Changes in physical violence and injury during sexual assaults over time among females 16-29 years.

Introduction: Despite movements like "Me Too" and refined laws, many young people in Sweden still experience sexual violence. The changing nature and severity of these assaults are of significant interest, especially due to common long-term effects like post-traumatic stress disorder (PTSD). Understanding these trends can help healthcare providers support victims and develop effective prevention strategies. This study aimed to examine changes in the severity of physical violence and injury during sexual assaults over the past decade among women aged 16-29 in Stockholm, Sweden, with a particular focus on trends in non-fatal strangulation and its associated factors.

Material and methods: This retrospective study analyzed data from the Emergency Clinic for Rape Victims at South General Hospital, which centralizes care for sexual assault victims in Region Stockholm, Sweden. A final sample of 1074 records of women aged 16-29 was included in the analysis (299 in 2012, 391 in 2017, and 384 in 2022). Data were analyzed using descriptive and regression analysis to assess adjusted odds ratios (AORs) and 95% confidence intervals (CIs).

Results: Most victims experienced physical violence during sexual assault (65.3% in 2012, 68.1% in 2017 and 67.6% in 2022). In 2022, there was an increase in hitting (13.7% to 21.7%, p = 0.008), multiple physical violence (28.4% to 37.7%, p = 0.012), and severe physical violence (15.1% to 28.9% p < 0.001) compared to 2012. Non-fatal strangulation rose significantly from 8.2% in 2012 to 24.5% in 2022 (p < 0.001), with adjusted AORs of 2.2 (95% CI: 1.2, 3.9) in 2017 and 3.3 (95% CI: 1.9, 5.8) in 2022 compared to 2012. Factors linked to non-fatal strangulation included assaults in a home environment (AOR = 1.8, 95% CI: 1.2, 2.8), vaginal penetration along with another sexual act (AOR = 2.9, 95% CI: 1.6, 5.1), and blunt force (AOR = 5.9, 95% CI: 4.0, 8.5). Genital injuries also increased significantly from 25.2% in 2012 to 37.6% in 2022.

Conclusions: This study highlights a rise in severe physical violence in sexual assaults, involving non-fatal strangulation and an increased presence of genital injuries. Findings underscore the need for thorough medical follow-up and nationally representative research to inform prevention and understand associated violence dynamics.