MedlinePlus Medical Encyclopedia: Rape
TREATMENT
In many cities, rape cases are referred to specific emergency rooms. This allows for more specialized care for the unique needs of the person who was raped, and assures proper procedures are followed to maintain the "chain of evidence" necessary for a case that may go to trial.
Such sexual assault treatment centers may also employ, or have available on-call, a team that is specialized in assessing and dealing with the emotional, physical, and legal issues a person who was raped faces. Most state laws require that the person be evaluated in the emergency room prior to the rape being officially reported.
It is recommended that a person go to the hospital immediately after the rape occurs, without changing clothes, showering, douching, or urinating. Such activities may alter or destroy evidence helpful in identifying and prosecuting the rapist.
Treatment focuses on providing enough emotional support while attempting to collect enough objective evidence to verify the person's complaint of rape. If the person who was raped has a support person she wants present, the treatment team should try to make that possible; otherwise someone (such as a nurse) should be "assigned" to stay with the person throughout the interviews and examination.
Someone who was attacked should not be left alone unless she wishes to be. She should be offered the choice of being interviewed in street clothes rather than in a patient gown.
The examination and collection of specimens should be fully explained beforehand, and whenever possible, the person should be given choices in an attempt to give her back a sense of control. Maintaining a supportive environment, free from any judgmental statements, may encourage a person who has been attacked to express whatever feelings arise.
Treatment includes addressing any potential for pregnancy or sexually transmitted diseases, offering information relevant to those possibilities, and providing care for the immediate physical and emotional trauma incurred, as well as planning follow-up care.
If there is a chance that the rapist is HIV-infected, post-exposure prophylaxis (PEP, a way to reduce the odds of infection by immediate use of antiretroviral medications) should be explained and offered. Referral to a local rape crisis center may be helpful. These centers offer peer support, and advice necessary for adequate healing from the trauma.
OUTLOOK
Recovery from a rape typically includes the acute phase (immediate period of physical pain and wound healing, emotional reactions and coping mechanisms put into action), and the reorganization phase (occurring about one week after the rape and lasting months to years, as the person attempts to "get on with life").
Group psychotherapy with other rape survivors as been show to be the most effective treatment.
COMPLICATIONS
Some women are never fully able to recover emotionally from a rape. Posttraumatic stress disorder (PTSD) is a common complication. Symptoms include recurrent nightmares, intrusive memories (flashbacks) of the event, social withdrawal, depression, anxiety, and numbing of emotions. Cognitive psychotherapy and antidepressant medications have been shown to be effective treatments for PTSD.
More than 50% of rape victims have some difficulty in re-establishing relationships with spouses or partners or, if unattached, in re-entering the "dating scene."
Any pre-existing psychiatric disorders may be worsened. Suicidal behaviors, depression, and substance abuse may develop or become more prominent.
CALL YOUR HEALTH CARE PROVIDER IF
You have been raped: go to the nearest emergency room right away. Do not shower or change your clothes.
You were sexually assaulted in the past but never sought or received adequate care.
You have been raped (recently or in the past) and are experiencing personal or relationship problems.
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