Article Text

Download PDFPDF
Sexually transmitted infections diagnosed in individuals presenting for forensic and medical care following sexual assault
  1. Vanita R Parekh1,2,
  2. Sarah J Martin1,2,
  3. Alexandra Tyson1,
  4. Anna Brkic1,
  5. Janine McMinn1,
  6. Cassandra Beaumont3,
  7. Francis J Bowden4
  1. 1 Clinical Forensic Medical Services, Canberra Health Services, Canberra, Australian Capital Territory, Australia
  2. 2 School of Clinical Medicine, Canberra Hospital Campus, Australian National University, Canberra, Australian Capital Territory, Australia
  3. 3 Canberra Hospital, Canberra Health Services, Canberra, Australian Capital Territory, Australia
  4. 4 Faculty of Medicine, Monash University School of Rural Health - Bendigo, Bendigo, Victoria, Australia
  1. Correspondence to Dr Vanita R Parekh, Clinical Forensic Medical Services, Canberra Health Services, Canberra, ACT 2605, Australia; vanita.parekh{at}act.gov.au

Abstract

Background People who report sexual assault express concerns regarding contracting sexually transmitted infection (STI); however, published literature regarding the risk of STI transmission in this context is sparse.

Method We audited STI and blood-borne virus (BBV) testing at a forensic and medical sexual assault care service in the Australian Capital Territory between 2004 and 2022. Eligibility for testing among 1928 presentations was defined based on risk (eg, reported penetration). Testing at presentation included chlamydia and gonorrhoea 1850, syphilis and BBV 1472, and after 2–6 weeks, 890 out of 1928 (46.2%) and after 3 months 881 out of 1928 (45.7%), respectively.

Results At presentation, 100 out of 1928 (5.2%) individuals were diagnosed with chlamydia, of those, 95 out of 1799 (5.3%) were female, and 5 out of 121 (4.1%) were male. Gonorrhoea was diagnosed in 7 out of 1920 (0.4%), 5 out of 95 female and 2 out of 5 male. Hepatitis B, which was all pre-existing, was diagnosed in 5 out of 1799 (0.3%). Overall, chlamydia prophylaxis was given to 203 out of 1928 (10.5%) and HIV post-exposure prophylaxis to 141 out of 1928 (7.3%).

At 2–6 weeks of follow-up, 10 out of 890 (1.1%) individuals were diagnosed with chlamydia, with no gonorrhoea diagnosed. There were no cases of syphilis, hepatitis B or HIV diagnosed at 3-month serology testing in 881 individuals. Chlamydia detection at follow-up was more common in the group aged 15–29 years. Of those provided with chlamydia prophylaxis, 203 out of 1928, only 16 out of 203 (7.9%) were diagnosed with chlamydia.

Conclusions The offer of STI testing is almost universally accepted by individuals presenting for post-sexual assault care. There were no identifiable factors to justify the routine use of chlamydia prophylaxis. STI testing provided an opportunity for screening and should remain part of the clinical care of people who report sexual assault.

  • sexual assault
  • chlamydia infections
  • sexual health
  • antibiotic prophylaxis
  • post-exposure prophylaxis

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Handling editor Bea Vuylsteke

  • Collaborators Extensive contributions were made by FAMSAC staff, laboratory analysis by Karina Kennedy, Michael DeSouza, and Lynette Chairuka. Michael Peek, Therese Toohey, Hugh Selby, and Bernard McMinn provided instrumental input.

  • Contributors Sexually transmitted infections diagnosed in individuals presenting for forensic and medical care following sexual assault. Conceptualisation: VRP, AB, JM, CB, FJB, HS, AT, SJM, MP. Methodology: JM, VRP, AB, CB, FJB. Software: JM, AB, VRP, CB. Validation: JM, VRP, AB. Formal analysis: JM, VRP, FJB, AB, SJM, AT, CB. Investigation: VRP, JM, AB, FJB, SJM, AT, CB. Resources: VRP, AB, JM, TT, MP, AM, AT, CB. Data curation VRP, JM, AB, KK, MD, LC, SJM, AT. Writing—original draft: VRP, JM, FJB, AB, SJM, AT, HS, JM, AB, BM, CB. Writing—review and editing: VRP, JM, FJB, AB, SJM, AT, CB, HS, BM, CB. Visualisation: JM, VRP, AB, AT, SJM. Supervision: FJB, VRP, AB, JM. Project administration: AB, VRP, JM.

  • Funding Publication was funded by the Canberra Hospital Private Practice Fund, the ACT Government and an Australian Government Research Training Programme.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.