Rationale:

• Patients may contract an STD after a sexual assault.
• Effective prophylaxis exists for bacterial STDs.
• Untreated gonorrhea and chlamydia can lead to PID with resultant infertility.
• Due to potential morbidity, treatment to prevent gonorrhea, chlamydia, and syphilis is a well-accepted standard, whereas treatment to prevent trichomonas or bacterial vaginosis is considered optional.
• Studies have shown limited follow-up rates in sexual assault patients.

Evidence:

• In a prospective observational study of 209 female sexual assault patients, preexisting Neisseria gonorrhoeae was found in 6%, cytomegalovirus in 8%, Chlamydia trachomatis in 10%, Trichomonas vaginalis in 15%, herpes simplex virus in 2%, Treponema pallidum in 1%, HIV-1 in 1%, and bacterial vaginosis in 34%. The 109 patients examined postassault and initially not given treatment showed an incidence of new STDs, including chlamydia in 2%, gonorrhea in 4%, trichomonas in 12%, and bacterial vaginosis in 19% (64).
• A prospective observation study of 26 sexual assault patients showed that most patients (73%) adhere to antibiotic regimens to prevent gonorrhea and chlamydia (65).

Comments:

• None.