Follow-up of sexual assault victims,☆☆,

Presented as Official Guest at the Sixtieth Annual Meeting of The South Atlantic Association of Obstetricians and Gynecologists, Lake Buena Vista, Florida, January 24-27, 1998.
https://doi.org/10.1016/S0002-9378(98)70361-8Get rights and content

Abstract

OBJECTIVES: Our goal was to describe medical findings and health-related concerns of sexual assault victims who returned for follow-up and to assess demographic and assault characteristics of victims who used follow-up services compared to those who did not.

STUDY DESIGN: This study is a retrospective cohort analysis involving records from two sources: the acute sexual assault evidentiary examination and the SAFE (Sexual Assault Follow-up Evaluation) Clinic visit. Data were extracted from the records of 389 adolescent and adult victims who reported an acute sexual assault and underwent a complete evidentiary examination between January 1, 1995, and June 30, 1997. Descriptive statistics were generated on demographic and historical information, assault characteristics, and medical and laboratory findings. For the subgroup that presented for follow-up, additional descriptive statistics were generated to describe their interim history, concerns, medical outcomes, treatments, and psychosocial functioning. χ2 analyses were used to identify differences in the group that returned for follow-up compared with the group that did not. Statistical significance was defined as P < .05.

RESULTS: There were no differences in age, race, or perpetrator factors between patients who used follow-up services and patients who did not return to the SAFE Clinic. Similarly, there were no other assault characteristics, relationships, or physical examination findings that were associated with follow-up patterns. A total of 31% (n = 122) of all sexual assault victims returned for a follow-up visit. Physical complaints were reported by 42.6%, but 98.0% had normal findings at a general examination, and 94.8% had a normal result of gynecologic examination. Pregnancy and sexually transmitted diseases, including human immunodeficiency virus, were identified through the follow-up clinic. Since the assault, 49.2% had been sexually active, 10% with multiple partners and 73.3% without consistent condom use. Disturbances in sleep, sexual function, and appetite were commonly reported among victims at follow-up. Numerous assault-related fears were reported.

CONCLUSIONS: Among recent rape victims, follow-up rates are low, and there are no factors that correlate with the use of follow-up services. Those who do come in for follow-up have physical complaints and health-related concerns that are related to their recent assault, but most have normal physical findings. Efforts to reach sexual assault victims will require aggressive and innovative strategies to remain in contact with women and girls after rape. (Am J Obstet Gynecol 1998;179:336-42.)

Section snippets

Methods

This study was approved by the institutional review board as a retrospective cohort analysis involving records from two sources, the acute sexual assault evidentiary examination and the SAFE Clinic visits. Data were extracted from records of female adolescents and adults (aged ≥12 years) who reported an acute sexual assault and underwent a complete evidentiary examination between January 1, 1995, and June 30, 1997. Cases were excluded if the assault did not represent a completed sexual assault

Results

There were 389 of 411 cases that met the study criteria and were included in the analysis. The average age of the victim was 24.3 (±10.2) years with a range of 12 to 88 years. African Americans composed 43% of the victims, and 55% were white. The average age of the assailant, or the youngest assailant if there were more than one, was 27.3 (±9.1) years with a range of 13 to 68 years (366 victims either knew the age of the assailant or made an estimation; if an age range was estimated, the lower

Comment

This study describes medical outcomes of female adolescents and women seen for follow-up of a sexual assault and analyzes characteristics associated with utilization of follow-up health care services. Our institution is the designated site for all sexual assault evidentiary examinations in a tricounty area serving a moderate-sized southern city. Our overall sample of sexual assault victims is similar to previous reports in age, race, assault characteristics, and physical findings.10, 13, 14

References (23)

  • Council on Scientific Affairs et al.

    Violence against women: relevance for medical practitioners

    JAMA

    (1992)
  • Cited by (83)

    • Mental health, sexual violence and the work of Sexual Assault Referral centres (SARCs) in England

      2015, Journal of Forensic and Legal Medicine
      Citation Excerpt :

      Despite the clear links between sexual violence and mental health disorders, self-harm, and suicidal intention only 10% of people in the “extensive physical and sexual abuse” group were currently in receipt of counselling or a talking therapy. Other studies have shown only 26% of those who are the victims of sexual violence receive follow-up mental health care.1,7 Whilst only a minority of victims obtain mental health care, those so do receive immediate support have reported improved mental health symptoms.2,3

    View all citing articles on Scopus

    From the Department of Obstetrics and Gynecologya and the Department of Psychiatry and Behavioral Sciences,b Medical University of South Carolina.

    ☆☆

    Reprint requests: Melisa M. Holmes, MD, 171 Ashley Ave, Charleston, SC 29425.

    0002-9378/98 $5.00 + 0   6/6/91625

    View full text