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Sex and rape; Date rape; Sexual assault
Rape is defined as sexual intercourse forced on a person without his or her permission, either by threat of force or on someone who is unable to give consent.
Sexual intercourse may be vaginal, anal, or oral, and may involve the use of a body part or an object.
According to most estimates, 80% - 90% of rapes are not reported to police. Current trends project that 1 in 3 American women will be sexually assaulted at some point during her life.
The typical rape victim is a 16 - 24-year-old woman. Anyone, however -- man or woman, adult or child -- can be the victim of rape. Other important facts about rape include:
Date rape occurs when someone forces another person they are dating or spending time with to have sex. Date rape may involve the use of drugs such as flunitrazepam (Rohypnol).
Rape is a violent act, and is most often committed by a male upon a female. However, some cases of rape have been reported in which a woman has raped a man.
The best response when being attacked may depend on both the victim and the situation. Attempting to get away and yelling for help is a good first step in most situations. Whether to fight back may depend on the size and behavior of the attacker, as well as whether he is armed.
AFTER A RAPE HAS OCCURRED
The victim may be acquainted or even live or work with a person who committed sexual assault. It is essential that rape victims be placed in an environment afterwards where they feel safe.
Victims of rape should be helped to understand that nothing about what happened was their fault. Nothing that they did should have allowed someone to have sex with them against their will. This includes dressing suggestively, or even kissing or performing other physically intimate activities with the person. Any fault or blame is solely on the rapist.
People who are raped may or may not be able to say that they were raped or seek help. Some may seek medical help for a different complaint, such as headaches, eating problems, pain, and sleep problems.
Emotional reactions differ greatly and may include:
Other physical problems are often present as well. Emergency room staff are specially trained to deal with all of these situations.
MEDICAL EXAMS AND TESTS AFTER RAPE
Seeking medical care after a rape is important. This should be done without changing clothes, showering, douching, or urinating.
Some people may wish to report the rape as a crime, while others may not want to report it. This can be a difficult decision, and no one should be forced into making a choice right away. Some people will change their minds about reporting the rape as a crime in the future.
In many cities, rape cases are referred to specific emergency rooms. This provides more specialized care, and assures that proper procedures are followed to maintain the "chain of evidence" necessary for a case that may go to trial. Most state laws require that the person be evaluated in the emergency room before the rape is officially reported.
While in the emergency room:
The health care providers will take a history in a supportive and nonjudgmental way. This will include the details of the attack:
If possible, this interview should be done with both health care providers and police present. However, even if you at first think you do not want to report this crime, it is important to have this interview with the health care team at least, as you may feel differently after a period of time. The evidence, including the history of what happened, is most accurate when obtained right away.
Other medical history information that is taken includes:
A complete physical examination should be done to document any signs of trauma. Pictures may be taken to note bruises, scrapes, or cuts. X-rays will be taken if the health care provider suspects fractures.
Many samples may be collected for evidence, including:
Blood tests and cultures will be done to check for the chance of pregnancy, infections, and to see if you were given a rape drug.
Treatment focuses on providing emotional support, while attempting to collect enough evidence to confirm the rape.
Treatment for the immediate physical and emotional trauma includes:
If there is a chance that the rapist is HIV-infected, the health care providers should explain and offer postexposure prophylaxis (PEP, a way to reduce the odds of infection immediately using antiretroviral medications).
Ongoing emotional support and therapy are key. Support groups, one-on-one talk therapy, or talk therapy groups can help a rape survivor work through his or her feelings and gain emotional strength. Victims often learn that talking about their memories and emotional pain is the best way to rebuild their lives.
Referral to a local rape crisis center may be helpful. These centers offer peer support and advice to help in recovery from the trauma.
Victims of rape struggle through a number of symptoms:
Many rape victims have difficulty in re-establishing relationships with spouses or partners or, if single, in re-entering the "dating scene."
Rape may worsen any pre-existing psychiatric disorders. Suicidal behaviors, depression, and substance abuse may develop or become more prominent.
However, working through these problems using therapy and support groups, rather than avoiding them, has been shown to be helpful in treating these symptoms and avoiding more chronic emotional problems.
Slaughter L. Sexual assault. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 64.
Lentz GM. Rape, incest, and domestic violence: Discovery, management, counseling. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 10.
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