Each year in the United States, according to the U.S. Department of Justice, more than 270,000 people are raped or sexually assaulted. The number is shocking enough. Also shocking is what happens afterward -- or what doesn't happen.
Too many of them don't get the medical care that they urgently need.
In a study published in June in the journal Contraception, researchers at the John H. Stroger Jr. Hospital of Cook County in Chicago identified 10 services they said should be offered to victims, usually women, after a sexual assault, such as rape crisis counseling and preventive treatment of sexually transmitted diseases. They then queried 187 emergency departments across Illinois (156 of which responded) and found that fewer than 1 in 10 routinely provided all of the services.
All of the emergency rooms provided medical care to assault victims, but just two-thirds offered rape crisis counseling and only 40% made emergency contraception available to their patients. Roughly two-thirds reported that they tested and treated for sexually transmitted infections, and less than one-third provided precautionary HIV treatment.
Other studies have shown similar results. A national study published in 2007 in the American Journal of Health-System Pharmacy looked at the treatment provided to almost 180,000 sexual assault or rape victims nationally in 2003. Antibiotic treatment to protect against sexually transmitted infections was provided in less than 10% of cases. A 2004 study of Pennsylvania emergency departments, published in the International Journal of Fertility and Women's Medicine, found that less than half routinely offered emergency contraception counseling.
"It's such a terrible event that happens in the lives of so many people in this country," says Dr. Ashlesha Patel, lead researcher in the Illinois study. "And it's simply not being taken care of in the way it should be."
Sexual assault victims require not just a careful forensic exam to obtain evidence for potential criminal proceedings, but also treatment for physical injuries and protection against pregnancy and infections such as HIV, gonorrhea, chlamydia and syphilis.
Rape crisis counseling is also crucial. Victims experience a variety of psychological reactions after an assault. Some grow fearful or anxious; others feel guilty or confused. All of them need an advocate -- often available through a rape crisis center -- to inform them of their medical and legal options, to support them through the treatment and reporting processes and to help them face their own reactions.
