Rationale:

• Patients may be unaware of the pervasiveness of sexual assault and that any sexual touching without consent constitutes assault and is illegal.
• Patients may also be unaware that increased ethanol consumption is linked to an increased risk of becoming victims of substance-facilitated sexual assault.
• Armed with this information, patients may be able to disengage themselves from assaultive situations before the completion of the act.

Evidence:

• A randomized, controlled trial evaluated the long-term impact of a dating violence prevention program (Safe Dates) on the subsequent sexual assault experience of 1566 adolescents. The program intervention was associated with a significant decrease in both sexual assault perpetration and victimization in the subsequent 1 to 4 years of measured data (1).
• A retrospective study found an association between physical resistance during attack and rape avoidance (2).
• Survey data obtained from 23,000 female university students in the Harvard School of Public Health College Alcohol Study found that 72% of those who reported being raped (4.7% of the total) were intoxicated. The use of alcohol increases the chance that a woman will succumb to a sexual assault (3).
• A random sample of 1238 college students found that increased ethanol consumption was associated with an increased risk of substance-facilitated rape over the subsequent 3-year period of study (4).

Comments:

• Sexual assault in most states includes any type of unwanted physical contact with a sexual organ and may even include aggressive, sexually suggestive statements. Exact legal definitions vary by state statute (see American Prosecutors Research Institute State Rape Statutes).
• Statutory rape is illegal sexual activity between two people that would otherwise be legal if not for their ages, based on the premise that a person under the age of consent cannot legally consent to sex. The age of consent ranges from 14 to 18 years; in most states, it is 16. Some state laws also consider the age difference between the two people, as well as their individual ages.
• The CDC evaluated the many federally funded sexual assault programs that may be available to physicians and patients in a publication detailing the process. The authors compiled a list of programs using a Web-based survey of all state and territory health departments, other government agencies involved in the administration of the program, and sexual assault coalitions (5).