Intended for healthcare professionals

Student Education

Protocols for managing the victims of sexual assault

BMJ 2004; 328 doi: (Published 01 May 2004) Cite this as: BMJ 2004;328:0405186
  1. Emma Wall, fourth year medical student1,
  2. Jan Welch, clinical director1
  1. 1Guy's King's, and St Thomas's School of Medicine, London
  2. 2The Haven Camberwell, King's College Hospital, London

As doctors, we will undoubted meet people who have been sexually assaulted and this requires specialist care. Emma Wall and Jan Welch explain how to manage victims of rape

Rape is common and victims may present in any number of medical settings (box 1). As well as victims' need for good medical care, evidence collection should be considered so that rapists can be identified and convicted. Throughout most of the United Kingdom, services for people who have been sexually assaulted are uncoordinated, of poor quality, and conviction rates are low. This is beginning to change as more specialist sexual assault referral centres are developed, which can provide care tailored to individual needs and concerns (box 2).

Box 1: Key facts

  • The recently reviewed legal definition of rape is the non-consensual penile penetration of the vagina, anus, or mouth1

  • Lifetime risk of being a victim of rape is 1 in 4 to 1 in 6 for women24

  • Adolescents and women under 25 are most at risk46

  • Approximately 10% of complainants are men57


Box 2: Integrated care of victims of sexual assault

Distress caused by the initial assault may be exacerbated by prolonged waiting and poor continuity of care in an environment not conducive to recovery.12 These problems have been tackled by sexual assault referral centres, which offer an integrated specialist service for victims of sexual assault. Facilities available include the treatment of minor injuries, emergency contraception, screening and treatment of sexually transmitted infection, psychosocial care, and forensic examination. Reporting of sexual assaults is encouraged and some centres provide opportunities for victims to provide anonymous evidence and intelligence. It is hoped that, as well as promoting recovery following assault, these centres may also help in increasing the number of convictions for sexual crimes. There are now eight sexual assault referral centres in the United …

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