Patient education: Care after sexual assault (The Basics)

What is sexual assault? — Sexual assault, or sexual violence, is any sex act done on a person without their consent. "Consent" means wanting and agreeing to do something.

The word "rape" is often used to describe forced vaginal, anal, or oral sex. This is a type of sexual assault. But any type of unwanted sex act is considered sexual assault. This includes kissing or touching another person without their consent.

A person can be sexually assaulted by a stranger or by someone they know, such as an acquaintance, partner, or relative.

How do I know if I have been sexually assaulted? — If someone does something without your consent, this is sexual assault. If you gave consent but then changed your mind, and the person does not stop, this is also assault.

Sexual assault can involve someone threatening you to make you do something, or physically forcing you to do something. It can also happen if you are drunk, passed out, or asleep. Even if the other person is not violent, you cannot give consent if you are not awake or thinking clearly.

If you were the victim of sexual assault, it is not your fault. Sexual assault is common, and you are not alone.

What should I do if I am sexually assaulted? — The first thing you should do is find a safe place away from the person who assaulted you. Then:

●Talk to a close friend or family member. Choose someone you trust who will give you support no matter what.

●Do NOT try to clean up before you get medical care. Doing this can wash away proof of what happened. In particular:

•Do not change clothes.

•Do not take a shower or bath.

•Do not brush your teeth.

•Do not wash the inside of your vagina or rectum.

•If you can wait, try not to go to the bathroom or eat anything until after you have seen a doctor or nurse.

●Call your doctor or nurse or go to the emergency department. Your doctor or nurse can offer advice on what to do and the best place to get help. In the emergency department, a doctor or specially trained nurse will talk with you and ask you questions about what happened. They will also do an exam and check for injuries to your genitals, mouth, or other body parts. Depending on the situation, they might offer you medicine to lower the chances of pregnancy or help prevent certain infections.

If you say that it's OK, the doctor or nurse can take samples of cells or fluid from your body and clothes. These samples can show who assaulted you and what they did. The doctor or nurse might also ask to take pictures of your injuries. You do not have to let them do anything you do not want.

You can always go to the emergency department in your local hospital. But if you are in the US and need help finding a place to go for care, you can call the sexual assault hotline at 1-800-656-HOPE (1-800-656-4673). Help is also available online at www.centers.rainn.org.

●Find a counselor who can support you. Good options include a crisis counselor, a social worker, a sexual assault nurse examiner, or your own doctor or nurse. If you are not sure who to call, your doctor or nurse or the hospital staff can help you find someone.

●Talk to your counselor about filing a police report. They can talk to you about your options and help you decide if this is something you want to do. They can also explain what steps to go through and what to expect if you choose to report your assault.

●See your doctor or nurse again 1 to 2 weeks later. They will talk to you about how you are feeling and check on how your injuries are healing. They might also do tests to check for pregnancy or infections that can be spread through sex.

Your doctor or nurse will also talk with you about how to protect yourself and others as you continue to heal. For example:

•They might advise you to use a condom if you choose to have sex within the next few months. That way, your partner(s) will be protected if you have an infection.

•They might also advise you to wait several months before trying to get pregnant, if this is something you are planning.

●Find out about "victim compensation services." Some states have programs that give money to victims of sexual assault. Your doctor, nurse, or counselor can help get you information about this if needed.

Remember, sexual assault is never the victim's fault. It might be hard to talk about what happened to you, but your doctor, nurse, or counselor is there to help.

What treatments might I get after a sexual assault? — It depends on your situation and what injuries you have. You might get treatment to:

●Fix serious injuries – For example, if you have any cuts or broken bones, these will be treated right away so they can heal properly.

●Prevent infections – You might get antibiotics, vaccines, or other medicines to help prevent certain sexually transmitted infections ("STIs").

●Lower the risk of pregnancy – If there is a chance that you could have gotten pregnant from the assault, you can take medicine to try to prevent this. This is called "emergency contraception." Emergency contraception pills can work if taken up to 5 days after unprotected sex, although the sooner you take them, the better they work. One form of emergency contraception, levonorgestrel (sample brand names: Plan B One-Step, Next Choice One Dose), is also available without a prescription at many pharmacies and at clinics like Planned Parenthood. This type should be used within 3 days of unprotected sex.

●Help you cope with your feelings – It is common to have lots of different emotions after a sexual assault. There are treatments that can help.

What if it has been a while since I was attacked? — Even if you did not get medical care immediately after the assault, see a doctor or nurse anyway. It doesn't matter if they can't collect proof of the attack. They can still help you understand your risk of infection or pregnancy and help you recover from the event. They can also make sure that you have the support you need, and offer advice on reporting the assault if you want to.

What if I do not want to report my assault? — At first, many people do not want to report their assault. You don't have to if you don't want to. But people often change their mind later.

●If you do not want to report the event, it can be useful to speak with a doctor or nurse anyway. They are trained to help. In most states, doctors and nurses can collect evidence without giving it to the police. Evidence is most useful when it is collected as soon as possible after the assault.

●If you see a doctor or nurse, they can take samples and write down your description of what happened. That way, if you decide you want to report the event later, the evidence has already been collected. You can also report an event later even if you have not seen a doctor or nurse.

What if I am still struggling? — It is common to feel stressed, worried, angry, or sad for some time after a sexual assault. These feelings can last even after your body has healed.

If you are struggling with feelings of depression or anxiety, or having trouble sleeping or doing your normal activities, tell your doctor or nurse. They can help you get the support and treatment you need. In the US, you can also call the National Sexual Assault Hotline at 1-800-656-HOPE (1-800-656-4673).

More on this topic

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Patient education: Intimate partner violence (The Basics)

Patient education: Care after sexual assault (Beyond the Basics)
Patient education: Emergency contraception (Beyond the Basics)