1. In theUS, one in three women will be a victim of sexual assault during her lifetime
2. In theUS, 7-10% of sexual assault victims are male.
3. In theUS, only 10-15% of sexual assaults are reported to the police
4. Evaluation of sexual assault victim should be performed by a trained provider.
5. Evaluation of sexual assault victim: Do psychological assessment
6. Evaluation of sexual assault victim: Evaluate areas of trauma; examine breasts, pelvic, anorectal areas.
7. Evaluation of the sexual assault victim: Do colposcopy if possible, to detect genital trauma.
8. Evaluation of the sexual assault victim: Do it as soon as possible after an assault.
9. Evaluation of the sexual assault victim: Screening for sexually transmitted disease not necessary if prophylactic treatment is to be given.
10. Evaluation of the sexual assault victim: Test for pregnancy testing in women of childbearing age.
11. Evaluation of the sexual assault victim: Do baseline tests for syphilis, hepatitis B
12. Evaluation of the sexual assault victim: Provide HIV counseling
13. Provide empiric treatment of sexually transmitted infections if the patient has declined testing for STD.
14. Empiric therapy for sexual assault victim: Ceftriaxone 250 mg IM for gonorrhea
15. Empiric therapy for sexual assault victim: Azithromycin 1 gram oral stat or doxycycline 100 mg oral twice daily for 7 days for chlamydia.
16. Empiric therapy for sexual assault victim: Metronidazole 2 grams oral stat for trichomoniasis.
17. Empiric therapy for sexual assault victim: Hepatitis B vaccine if not been previously immunized.
18. Empiric therapy for sexual assault victim: Prophylactic treatment for HIV is controversial.
19. Empiric therapy for sexual assault victim: The risk of HIV is low. But most recommend treatment if can be given in < 72 hours and ideally within 4 hours.
20. Empiric therapy for sexual assault victim: Give post coital contraception
21. Empiric therapy for sexual assault victim: Acute crisis counseling should be offered.
22. Sexual assault victim: Many patients experience psychological and physical symptoms over many months following the assault.
23. Sexual assault victim: Follow-up at 2 weeks, with psychosocial counseling, STD testing for patients who did not take empiric therapy or who have symptoms, and pregnancy testing.
24. Sexual assault victim: Give Hepatitis B vaccine at one and six months to complete the vaccine course
25. Sexual assault victim: Repeat HIV and RPR testing at 12 and 24 weeks; some also recommend testing at six weeks.
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