A care package for managing female sexual assault in genitourinary medicine

Stranger rape; distinctions between the typical rape type and other types of rape. A study based on data from Center for Victims of Sexual Assault

OBJECTIVE

The aim of this descriptive cohort study was to characterize stranger rape compared to other types of rape.

METHOD & MATERIALS

All cases of women aged 12 years or older, who contacted a Center for Victims of Sexual Assault in the region of Southern Denmark and underwent a forensic examination in 2018, were collected and analyzed. Descriptive frequencies, Pearson's χ²-test and Fisher's exact-test were performed.

RESULTS

Compared to other types of rape, stranger rape were reported to the police more frequently, earlier and more frequently independently, without contact to family, friends or other authorities. In cases of stranger rape women were exposed to threats and violence more often, and clinical findings were found to coincide with the women's report more frequently. Regarding the offenders' level of planning, it was not possible to find significant differences between stranger rape and other rape types by comparing frequencies of the offenders' use of condoms and weapons and/or other remedies as surrogate markers for degree of planning.

CONCLUSION

There were several significant characteristic differences between stranger rape and other types of rape. Characterizing the 'archetypical rape' in opposition to other and more frequent types of rape, may give the public, the police, the courts and aid organizations the background needed to understand the importance of rape typologies when handling cases of sexual assault.

Health care-based interventions for women who have experienced sexual violence: a review of the literature

Thirty publications that evaluated health care-based interventions for women who experienced sexual violence were reviewed. The findings highlight that clinicians often need training in the provision sexual assault care, and that not all emergency departments have sexual assault care protocols. Studies examining effectiveness found that Sexual Assault Nurse Examiner programs are very helpful, that health care-based sexual assault treatment settings attract more women than do forensic-based settings, that sexual assault survivors often prefer a combination of medication and counseling treatment, and that preexam administration of a video explaining the collection of forensic evidence may reduce women's stress during the procedure. Studies on postexposure HIV prophylaxis found that many women did not complete the treatment regimen, often because of side effects. Emergency contraception to prevent postrape pregnancy is not consistently offered to women. Only one study reported on abortion as part of the range of sexual assault services.

Measuring the quality of medical care for women who experience sexual assault with data from the National Hospital Ambulatory Medical Care Survey

STUDY OBJECTIVE

We provide new descriptive epidemiology on the demography and quality of care of women who experience sexual assault. Two limited aspects of emergency department treatment received by women who have experienced sexual assault are examined: (1) administration of emergency contraception to prevent pregnancy and (2) screening and treatment for sexually transmitted diseases (STDs).

METHODS

A nationally representative survey on the basis of 7 years of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) was analyzed. Estimates of mean numbers of patients treated and characteristics of patients are reported for administration of emergency contraception and compliance with STD guidelines.

RESULTS

Analysis shows that the number of rapes per year reported in the NHAMCS data is highly consistent with the number of forcible rapes reported by the Federal Bureau of Investigation. Results show statistically significant differences in patients who receive screening on the basis of age and also suggest that the same difference exists for STD medications received. Accounting for differences in screening and medications by age does not completely explain why a large portion of the patients are neither screened nor receive STD medications.

CONCLUSION

Women are not receiving the full complement of treatment, as suggested by the Centers for Disease Control and Prevention guidelines. Administration of emergency contraception is less frequent in the NHAMCS sample than in hospitals with a sexual assault treatment program that report administration of emergency contraception. It is important to assess care for patients experiencing sexual assault in a nationally representative sample to identify deficiencies in treatment and areas in need of improvement.