women s health issues
Sexual Assault and Rape
Treatment of Rape and Sexual Assault
Treatment of any physical injuries Drugs and sometimes vaccines to prevent infections, including HIV infection Emergency contraception if the woman wants it Psychologic support or intervention After the examination, the victim is offered facilities to wash, change clothing, use mouthwash, and urinate and defecate if needed. Any physical injuries are treated. Tears in the genitals or anus may need to be surgically repaired. Treatment can be effectively treated with psychotherapy and drug therapy. Health care practitioners explain the psychologic reactions that commonly occur after a sexual assault (such as excessive anxiety or fear or guilt) to the victim. This information can help victims accept and deal with their reactions. Practitioners also reassure the victims that the assault was not their fault and provide general support. As soon as feasible, a person trained in rape crisis intervention meets with the victim. Victims are referred to a rape crisis team if one is located in the area. This team can provide helpful medical, psychologic, and legal support. For victims, talking about the rape and their feelings about it can help them recover. If victims continue to have symptoms after the rape, they may be referred to a psychologist, social worker, or psychiatrist. Family members and friends may have some of the same feelings as the victim: anxiety, anger, or guilt. They may irrationally blame the victim. Thus, in addition to their own feelings, rape victims may have to handle negative, sometimes judgmental or other negative reactions of family members and friends, as well as those of officials. These reactions can interfere with recovery. Family members or close friends may benefit from meeting with a member of the rape crisis team or sexual assault evaluation unit to discuss their feelings and how they can help the victim. Usually, listening supportively to the victim and not expressing strong feelings about the assault are most helpful. Blaming or criticizing the victim may interfere with recovery. A support network of health care practitioners, friends, and family members can be very helpful to the victim. Sexually transmitted infections are treated with antibiotics. Victims who have not been vaccinated against hepatitis B are given the vaccine, followed by two more doses, at 1 month and 6 months after the first dose. The Human Papillomavirus (HPV) Vaccine is given after a rape to people aged 9 to 26 years if they are unvaccinated or incompletely vaccinated. If test results for HIV are positive, the victim probably had HIV infection before the rape because HIV infection acquired through sexual intercourse typically cannot be detected until 9 days to 6 months later. If test results for HIV are positive, Antiretroviral Treatment of Human Immunodeficiency Virus (HIV) Infection is started immediately. If test results for HIV are negative, the HIV test is repeated several times over the next several months. Drugs to prevent HIV infection may be offered to the victim. On average, the chance of developing HIV infection after rape from an unknown assailant is low. Risk may be higher if any of the following occurred: Anal penetration Bleeding (from the assailant or victim) Male-male rape Rape by several assailants (as may happen to men in prison) Rape that occurs in areas where HIV infection is unusually common Treatment to prevent HIV infection is most effective if startedwithin4 hours after penetration and should not be given ifmore than72 hours have passed since penetration. Emergency Contraception is provided if the woman wants it and has a negative pregnancy test. Usually, it consists of a high dose of a hormonal drug given immediately by mouth, then repeated 12 hours later. Inserting an intrauterine device (IUD) within 5 days of the rape is also effective at preventing pregnancy. If pregnancy results from the rape, doctors counsel women about their options, including continuing the pregnancy or abortion. 