Rape is defined as sexual intercourse that is forced on a person without his or her permission. It may involve physical force, the threat of force, or it may be done against someone who is unable to give consent.
Sexual intercourse may be vaginal, anal, or oral, and may involve the use of a body part or an object.
According to most estimates, 80 - 90% of rapes are not reported to police. Current trends project that 1 in 3 American women will be sexually assaulted at some point during their lives.
The typical rape victim is a 16- to 24-year-old woman. Anyone, however -- man or woman, adult or child -- can be the victim of rape. In most cases, the victim knows the rapist.
Other important facts about rape include:
Date rape occurs when someone forces another person they are dating or spending time with to have sex. Date rape may involve the use of drugs such as flunitrazepam (Rohypnol).
The best response when being attacked may depend on the victim, the attacker, and the situation. Trying to get away and yelling for help are good first steps in most situations. Whether to fight back may depend on the size and behavior of the attacker, as well as whether a weapon is involved.
AFTER A RAPE HAS OCCURRED
The victim may know, or even live or work with a person who sexually assaulted them. It is essential that rape victims get help to find an environment where they feel safe after the attack.
People who are raped may not be able to say they were raped or seek help. Some may get medical help for a different complaint, such as headaches, eating problems, pain, or sleep problems.
Emotional reactions can be very different in each person, and may include:
Victims of rape should be helped to understand that nothing about what happened was their fault. Nothing that they did should have allowed someone to have sex with them against their will. This includes dressing suggestively, or even kissing or performing other physically intimate activities. Any fault or blame is solely on the rapist.
TREATMENT
Most state laws require that the person be evaluated in the emergency room before the rape is officially reported. In many cities, rape cases are referred to specific emergency rooms where staff are trained to:
If a woman who is raped might be pregnant, health care providers will discuss methods of emergency contraception.
If there is a chance that the rapist is HIV-infected, the health care providers should explain ways to reduce the odds of HIV infection. This may involve the immediate use of medicines used to treat HIV, called antiretrovirals. This process is called post exposure prophylaxis (PEP).
The person who was raped may also need to be treated for other sexually transmitted infections.
Most importantly, the person needs support and information to begin the process of healing after a sexual assault.
RESOURCES:
Sex and rape; Date rape; Sexual assault
Slaughter L. Sexual assault. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 64.
Lentz GM. Rape, incest, and domestic violence: Discovery, management, counseling. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 10.
Linden JA. Care of the adult patient after sexual assault. N Engl J Med. 2011;365:834-841.
Centers for Disease Control and Prevention (CDC). Sexual assault and STDs. In: Sexually transmitted diseases treatment guidelines. 2010. MMWR Recomm Rep. 2010:17(59)(RR-12):90-95.
Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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