Summary points

• Rape and sexual assault are common, particularly among young women although men and children may also be assaulted

• Perpetrators are usually known to those they assault

• People who have been sexually assaulted often seek medical help but may not disclose the assault

• Management includes treatment of injuries; emergency contraception; prevention of infections, including HIV; and psychosocial support

• Although many people experience psychological symptoms after rape, most recover

• A minority of people after assault have significant and disabling persistent symptoms that require specialist intervention and active treatment

• Collection of evidence may be crucial in identifying and prosecuting perpetrators

• Optimal acute management is the provision of all necessary services in one place and in a sensitive, safe, and forensically secure environment

Sources and selection criteria

We searched Medline using the term “sexual assault”. We also took account of the Cochrane review of interventions for emergency contraception and for trauma related symptoms and the prevention of post-traumatic stress disorder. Guidance from the National Institute for Health and Clinical Excellence and national and World Health Organization guidelines were also considered. We searched our personal archives of references and consulted experts.