After sexual assault: a survival guide

Robin Wulffson MD's picture
sexual assault, rape,sexual predator, rape crisis center, survival guide
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According to a new study by the Centers for Disease Control and Prevention (CDC), which was released on December 14, sexual assault is far more common than previously thought. The survey found that nearly one in five women responded that they had been raped or had experienced an attempted rape at some point; furthermore, 25% reported having been beaten by an intimate partner and 16% reported that they had been stalked.

Anyone who has been a victim of sexual assault should be seen within 24 hours at a hospital emergency room where specially-trained teams can attend to any medical needs and also collect forensic evidence and provide counseling. If one is unsure of where to go to seek help, she (or he) should look up the number for a rape crisis hot line in a phonebook or on the Internet. This should be done regardless of the nature of the assault and even if the attack occurred days or weeks earlier. In a number of cases, the victim may be too terrified or ashamed to seek help. In these cases, a friend or relative should step in and take charge; thus, if an individual becomes aware of an assault on a friend or family member, he or she should become that person’s advocate.

Approximately 650 rape crisis centers are scattered throughout the United States, primarily in urban areas, where one can receive treatment as well as advice and/or referrals over the telephone. Help is available by contacting the National Sexual Assault Hotline at (800) 656-HOPE (4673), or online at www.rainn.org, the Web site of the Rape, Abuse and Incest National Network.

Whether the assailant was a stranger or, as occurs in 80% of cases, an acquaintance or relative, the attacker is likely to have had prior victims and is likely to commit future assaults. Supplying the identity of a sexual perpetrator will likely get that individual off the streets. An aid to that goal is to present at an emergency room as soon as possible so that high-quality forensic evidence can be obtained.

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It is the sexual assault victim’s prerogative whether to report the incident to the police. It is possible to file a report weeks or even months after a sexual assault. Even if she (or he) is only interested in medical help, the victim may change her (or his) mind later. If that situation occurs, the National Center for the Victims of Crime urges a course of action that best preserves evidence that could lead to apprehension and conviction of the sexual predator.

If a sexual assault victim seeks prompt medical attention, the center advises that before evidence collection by a trained professional, victims should avoid the following: use the restroom; shower, bathe or douche; brush their teeth or gargle; brush or comb their hair; eat or drink anything; clean up the crime scene; or throw away clothes worn during the attack.
The CDC study, known as the National Intimate Partner and Sexual Violence Survey, was begun in 2010 with the support of the National Institute of Justice (NIJ) and the Department of Defense (DoD). The study is an ongoing telephone survey of a nationally representative sample of 16,507 adults; it embraces a broad definition of intimate partner and sexual violence broadly. The investigators obtained information on types of aggression not previously studied in national surveys, including sexual violence other than rape, psychological aggression, coercion, as well as control of reproductive and sexual health. In addition, they garnered data regarding the physical and mental health of violence survivors. The study group was comprised of 9,086 women and 7,421 men; each interview lasted about 25 minutes.

The surveyors found that sexual violence disproportionately affects women. One-third of the women reported that they had been victims of a rape, beating, stalking, or a combination of assaults. The researchers defined rape as completed forced penetration, forced penetration facilitated by drugs or alcohol, or attempted forced penetration. However, using that definition, 1% of the women surveyed reported being raped in the previous year, a figure that suggests that 1.3 million women annually may be victims of rape or attempted rape in the U.S. The investigators note that the figure is significantly higher than previous estimates. The Rape, Abuse and Incest National Network estimated that 272,350 individuals in the U.S. were victims of sexual violence last year. Only 84,767 assaults defined as forcible rapes were reported in 2010, according to national statistics from the FBI.

The researchers also found that sexual violence was not limited to women. One in seven men reported that they had been subjected to severe violence at the hands of an intimate partner, the survey found, and one in 71 men (1-2%) had been raped, many when they were younger than 11.

Most of the women who reported that they had been victims of sexual violence, rape, or stalking reported symptoms of post-traumatic stress disorder (PTSD), as did about one-third of the men. Women who had experienced such violence were also more likely to report having asthma, diabetes, or irritable bowel syndrome than women who had not. Both men and women who had been assaulted were more likely to report frequent headaches, chronic pain, difficulty sleeping, limitations on activity, as well as poor physical and mental health.

The survey also found that a young age was a significant risk factor for sexual violence and assault. Approximately 28% of male victims of rape reported that they were first assaulted when they were no older than 10. Only 12% of female rape victims were assaulted when they were 10 or younger; however, almost 50% of female victims said they had been raped before they turned 18. About 80% of rape victims reported that they had been raped before age 25.

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