NCJ Number
197494
Date Published
November 1997
Length
7 pages
Annotation
This document presents current information on the obstetric-gynecologic issue of treatment of sexual assault.
Abstract
Sexual assault is any sexual act performed by one person on another without the person’s consent. The legal definitions of sexual assault vary from State to State. Sexual assault includes genital, anal, or oral penetration by a part of the accused’s body or by an object, resulting from force, the threat of force either on the victim or another person, or the victim’s inability to give appropriate consent. The actual incidence of sexual assault in the United States is unknown but appears to be rising. Misconceptions that society has about victims of sexual assault include the beliefs that women encouraged the assault by their behavior or dress, that they did not offer sufficient resistance, and that they were promiscuous. The psychological impact of sexual assault is intense anxiety, anger, or fear. A rape-trauma syndrome often occurs with the acute phase lasting for hours or days and characterized by a distortion or paralysis of the individual’s coping mechanisms. The delayed phase is characterized by flashbacks, nightmares, and phobias, in addition to gynecologic and menstrual complaints, and can last for months or years after the event. The physician evaluating the sexual assault victim has both medical and legal responsibilities. They should be aware of State statutory requirements that may involve the use of kits for gathering evidence. Informed consent must be obtained before the examination is begun and specimens are collected. A careful history and physical examination should be performed. Physical injuries should be assessed and treated. The physician should provide prophylactic antibiotic therapy, offer immunizations, provide therapy for unwanted conception, and offer tests for hepatitis B virus, HIV, and syphilis. Arrangements for follow-up medical care and counseling should be made. Legal concerns include providing accurate recording of events, documenting injuries, collecting samples for evidence, reporting to the authorities as required, and assuring chain of evidence. When the medical and legal needs have been addressed, counseling should be provided by other health personnel, particularly those trained to handle rape-trauma victims. 1 table, 25 references