Beyond the Status Quo: Supported Self-Collection after Sexual Assault

In this episode of Beyond the Rape Kit: Canada’s Forensic Frontline, we sit down with Victoria Donkin, social worker and health equity researcher at She Matters, a Survivor-led organization working to improve access to justice and care for people impacted by sexual violence. Victoria is leading the first Canadian research examining the feasibility of supported self-collection of sexual assault evidence. She takes us through what these kits are, what they are not, and what it would take to make them work within Canadian health, forensic, and legal systems.

Together, we look at how early evidence kits are already used in the UK, Australia, and Kenya, unpack the chain of custody and admissibility questions that come with self-collection, and put the harder concerns on the table directly. Does supported self-collection replace forensic nurses, or does it reach Survivors the current system never touches? Who holds the chain of custody when the person in the room is a trained support worker rather than a forensic nurse? And can a practice stand up in court before it has ever been tested there?

Debbie Smith, Laurance Webb, Angelika Fennell, Elizabeth Nathan, Christine Bassindale, Maureen Phillips • 2014 • Forensic Science, Medicine and Pathology

Early evidence kit (self-collection kit) specimens are effective in recovery of spermatozoa, and in particular urine and vulval gauze wipe are worthwhile early forensic specimens for the detection of spermatozoa. Collection of early evidence specimens led to detection of spermatozoa-positive cases, which were not detected by subsequent full forensic specimen collection.

Lisa Smith, Jon Wetton, Gurdeep Lall, Heather Flowe, Mark Jobling • 2017 • Science & Justice

In developed countries, DNA profiling routinely forms part of the forensic strategy in the investigation of sexual violence. Medical examinations provide opportunities for recovering DNA evidence from intimate swabs, which can be particularly probative in cases where the identity of the perpetrator is unknown and proof of intercourse between two people is required. In low-resource environments, such as developing countries, remote geographic locations, conflict (and post-conflict) affected regions and displaced communities where access to medical examinations is lacking, DNA evidence is not available to support prosecutions and perpetrators are rarely identified and held accountable for crimes of sexual violence. This paper reports the results of a proof-of-concept study testing the efficacy of a novel self-examination intimate swab designed for recovering DNA following unprotected sexual intercourse. The results of this study corroborate previous research which has demonstrated that male DNA profiles can be successfully recovered by post-coital, self-examination methods, and discusses how this novel approach could enable the integration of DNA evidence into victim-centred approaches to investigating and prosecuting sexual violence in low-resource environments. The results and discussion challenge the prevailing assumption that intimate DNA swabs must be collected by trained medical professionals in order to be of evidential value.

Lisa Smith, Wangu Kanja, Jessica Ritchie • 2020 • AWSC Third Annual International Conference on the Status of African Women

Sexual and gender-based violence (SGBV) is challenging to investigate and prosecute. One of the critical challenges to prosecuting sexual violence is the frequent lack of forensic evidence, the improper handling of evidence, and problems in the chain of custody of evidence. All these issues contribute to complaints being dropped by victims, police not proceeding with an investigation, and lack of successful prosecution. DNA can make a significant contribution towards investigations of sexual violence as it can provide an objective method of identifying offenders of sexual violence. This project introduces a new, but reliable way to collect and preserve DNA in Kenya. The design of the DNA kits enables victims to self-administer intimate DNA swabs, supervised in a healthcare setting. This approach makes DNA evidence recovery possible in clinics with no trained forensic medical professionals, and empowers women to take a more active role in their medical examination. The process encourages the timely collection of DNA evidence (within 72 hours) to ensure a viable sample for analysis. Further, the tamper-proof, self-drying packaging allows the samples to be air-dried to preserve the integrity of the DNA, and also maintains the chain of custody by reducing the chances of contamination, tampering and human error – overall enhancing access to high-quality evidence for victims, police, and prosecutors

Matilda-Jane Oke • 2024 • International Journal of Legal Medicine

Forensic evidence from genital swabs can play an important role in sexual assault prosecutions, and clinician-collected genital samples are considered best practice. However, some TGD patients may be reluctant to have a genital examination and clinician-collected samples. Offering a suitable alternative e.g., specimen self-collection, could be an additional means of providing trauma-informed care.

Ministry of Health • 2025 • NSW Health Guideline

Early evidence collection can be offered as part of an integrated crisis response when a person has experienced a recent sexual assault. Early collection of forensic and toxicology samples is to be offered in all Sexual Assault Services and Level 3-6 Emergency Departments. This may also be offered in other NSW Health settings at the discretion of districts/networks. The district/network must consult with the Sexual Assault Service to draft local processes that follow the principles and processes within this guideline. Local processes must include a pathway for involving a Sexual Assault Service in the collection, storage, release and destruction of forensic and toxicology samples and ensure psychosocial support for the patient is prioritised. EEKs are to be offered to adults, young people and to children who can self-collect samples with verbal and written guidance, if there is a disclosed or suspected sexual assault and a delay in a medical and forensic examination. As a general rule, an early evidence kit may not be appropriate for very young children, who cannot yet self-toilet or clean their teeth. An EEK may be offered to a patient 16 years and over who is intoxicated but has the capacity to self-collect samples.

When to offer an Early Evidence Kit (EEK)

Circumstances in which it may be appropriate to offer early evidence collection include where:

• The patient has medical or psychosocial needs that require immediate attention prior to a medical and forensic assessment.

• The medical and forensic examiner is delayed or unavailable.

• Medical and forensic services are not offered at the site where the patient initially presents, and the patient will need to be transferred to another site for a full medical and forensic examination.

• A patient aged 16 or over has temporary reduced capacity (for example, intoxicated and/or substance affected or experiencing an acute mental health episode) and is unable to give formal consent for a full medical and forensic examination, but is expected to regain full capacity and the responding clinician believes it is in their best interest to collect early evidence samples.

• When a decision has otherwise been made, in consultation with the patient or the patient’s parent/guardian, to defer a full medical and forensic examination

She Matters • 2026

In many communities across Canada—particularly rural, remote, or underserved areas—survivors of sexual violence face significant barriers to accessing forensic examinations. These barriers may include geographic isolation, limited availability of Sexual Assault Nurse Examiners (SANEs) or specially trained medical professionals, long wait times, or personal and systemic mistrust of medical and legal institutions. As a result, many survivors are left without timely access to evidence collection services. 

These delays can have serious consequences. Evidence such as DNA only remains on the body for a limited period of time, and everyday actions—like using the washroom, eating, drinking, or bathing—can quickly degrade or eliminate it. The sooner a sample is collected, the higher the likelihood of obtaining usable evidence.

To address similar gaps, several countries have explored supported self-collection as a way for survivors to preserve time-sensitive forensic evidence when full exams are unavailable. Models in Australia and the United Kingdom — where supported self-collection is often referred to as early evidence kits — allow survivors to collect swabs or clothing samples in supported settings, without replacing the option of a comprehensive forensic exam. These international examples highlight supported self-collection as a supplementary pathway, one that prevents the loss of crucial DNA evidence, and prioritizes survivor autonomy and safety.

Office of the Federal Ombudsperson for Victims of Crime

Innovative tools offer survivors more control. The paceKit initiative allows for self-collection of DNA evidence with support from a trained frontline worker. Survivors use the kit to swab for DNA, submit clothing, and document the incident on their own terms. It provides accessibility for people who live in rural and remote communities.

Dr. Kim Stanton • 2025 • Province of British Columbia

A BC organization has recently developed a supported forensic self-collection kit for victims of sexual assault, to be used within 48 hours of an assault. The PACE kit is being piloted in two locations in the province: Trail and Terrace. The kit includes forensic tools, user support, and a system for evidence preservation following a sexual assault. Following the collection of evidence, the kits can be securely provided to the police, who will maintain the chain of custody until a survivor decides whether they want to initiate a criminal proceeding.

For survivors who may not otherwise have access to SAEKs, the PACE kit may provide a more accessible means of collecting evidence following the trauma of a sexual assault. In addition to improving access for survivors who live in areas that are underserved by the health care system, these kits may be important tools for members of the 2SLGBTQIA+ community, Indigenous survivors, or others who have faced historical discrimination or a lack of understanding in traditional health care or criminal law settings. However, self-collection is a relatively new option, and issues may arise about admissibility and reliability when their results are offered in court.

The government, with meaningful input from anti-violence sector organizations, particularly Indigenous and northern community-based organizations, should evaluate the pilot programs in Trail and Terrace to determine the efficacy of making the self-collection initiative available across the province. The results of this evaluation should be shared with federal-provincial-territorial partners.

Dr. Roberto Leon • 2017 • This Changed My Practice (UBC CPD)

I noticed in the back of the COBAS swab a set of instructions for self-collection and handling. I came across a publication in the British Medical Journal by Sarah A. Schoeman: Assessment of best single sample for finding chlamydia in women with and without symptoms: a diagnostic test study 1. Participants took a vaginal swab before a routine gynecological exam, and clinicians then took an endocervical swab during examination.

Of the 3867 participants with complete results, 10.2% were infected with chlamydia. Self-collected vulvovaginal swabs were significantly more sensitive than endocervical swabs (97% vs 88%; P<.00001) and had equal septicity (99.9% vs 100%). In women with symptoms of a sexually transmitted infection (STI) or vaginitis, the sensitivity was 97% vs 88% (P<.0008); in those with no symptoms, the sensitivity was 97% vs 89% (P<.002). In those with symptoms, using endocervical samples rather than vaginal swabs would have missed 9% of infections, or 1 in every 11 cases of chlamydia in this study.

My personal interpretation of why the self-administered vaginal swabs (SAVS) are better than the physician administered ones is that the swabs should be in contact against the vaginal walls or the cervix for 30 seconds, and by watching the residents perform them in my office, most just touch the vaginal walls or the cervix for 5 seconds or so. And when they do an endocervical swab, they often don’t remove the cervical mucus (there are 2 Q-tips in the sample kit, one for mucous removal, one for sampling). The mucus is rich in antibodies, and less likely to test positive.

I then reviewed some of the literature on the self-collection for the other STI’s and vaginitis, and they all revealed at least an equivalent but often better detection rate with the SAVS than the physician performed swabs 2,3,4. In terms of patient’s preference, 90% of women found it very easy to self-collect a vaginal swab, and 67% preferred a vaginal swab over a pelvic examination5.

I also looked at the accuracy of urine testing’s comparing to vaginal swabs. According to a CDC report, first catch urine from women may detect up 10% fewer chlamydia and gonorrhea infections compared with vaginal and endocervical samples 6. In men, urine testing is the gold standard for diagnosing STIs, but not in women.

If SAVS were more accurate and preferred by patients, why not use them? I did not find any negative implications7, so I started offering them to my patients regularly since then.

Lisa Smith, Heather Flowe, Jon Wetton, Mark Jobling • 2018 • The Conversation

DNA is often not collected in low-resource environments because women can’t get to medical facilities or trained personnel. Survivors may also be reluctant to be medically examined – often by male doctors – and the procedures they go through to report the abuse might not be safe.

Adopting self-examination DNA collection techniques can help to overcome some of these barriers. We are still working on the final design of the swab but the prototype we used in the proof-of-concept study was very similar to a tampon.

The swab must be comfortable to use, safe for the user and have instructions that are easy to follow. We will use a specially designed applicator, to reduce the risk of contamination, and tamper-proof packaging to meet international criminal justice system standards.

To test the effectiveness of a self-administered swab we recruited heterosexual couples who engaged in consensual, unprotected sex. Female participants then used self-administered intimate swabs between 12 and 36 hours after intercourse. This helped us to determine whether this method could successfully recover male DNA.

We analysed the results and confirmed that the self-administered swabs could successfully collect male DNA up to 32 hours after intercourse. Only one of the 14 samples failed to detect the male DNA profile; this was the swab that was used after the longest delay since intercourse (34 hours).

The Science Show, ABC Radio National

Hundreds of thousands of women have been raped as part of conflicts in Rwanda, the former Yugoslavia, the Democratic Republic of the Congo and elsewhere. Figures are seen as very conservative as only about 10% of rapes are reported. Lisa Smith has developed a self-examination swab designed for women to collect DNA evidence to a standard accepted by courts.

The West Australian