S

sexual assault Unwilling, unconsenting, or
forced sexual interaction. Sexual assault involves
implied or actual use of VIOLENCEto force compli-
ance and is an act of violence, not an act of sexual
gratification. Sexual assault is also criminal act and
has potentially serious health consequences. Rape
is sexual assault in which there is attempted or
completed penetration of the VAGINA, ANUS, or
MOUTHby the PENIS, finger, or an object. In some
states the legal term for penetration other than
vaginal is sodomy.Incest is sexual assault in which
the perpetrator is a family member and may occur
as a form of CHILD ABUSE.
Women, men, and children may be the victims
of sexual assault. Those at highest risk are women
between the ages of 16 and 20. About 100,000
sexual assaults are reported to police in the United
States each year, which health experts believe rep-
resents perhaps only 1 in 4 of sexual assaults that
actually occur. Sexual assault in which the victim
is male is even less frequently reported.

Legal Issues of Sexual Assault

Though it is a natural desire to immediately bathe
or shower after a sexual assault, it is crucial to first
seek medical attention. SEMENand other bodily
fluid samples are essential for identifying the per-
petrator of the assault, even when the victim
knows the assailant. Hospital emergency depart-
ments often have staff (sexual assault nurse exam-
iners) who have special training in obtaining such
samples and conducting sexual assault examina-
tions that are in compliance with the standards of
legal evidence. Most hospitals have sexual assault
advocates and support services they contact who
can provide assistance for the victims of sexual
assault.

Health Issues of Sexual Assault

Traumatic injury resulting from forceful penetra-

tion, SEXUALLY TRANSMITTED DISEASES (STDS),

unwanted PREGNANCY, and emotional trauma are

the key health issues of sexual assault. Doctors

may recommend or administer (with consent)

emergency CONTRACEPTION when pregnancy is a

possibility. Doctors also typically offer ANTIBIOTIC

PROPHYLAXISas a defense against STDs, with recom-

mended follow-up testing for STDs that have

longer incubation periods or are viral, such as HEP-

ATITIS, HIV/AIDS, SYPHILIS, and GONORRHEA.

The emotional consequences of sexual assault

can be long lasting and significant. Doctors recom-

mend counseling even when the person does not

feel it is necessary. ACUTE STRESS DISORDERandPOST-

TRAUMATIC STRESS DISORDER (PTSD) are common.

Sexual assault may result in prolonged inability to

form intimate relationships or enjoy sexual part-

nerships, either in existing circumstances such as

marriage or in subsequent circumstances.

Risk Reduction Measures

Because sexual assault is a criminal act of violence

that is often random, it is not possible to com-

pletely prevent attack. However, law enforcement

officials recommend these measures to reduce the

risk for sexual assault

• maintain high awareness of one’s surroundings,
  particularly during times of darkness (including
  early morning hours especially in the winter)


• when walking alone, walk at a purposeful
  stride and in the center or closer to the curb
  side of sidewalks


• do not enter a car, home, or other setting if
  anything about it seems suspicious

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