Results showed that 60% of emergency departments screen for STDs. Additionally, 85.9% provide EC counseling, 87.7% administer the first dose in the emergency department, and 64.7% offer HIV postexposure prophylaxis (PEP). Interestingly, only 67.9% of emergency departments have an EC policy and only 55.3% have a nonoccupational HIV PEP policy. As such, the majority of academic emergency departments are apparently offering EC counseling, EC treatment, and HIV PEP to victims of sexual assault, despite the absence of institutional policies.
These summaries were written by SVPEP staff and are based on original papers published within the last 6 years. The information available on this web site is provided as a public service and does not necessarily reflect the opinion of the U.S. Centers of Disease Control and Prevention, the Arizona Department of Health Services, or the University of Arizona. To conduct an individual search or locate older articles use the Search Summary Database which includes over 600 articles related to sexual violence.
Medical Response
Azikiwe, N., Wright, J., Cheng, T., & D’Angelo, L. J. (2005). Management of rape victims (regarding STD treatment and pregnancy prevention): Do academic emergency departments practice what they preach? Journal of Adolescent Health, 36, 446-448.
Sat, 2005-01-01
This study examined the difference between institutional policy and practice concerning the role of emergency contraception (EC) and STD-screening for sexual assault cases in 85 emergency departments.
Elklit, A., & Shevlin, M. (2010). General practice utilization after sexual victimization: A case control study. Violence Against Women, (online).
Tue, 2010-03-16
Utilization of health care services was greater among those who sought services from a center for rape victims.
Data from 1999-2005 from the Danish Civil Registration System was used to examine the relationship between visiting the Centre for Rape Victims (CRV) and frequency of visits to a general practitioner. Findings indicated that contact with a general practitioner was higher among those who visited the CRV than the control group. Results of this study may be used to estimate health needs of victims of sexual violence.
This was a case-control study conducted in Denmark.
Fitzgerald, M.M., Danielson, C.K., Saunders, B., & Kilpatrick, D.G. (2007).Youth victimization: Implications for prevention, intervention, and public policy. The Prevention Researcher, 14, 3-7.
Wed, 2007-08-01
Policies and practices are needed to minimize the harm of youth victimization by encouraging assessment, targeted prevention, and treatment interventions.
The authors review national prevalence rates of youth victimization, including: sexual, emotional or physical abuse; witnessing domestic or community violence; property crime; and excessive punishment. They note gender and race/ethnicity differences in prevalence rates as well as mental health effects. Specific recommendations for assessing risk and resiliency factors as well as screening for victimization in clinical settings are given. The authors discuss the importance of targeted interventions for specific groups, and urge adoption of an ecological model. Finally, the authors discuss how public and organizational policies can help decrease the impact of victimization and increase the availability of supportive services for youth and their families.
Jones, J. S., Alexander, C., Wynn, B. N., Rossman, L., & Dunnuck, C. (2009). Violence: Recognition, management and prevention. Why women don't report sexual assault to the police: The influence of psychosocial variables and traumatic injury. The Journal of Emergency Medicine, 36, 417-424.
Fri, 2010-01-29
Environmental factors such as prior relationships with perpetrators and time between assault and forensic exams were primary reasons for women not reporting a sexual assault to the police.
This study identified reasons why women may not report sexual assaults to police and the differences in demographics, assault characteristics, and injury patterns between those who do and do not report assaults. Data was gathered from 337 adult women who presented to a YWCA Nurse Examiner Program or emergency department. Results indicated that one out of four of the women did not report the rape to the police. No differences were reported in frequency or severity of injuries between reporters and non-reporters. Age, martial status, and ethnicity were not associated with reporting. Women who did not report were more likely to be employed, had a history of drug or alcohol use, knew the perpetrator, and had longer intervals of time between assault and forensic evaluation. The authors suggested that a strategy to increase reporting may be to increase the likelihood of arrest and prosecution of perpetrators.
Documentation of the clinical exam may not have been uniform across all nurse examiners.
Kimerling, R., Street, A. E., Gima, K., & Smith, M.W. (2008). Evaluation of universal screening for military-related sexual trauma. Psychiatric Services, 59, 635-640.
Fri, 2008-08-01
Universal screening may play an important role in secondary prevention efforts for military sexual trauma.
In 2005, 33,259 women and 540,381 men were screened for military sexual trauma which the Veterans Health Administration refers to military sexual trauma as severe or threatening forms of sexual harassment and sexual assault sustained in military service. The purpose of the study was to evaluate screening efforts and to explore if there was association with increased use of mental health services and sexual trauma screening. Women and men who had positive screens had higher rates of post screen mental health treatment. The screens increased utilization of mental health services among individuals without a history of mental health treatment.
The study does not show a causal relationship between screening and use of mental health services.
Magid, D. J., Houry, D., Koepsell, T. D., Ziller, A., Soules, M. R., & Jenny, C. (2004). The epidemiology of female rape victims who seek immediate medical care: Temporal trends in the incidence of sexual assault and acquaintance rape. Journal of Interpersonal Violence, 19, 3-12.
Thu, 2004-01-01
The emergency department is an important source of information about sexual assault occurrence since victims of sexual assault usually go to the emergency department for medical assistance after being assaulted.
This is a study comparing the number of female sexual assault victims treated in a Colorado county’s emergency department between July and November of 1974 and 1991. It was hypothesized that there would be a significant increase in the incidence of sexual assault between 1974 and 1991. As predicted, there was a 60% increase in sexual assault incidence with this increase primarily caused by an increase in sexual assaults involving known assailants. Moreover, victims in the emergency department reported more physical force and physical injury in 1991 when compared to 1974. Additional differences between study years (e.g., incidence of oral/anal intercourse during assaults as well as administration of pregnancy prophylaxis and antibiotics) are also presented. Implications of these findings concerning rates of acquaintance rape, reporting rates, and changes in treatment practices are discussed.