trends in child maltreatment statistics collected by the U.S. federal government and found a national decline in the incidence of both physical and sexual abuse that began in the middle of the 1990s and continues through the present. While there is no consensus about the factors behind the decline, Finkelhor and his colleagues cite a number of potential reasons (e.g., prevention and social intervention, incarceration and treatment of offenders, higher thresholds for reporting, etc.) that may be related to the decline in the incidence of child sexual assault.
SECTION 2: DEMOGRAPHIC PROFILE
Victim Profile Hawaii
In the 9.5 year period between 2001 and 2010, SATC served an average of 508 victims per year, ranging from 467 in 2004 to 562 in 2007. These numbers represent more than one victim per day seeking assistance and do not reflect the number of services each victim received or the length of time each victim remained in contact with the SATC.
Fluctuations in the number of victims assisted across time most likely reflects variable staffing ratios due to funding constraints rather than victim needs. Table 1 details demographics variables within the SATC population.
Age
For the current 10 year review, 58.2% of victims were minors. The average age of all victims combined was 18.65 years. The average age of a female victim receiving services at the SATC was 19.43 while the average age of a male victim was 13.19. However, as seen in Figure 2, the peak or modal age group for females was 12-15 years while for males it was 6-11 years.
Figure SEQ Figure \* ARABIC 3: Age Distribution of Female and Male Sexual Assault Victims
Table SEQ Table \* ARABIC 1: Demographic Characteristics of Sexual Assault Victims Seeking Treatment at SATC, 2001-2010 (Percentages)
DemographicAll N=4,763Females N=4,172Males N=591Age (in years)
0-5
6-11
12-15
16-17
18-22
23-29
30-45
46 and over
13.1
13.4
22.4
9.1
14.2
11.6
12.0
4.3
11.6
10.8
23.2
9.4
15.3
12.5
12.6
4.7
24.0
32.0
16.8
6.4
6.3
5.1
7.8
1.7Ethnicity
Hawaiian/part Hawaiian
Caucasian
Filipino
Japanese
Black
Samoan
Korean
Hispanic
Chinese
American Indian/Native Alaskan
Other Pacific Islander
Vietnamese
Other Asian (not mixed)
Other (Not mixed)
Mixed (non-Hawaiian)
28.2
22.7
8.1
5.6
2.2
2.1
1.3
2.8
1.4
0.3
1.4
0.2
0.7
0.6
22.4
27.4
22.8
8.2
5.9
2.1
2.3
1.4
2.9
1.4
0.3
1.4
0.2
0.8
0.7
22.3
33.5
22.3
7.4
3.1
2.5
0.6
0.8
1.9
1.4
0.0
1.9
0.4
0.0
0.6
23.6Marital Status (victims 18 and older)
Single
Married
Separated
Divorced
Widowed
69.8
15.1
5.1
8.9
1.1
69.3
15.1
5.3
9.2
1.1
78.2
14.5
1.8
4.5
0.9Employment Status (victims 18 and older)
Employed
Unemployed
Student
Retired
51.7
21.8
25.4
1.1
51.6
21.6
25.9
0.9
53.4
25.0
18.2
3.4
Gender
During this decade, 87.6% of victims seen at the SATC were female while 12.4% were male. These figures do not reflect victims seen through domestic violence shelters because including this population would have artificially inflated the number of female victims seen. Both national prevalence rates and local statistical projections on prevalence indicate that significantly more females than males are victims of sex assault ADDIN EN.CITE Truman201123(Truman, 2011)232346Truman, J.L.Criminal victimization, 20102011Washington, DCDepartment of Justice, Bureau of Justice StatisticsNCJ 235508(HYPERLINK \l "_ENREF_44" \o "Truman, 2011 #23"Truman, 2011). In 2009, females compromised 90.8% of the SATCs population, but a year later, in 2010, this had decreased to 85%, while the number of males serviced increased to nearly 15%.
Figure SEQ Figure \* ARABIC 4: Sex of Victim by Intake Year
EMBED Excel.Chart.8 \s
Age and Gender
In looking at the age of victims within gender categories, female victims were well distributed across all age categories up to 45 years or older with the highest percentage (23.2%) of victims in the 12 15 years category. In contrast, 56% of male victims were under 11 years of age. From age 12 years and older, few males sought services at SATC. Males were significantly younger than females (t (4761)=11.480, p<.000) with 73% of male victims under the age of 15 when they sought services at SATC as opposed to 45% of female victims who were under 15 years.
Ethnicity
According to the 2010 U.S. Census Bureau, Native Hawaiians and Other Pacific Islanders represented 9.5% of Honolulus total population ADDIN EN.CITE U.S. Census Bureau201250(U.S. Census Bureau, 2012)505012U.S. Census Bureau,: .State and County QuickFacts2012http://quickfacts.census.gov/qfd/states/15/15003.html(HYPERLINK \l "_ENREF_45" \o "U.S. Census Bureau, 2012 #50"U.S. Census Bureau, 2012). However, victims with Hawaiian/part-Hawaiian ancestry comprised 28.2% of victims served at SATC while 3.5% of the victims were Other Pacific Islanders. Thus, SATC serviced more victims who were Native Hawaiians and Other Pacific Islanders relative to other ethnic groups.
The percentage of Caucasian victims (22.7%) was roughly consistent with 22.2% of Caucasians residing in Honolulu per the 2010 census. Asian victims constituted 23.6% of victims served at SATC, although they comprised roughly 44% of Honolulus population. There was a large category of victims (22.4%) under the Mixed Non-Hawaiian heading who reflected the diverse multi-ethnic population of Hawaii. This is consistent with persons residing in Honolulu County and identifying as more than one race per the 2010 census (21.6%).
Marital and Job Status
The majority of adult victims were single (69.8%) and about half of victims were employed, while over 25% reported they were students. Among adult victims, 21.8% were unemployed. The SATC serves clients regardless of their ability to pay for services and is a resource for victims who may be indigent or uninsured.
Assault Characteristics Hawaii
Relationship of Offender to Victim
The relationship of the offender to the victim was organized into 5 different categories as follows: intimate, family, acquaintance, authority figure, and stranger. The vast majority of victims reported they knew their perpetrator (83.1%) while stranger assaults accounted for 13.3% of all cases. Victims were assaulted by intimate partners in 10.5% of the cases and by family members in 29.2% of the sample. Assault by acquaintances was reported by 40.3% of victims. This data is consistent with national statistics which show that the most victims know their assailant ADDIN EN.CITE Truman201123(Truman, 2011)232346Truman, J.L.Criminal victimization, 20102011Washington, DCDepartment of Justice, Bureau of Justice StatisticsNCJ 235508(HYPERLINK \l "_ENREF_44" \o "Truman, 2011 #23"Truman, 2011).
By Gender: The overall female population at SATC was assaulted most frequently by acquaintances (40.4%), family members (27.9%) and strangers (13.9%). In contrast, male victims were significantly more like to be assaulted by family members (39.9%) followed by acquaintances (39.4 % ; = 7 2 . 6 , p <