Management of female sexual assault.

A sexual assault occurs once every 6.4 minutes in the United States. One in every six women will be raped during her lifetime. Although a woman is four times more likely to be assaulted by someone she knows than by someone she does not know, the majority of these crimes go unreported even though rape is a felony. The purpose of the medical examination after a sexual assault is to assess the patient for physical injuries and to collect evidence for forensic evaluation and possible legal proceedings. Laboratory samples should be obtained at the initial visit and should include testing for pregnancy, syphilis, hepatitis B and human immunodeficiency virus infection. Treatment should address physical injuries, pregnancy prophylaxis, sexually transmitted diseases and psychosocial sequelae. Appropriate referral services should be initiated during the initial visit. Victims of sexual assault require appropriate care, follow-up and information regarding their legal rights. Family physicians should be familiar with the state laws governing collection of evidence and should be prepared to advise the patient to report the crime. The history should be confined to medically relevant facts and should be conducted in a safe and quiet environment.