Introduction During a sexual assault (SA), female victims may become infected with sexual transmitted infections (STI). Because of possibly high infection rates and low percentage returning for treatment, several STI clinics provide empiric antimicrobial therapy at the first consultation. The objective of this study was to assess the STI prevalence and follow-up of female sexual assault victims (SAV) at the STI clinic of Amsterdam, the Netherlands.
Methods In the electronic patient database, SA is recorded as one of the reasons for visiting the clinic. We collected routine clinical data from the period 2005–2016. Characteristics and STI screening results of SAV and non-victims (NV) were compared. Backward multivariable logistic regression analysis was conducted to assess whether SAV was associated with STI positivity (chlamydia, gonorrhoea, infectious syphilis, infectious hepatitis B, and/or HIV).
Results Between 2005 and 2016 166,808 STI consultations were performed with female clients and in 1066 consultations SA was reported. In 96% of the assaults no condom was used. All the assailants were male. Forensic examination was performed in 22% of the cases. Prior to the STI clinic consultation, in 10% an HIV test had been performed, 27% were vaccinated for hepatitis B and in 11% a pregnancy test was performed. SAV were less often Dutch (60% vs. 68% in NV, p<0.001), the median age was 24 years (vs. 24 in NV, p=0.003) and 34% reported STI related complaints (vs. 24% in NV, p<0.001). STI positivity was 11.7% in SAV and 11.8% in NV (p=0.53). In the multivariable analysis being an SAV was not associated with STI (OR 0.99; 95% CI 0.82–1.19). 91.3% of the SAV requiring antibiotics returned to the clinic.
Conclusion The STI positivity in female SAV was comparable to NV attending the STI clinic. The return rate for treatment was high and does not support empiric prophylactic antimicrobial therapy. As most victims were not tested for HIV, and did not receive a hepatitis B vaccination after the assault, STI clinics can play a key role in providing care to SAV including STI testing.
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