Sexual assault

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Background

  • Male victim in 10% of cases
  • Toluidine blue: detects vulvar tears
  • Wood's lamp: detects semen stains

Risks

  • Pregnancy
    • Without contraception 1-5%
    • If mid-cycle (days 14-16) risk is higher
  • STD (5-10%)
  • HIV
    • Consensual vaginal intercourse 0.1-0.2%
    • Consensual receptive anal intercourse 0.5-3%

Clinical Features

  • History of sexual exposure

Differential Diagnosis

Genitourinary trauma

Evaluation

General

  • Check for life threats first
  • Ask patient not to change, shower, eat, or drink
  • Defer GU examination
  • Contact SANE (sexual assault nurse examiner), if patient consents, and police (if report not already filed and patient consents, or if required by law)

Labs

  • Pregnancy test
  • Rapid HIV
  • consider hepatitis panel, RPR
  • GC/chlamydia, if not collected by SANE
  • Basic labs, LFTs, if considering HIV PEP

Management

Other STDs

There is currently no PEP for Hep C

Disposition

  • Typically outpatient

See Also

External Links

References