Sexual Assault Author: Carolyn J. Sachs, MD, MPH
Editorial changes - 2008-05-02
Author information and module status
Prevention
Screening
Diagnosis
Consultation for Diagnosis
Hospitalization
Non-drug Therapy
Drug Therapy
Patient Education
Consultation for Management
Follow-up
Tables
Figures
References
Glossary
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Patient Information
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References
1. 2Foshee VA, Bauman KE, Ennett ST, Suchindran C, Benefield T, Linder GF. Assessing the effects of the dating violence prevention program “Safe Dates” using random coefficient regression modeling. Prev Sci. 2005:1-14. (PMID: 16047088)
2. 2Clay-Warner J. Avoiding rape: the effects of protective actions and situational factors on rape outcome. Violence Vict. 2002;17:691-705. (PMID: 12680683)
3. 2Mohler-Kuo M, Dowdall GW, Koss MP, Wechsler H. Correlates of rape while intoxicated in a national sample of college women. J Stud Alcohol. 2004;65:37-45. (PMID: 15000502)
4. 1Kaysen D, Neighbors C, Martell J, Fossos N, Larimer ME. Incapacitated rape and alcohol use: A prospective analysis. Addict Behav. 2006. (PMID: 16446044)
5. 3Basile KC, Lang KS, Bartenfeld TA, Clinton-Sherrod M. Report from the CDC: Evaluability assessment of the rape prevention and education program: summary of findings and recommendations. J Womens Health (Larchmt). 2005;14:201-7. (PMID: 15857265)
6. 1Resnick HS, Holmes MM, Kilpatrick DG, Clum G, Acierno R, Best CL, et al. Predictors of post-rape medical care in a national sample of women. Am J Prev Med. 2000;19:214-9. (PMID: 11064223)
7. 3Conoscenti LM, McNally RJ. Health complaints in acknowledged and unacknowledged rape victims. J Anxiety Disord. 2006;20:372-9. (PMID: 16564439)
8. 2Chandler HK, Ciccone DS, Raphael KG. Localization of pain and self-reported rape in a female community sample. Pain Med. 2006;7:344-52. (PMID: 16898946)
9. 2Hilden M, Schei B, Swahnberg K, Halmesmäki E, Langhoff-Roos J, Offerdal K, et al. A history of sexual abuse and health: a Nordic multicentre study. BJOG. 2004;111:1121-7. (PMID: 15383115)
10. 2Eberhard-Gran M, Schei B, Eskild A. Somatic symptoms and diseases are more common in women exposed to violence. J Gen Intern Med. 2007;22:1668-73. (PMID: 17922169)
11. 2Feldhaus KM, Houry D, Kaminsky R. Lifetime sexual assault prevalence rates and reporting practices in an emergency department population. Ann Emerg Med. 2000;36:23-7. (PMID: 10874231)
12. 2Bonomi AE, Anderson ML, Rivara FP, Thompson RS. Health outcomes in women with physical and sexual intimate partner violence exposure. J Womens Health (Larchmt). 2007;16:987-97. (PMID: 17903075)
13. 3Marc B, Baudry F, Vaquero P, Zerrouki L, Hassnaoui S, Douceron H. Sexual assault under benzodiazepine submission in a Paris suburb. Arch Gynecol Obstet. 2000;263:193-7. (PMID: 10834331)
14. 3McFarlane J, Malecha A, Watson K, Gist J, Batten E, Hall I, et al. Intimate partner sexual assault against women: frequency, health consequences, and treatment outcomes. Obstet Gynecol. 2005;105:99-108. (PMID: 15625149)
15. 1Marx BP, Calhoun KS, Wilson AE, Meyerson LA. Sexual revictimization prevention: an outcome evaluation. J Consult Clin Psychol. 2001;69:25-32. (PMID: 11302273)
16. 2Coid J, Petruckevitch A, Chung WS, Richardson J, Moorey S, Cotter S, et al. Sexual violence against adult women primary care attenders in east London. Br J Gen Pract. 2003;53:858-62. (PMID: 14702905)
17. 3Murphy GH. Capacity to consent to sexual relationships in adults with learning disabilities. J Fam Plann Reprod Health Care. 2003;29:148-9. (PMID: 12885309)
18. 1Resnick H, Acierno R, Waldrop AE, King L, King D, Danielson C, et al. Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology. Behav Res Ther. 2007;45:2432-47. (PMID: 17585872)
19. 3California Penal Code 679.04 Victim of sexual assault; right to advocate and support person. Available at: http://ag.ca.gov/victimservices/pdf/penalcode679_04.pdf.
20. 2Campbell R, Raja S. Secondary victimization of rape victims: insights from mental health professionals who treat survivors of violence. Violence Vict. 1999;14:261-75. (PMID: 10606433)
21. 2Campbell R, Sefl T, Barnes HE, Ahrens CE, Wasco SM, Zaragoza-Diesfeld Y. Community services for rape survivors: enhancing psychological well-being or increasing trauma? J Consult Clin Psychol. 1999;67:847-58. (PMID: 10596507)
22. 1Sugar NF, Fine DN, Eckert LO. Physical injury after sexual assault: findings of a large case series. Am J Obstet Gynecol. 2004;190:71-6. (PMID: 14749638)
23. 2Rambow B, Adkinson C, Frost TH, Peterson GF. Female sexual assault: medical and legal implications. Ann Emerg Med. 1992;21:727-31. (PMID: 1590616)
24. 3Lynnerup N, Hjalgrim H, Eriksen B. Routine use of ultraviolet light in medicolegal examinations to evaluate stains and skin trauma. Med Sci Law. 1995;35:165-8. (PMID: 7776867)
25. 1Nelson DG, Santucci KA. An alternate light source to detect semen. Acad Emerg Med. 2002;9:1045-8. (PMID: 12359543)
26. 1Wawryk J, Odell M. Fluorescent identification of biological and other stains on skin by the use of alternative light sources. J Clin Forensic Med. 2005;12:296-301. (PMID: 15925535)
27. 2Gabby T, Winkleby MA, Boyce WT, Fisher DL, Lancaster A, Sensabaugh GF. Sexual abuse of children. The detection of semen on skin. Am J Dis Child. 1992;146:700-3. (PMID: 1375806)
28. 2Do sex assault victims receive adequate care? If not, you risk fines, violations. ED Manag. 2002;14:61-4, suppl 1. (PMID: 12046235)
29. 1Read KM, Kufera JA, Jackson MC, Dischinger PC. Population-based study of police-reported sexual assault in Baltimore, Maryland. Am J Emerg Med. 2005;23:273-8. (PMID: 15915397)
30. 2Lauber AA, Souma ML. Use of toluidine blue for documentation of traumatic intercourse. Obstet Gynecol. 1982;60:644-8. (PMID: 7145256)
31. 2McCauley J, Gorman RL, Guzinski G. Toluidine blue in the detection of perineal lacerations in pediatric and adolescent sexual abuse victims. Pediatrics. 1986;78:1039-43. (PMID: 3786029)
32. 2Jones JS, Rossman L, Hartman M, Alexander CC. Anogenital injuries in adolescents after consensual sexual intercourse. Acad Emerg Med. 2003;10:1378-83. (PMID: 14644791)
33. 1Hochmeister MN, Whelan M, Borer UV, Gehrig C, Binda S, Berzlanovich A, et al. Effects of toluidine blue and destaining reagents used in sexual assault examinations on the ability to obtain DNA profiles from postcoital vaginal swabs. J Forensic Sci. 1997;42:316-9. (PMID: 9068192)
34. 2Lenahan LC, Ernst A, Johnson B. Colposcopy in evaluation of the adult sexual assault victim. Am J Emerg Med. 1998;16:183-4. (PMID: 9517700)
35. 2Ernst AA, Green E, Ferguson MT, Weiss SJ, Green WM. The utility of anoscopy and colposcopy in the evaluation of male sexual assault victims. Ann Emerg Med. 2000;36:432-7. (PMID: 11054195)
36. 2Adams JA, Knudson S. Genital findings in adolescent girls referred for suspected sexual abuse. Arch Pediatr Adolesc Med. 1996;150:850-7. (PMID: 8704893)
37. 2McCann J, Miyamoto S, Boyle C, Rogers K. Healing of hymenal injuries in prepubertal and adolescent girls: a descriptive study. Pediatrics. 2007;119:e1094-106. (PMID: 17420260)
38. 2Mann MJ. Hair transfers in sexual assault: a six-year case study. J Forensic Sci. 1990;35:951-5. (PMID: 2391483)
39. 2Willott GM, Allard JE. Spermatozoa—their persistence after sexual intercourse. Forensic Sci Int. 1982;19:135-54. (PMID: 7040183)
40. 1Soules MR, Pollard AA, Brown KM, Verma M. The forensic laboratory evaluation of evidence in alleged rape. Am J Obstet Gynecol. 1978;130:142-7. (PMID: 619653)
41. 1Morrison AI. Persistence of spermatozoa in the vagina and cervix. Br J Vener Dis. 1972;48:141-3. (PMID: 5032772)
42. 1Campbell R, Townsend SM, Long SM, Kinnison KE, Pulley EM, Adames SB, et al. Responding to sexual assault victims' medical and emotional needs: a national study of the services provided by SANE programs. Res Nurs Health. 2006;29:384-98. (PMID: 16977639)
43. 2Gibb AM, McManus T, Forster GE. Should we offer antibiotic prophylaxis post sexual assault? Int J STD AIDS. 2003;14:99-102. (PMID: 12662387)
44. 1Nelson MS, Benzinger EA, Budzynski MJ, Boodee MT, Matthews A, Buel E, et al. Validation of probe EFD52 (D17S26) for forensic DNA analysis. J Forensic Sci. 1996;41:557-68. (PMID: 8754565)
45. 1Tahir MA, Caruso JF, Hamby PP, Sovinski SM. Deoxyribonucleic acid profiling by restriction fragment length polymorphism analysis—a compilation of validation studies. Sci Justice. 1996;36:173-82. (PMID: 8789934)
46. 2McGregor MJ, Lipowska M, Shah S, Du Mont J, De Siato C. An exploratory analysis of suspected drug-facilitated sexual assault seen in a hospital emergency department. Women Health. 2003;37:71-80. (PMID: 12839308)
47. 1Haller C, Thai D, Jacob P 3rd, Dyer JE. GHB urine concentrations after single-dose administration in humans. J Anal Toxicol. 2006;30:360-4. (PMID: 16872565)
48. 2Elian AA. A novel method for GHB detection in urine and its application in drug-facilitated sexual assaults. Forensic Sci Int. 2000;109:183-7. (PMID: 10725654)
49. 2Elian AA. Determination of endogenous gamma-hydroxybutyric acid (GHB) levels in antemortem urine and blood. Forensic Sci Int. 2002;128:120-2. (PMID: 12175790)
50. 3Abbey A, Zawacki T, Buck PO, Testa M, Parks K, Norris J, et al. How does alcohol contribute to sexual assault? Explanations from laboratory and survey data. Alcohol Clin Exp Res. 2002;26:575-81. (PMID: 11981135)
51. 1Negrusz A, Moore CM, Stockham TL, Poiser KR, Kern JL, Palaparthy R, et al. Elimination of 7-aminoflunitrazepam and flunitrazepam in urine after a single dose of Rohypnol. J Forensic Sci. 2000;45:1031-40. (PMID: 11005178)
52. 1Mishalani SH, Seliktar J, Braunstein GD. Four rapid serum-urine combination assays of choriogonadotropin (hCG) compared and assessed for their utility in quantitative determinations of hCG. Clin Chem. 1994;40:1944-9. (PMID: 7923777)
53. 2Derhammer F, Lucente V, Reed JF 3rd, Young MJ. Using a SANE interdisciplinary approach to care of sexual assault victims. Jt Comm J Qual Improv. 2000;26:488-96. (PMID: 10934639)
54. 2Sievers V, Murphy S, Miller JJ. Sexual assault evidence collection more accurate when completed by sexual assault nurse examiners: Colorado's experience. J Emerg Nurs. 2003;29:511-4. (PMID: 14631337)
55. 2Stermac LE, Stirpe TS. Efficacy of a 2-year-old sexual assault nurse examiner program in a Canadian hospital. J Emerg Nurs. 2002;28:18-23. (PMID: 11830729)
56. 2Rovi S, Shimoni N. Prophylaxis provided to sexual assault victims seen at US emergency departments. J Am Med Womens Assoc. 2002;57:204-7. (PMID: 12405238)
57. 2Amey AL, Bishai D. Measuring the quality of medical care for women who experience sexual assault with data from the National Hospital Ambulatory Medical Care Survey. Ann Emerg Med. 2002;39:631-8. (PMID: 12023706)
58. 2Burgess AW, Holmstrom LL. Rape trauma syndrome. Am J Psychiatry. 1974;131:981-6. (PMID: 4415470)
59. 2Ullman SE, Filipas HH, Townsend SM, Starzynski LL. The role of victim-offender relationship in women's sexual assault experiences. J Interpers Violence. 2006;21:798-819. (PMID: 16672742)
60. 2Foa EB, Hearst-Ikeda D, Perry KJ. Evaluation of a brief cognitive-behavioral program for the prevention of chronic PTSD in recent assault victims. J Consult Clin Psychol. 1995;63:948-55. (PMID: 8543717)
61. 1Krakow B, Hollifield M, Johnston L, Koss M, Schrader R, Warner TD, et al. Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial. JAMA. 2001;286:537-45. (PMID: 11476655)
62. 2Vaa G, Egner R, Sexton H. Sexually abused women after multimodal group therapy: a long-term follow-up study. Nord J Psychiatry. 2002;56:215-21. (PMID: 12079574)
63. 1Jenny C, Hooton TM, Bowers A, Copass MK, Krieger JN, Hillier SL, et al. Sexually transmitted diseases in victims of rape. N Engl J Med. 1990;322:713-6. (PMID: 2155389)
64. 2Putz M, Thomas BK, Cowles KV. Sexual assault victims' compliance with follow-up care at one sexual assault treatment center. J Emerg Nurs. 1996;22:560-5. (PMID: 9060319)
65. 3Gostin LO, Lazzarini Z, Alexander D, Brandt AM, Mayer KH, Silverman DC. HIV testing, counseling, and prophylaxis after sexual assault. JAMA. 1994;271:1436-44. (PMID: 8176804)
66. 2Royce RA, Seña A, Cates W Jr, Cohen MS. Sexual transmission of HIV. N Engl J Med. 1997;336:1072-8. (PMID: 9091805)
67. 2Cardo DM, Culver DH, Ciesielski CA, Srivastava PU, Marcus R, Abiteboul D, et al. A case-control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. N Engl J Med. 1997;337:1485-90. (PMID: 9366579)
68. 3Myles JE, Hirozawa A, Katz MH, Kimmerling R, Bamberger JD. Postexposure prophylaxis for HIV after sexual assault [Letter]. JAMA. 2000;284:1516-8. (PMID: 11000643)
69. 2Wiebe ER, Comay SE, McGregor M, Ducceschi S. Offering HIV prophylaxis to people who have been sexually assaulted: 16 months' experience in a sexual assault service. CMAJ. 2000;162:641-5. (PMID: 10738449)
70. 3Fong C. Post-exposure prophylaxis for HIV infection after sexual assault: when is it indicated? Emerg Med J. 2001;18:242-5. (PMID: 11435354)
71. 2Linden JA, Oldeg P, Mehta SD, McCabe KK, LaBelle C. HIV postexposure prophylaxis in sexual assault: current practice and patient adherence to treatment recommendations in a large urban teaching hospital. Acad Emerg Med. 2005;12:640-6. (PMID: 15995097)
72. 3Smith DK, Grohskopf LA, Black RJ, Auerbach JD, Veronese F, Struble KA, et al. Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States: recommendations from the U.S. Department of Health and Human Services. MMWR Recomm Rep. 2005;54:1-20. (PMID: 15660015)
73. 3AIDS Institute. HIV prophylaxis following sexual assault: guidelines for adults and adolescents. New York, NY: AIDS Institute, New York State Department of Health; 1998.
74. 3Myles JE, Bamberger J. Offering HIV prophylaxis following sexual assault: recommendations for the state of California. California HIV postexposure prophylaxis after sexual assault task force; 2001.
75. 3Rhode Island Department of Health. State Department of Health Announces Release of HIV Post Exposure Guidelines. RI First State to Produce Comprehensive Guidelines for Nonoccupational HIV Exposures. September 25, 2002. Available at: http://www.health.ri.gov/media/020925a.php.
76. 3Massachusetts Department of Public Health. HIV Prophylaxis Following Non-Occupational Exposures Recommended Protocol Components. Available at: http://www.state.ma.us/dph/aids/guidelines/exposure_nonwork.htm.
77. 3Centers for Disease Control and Prevention; Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. 2006;55:1-94. (PMID: 16888612)
78. 3Stewart FH, Trussell J. Prevention of pregnancy resulting from rape: a neglected preventive health measure. Am J Prev Med. 2000;19:228-9. (PMID: 11064225)
79. 1Trussell J, Rodríguez G, Ellertson C. Updated estimates of the effectiveness of the Yuzpe regimen of emergency contraception. Contraception. 1999;59:147-51. (PMID: 10382076)
80. 1Levonorgestrel is more effective, has fewer side-effects, than Yuzpe regimen. Prog Hum Reprod Res. 1999:3-5. (PMID: 12349416)
81. 1von Hertzen H, Piaggio G, Ding J, Chen J, Song S, Bártfai G, et al. Low dose mifepristone and two regimens of levonorgestrel for emergency contraception: a WHO multicentre randomised trial. Lancet. 2002;360:1803-10. (PMID: 12480356)
82. 1Ellertson C, Evans M, Ferden S, Leadbetter C, Spears A, Johnstone K, et al. Extending the time limit for starting the Yuzpe regimen of emergency contraception to 120 hours. Obstet Gynecol. 2003;101:1168-71. (PMID: 12798519)
83. 2Whiteside JL, Katz T, Anthes T, Boardman L, Peipert JF. Risks and adverse outcomes of sexually transmitted diseases. Patients' attitudes and beliefs. J Reprod Med. 2001;46:34-8. (PMID: 11209629)
84. 1Ackerman DR, Sugar NF, Fine DN, Eckert LO. Sexual assault victims: factors associated with follow-up care. Am J Obstet Gynecol. 2006;194:1653-9. (PMID: 16635464)
85. 2Boykins AD, Mynatt S. Assault history and follow-up contact of women survivors of recent sexual assault. Issues Ment Health Nurs. 2007;28:867-81. (PMID: 17729171)
86. 2Wiley J, Sugar N, Fine D, Eckert LO. Legal outcomes of sexual assault. Am J Obstet Gynecol. 2003;188:1638-41. (PMID: 12825004)
87. 3Stephenson J. PEP talk: treating nonoccupational HIV exposure. JAMA. 2003;289:287-8. (PMID: 12525212)
FAQs
Carolyn J. Sachs, MD, MPH has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.

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