Medical treatment is one important assistance every rape victim deserves to ensure that there is a reduction in psychological stress as well as to prevent Sexually transmitted diseases. Also, many rape cases result in unwanted pregnancy which is avoidable when the right action is taken.
When we mention medical treatment or assistance for a rape victim, many think a physician has to be at every rape scene to offer assistance. However, the assistance can start with anybody before inviting the medical team.
To start with, most rape victims experience a post-traumatic experience. The first step and the most important help is to stabilize the patient and assure him/her that all hope is not lost.
However, the care does not end there. It is wise to call the attention of physicians to make sure that all that health risks are put in control. These risks include the risk of pregnancy and the risk of Sexually transmitted diseases such as HIV, Hepatitis e.t.c.
What is rape?
FBI defines rape as “penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.”1
According to statistics from National Sexual Violence Resource Center ( NSVRC), Nearly 1 in 5 women (18.3%) and 1 in 71 men (1.4%) in the United States have been raped at some time in their lives, including completed forced penetration, attempted forced penetration, or alcohol/drug-facilitated completed penetration.
Nevertheless, rape victims can always call the Police on 911 for help and safety, or Call the National Sexual Assault Hotline at 800.656.HOPE (4673).
Also, you can chat online with a trained staff of Rape, Abuse and Incest National Network (RAINN) for confidential crisis support at Online.rainn.org for online support.
Medical treatment for rape
The simple truth is that rape victims need help and support- not just sorry. The quality of medical treatment received by a rape victim is proportional to the rate of recovery and survival.
Therefore, act fast to make sure that the patient gets all the help she needs as many prophylaxes are time-dependent. Below are the medical treatment a rape victim should have;
- Emotional support
- Laboratory Examination
- Prophylaxis for Sexual Transmitted Diseases
- Emergency Contraceptives
- Follow up
1. Render an emotional support
Rape is more psychological than physical. Studies have established a relationship between a sexual assault or rape and attempted suicide. Therefore, the first thing to do is to reassure the victim and offer palliative measures for mental stress.
Also, you will have to be careful with your assertions because the victim may misunderstand you and take things personally. In that regard, try to let the victim understand that the incident is not his/her fault and you are only around to help.
Politely ask them to trust you and tell you anything you need to do to help. Never try to impose anything on the victim but respect every decision they make. For example, Let the reporting of the incidence be a decision of the victim.
a 2. Laboratory examination of the victim
There is a risk of getting infected with sexually transmitted diseases after rape. The HIV status of the victim is important to decide if the victim requires Post Exposure Prophylaxis or not.
However, the type of test to carry out on the victim depends on the available resources in the health facility. The STI – specific nucleic acid amplification (NAAT) is on a recommendation for Chlamydia and gonorrhea. In facilities where NAAT is not available, the Urethra swab or first-catch urine serves as an improvise to isolate anyan organism present for analysis.
Also, It is important to take a Blood sample to check for syphilis and Hepatitis B surface antigen (HBsAg).
3. Initiate prophylaxis for sexually transmitted diseases
Prophylaxis does not mean the organism is already implicated but will serve as a precautionary measure to prevent it from occurring.
In other words, some drugs when taken after sexual exposure can prevent the transmission of diseases. Some of these diseases include; Hepatitis, HIV, Gonorrhea, Human Papilloma Virus, Chlamydia e.t.c.
Center for disease control and prevention published a guideline in 2015 that address prophylaxis for HIV and STD after rape or sexual assault.5
Post-coital prophylaxis for Urinary tracts infections
This involves taking a single dose of an effective antimicrobial (e.g., nitrofurantoin 50 mg, trimethoprim-sulfamethoxazole [TMP-SMX] 40/200 mg, or cephalexin 500 mg) after sexual intercourse.6
HIV Post Exposure Prophylaxis
If the rape survivor is HIV negative, a 28 days Post Exposure prophylaxis of zidovudine or other alternatives is on a recommendation to ward off the risk of getting HIV infection.
Hepatitis prevention
Hepatitis B vaccine (without hepatitis B immune globulin) is necessary if the victim has not been previously vaccinated against HBV. The first dose is on the first day of examination, further doses are during 1 – 2 months and 4 – 6 months after the first dose.
Human Papilloma virus
CDC now recommends 2 doses of the vaccine rather than the 3 doses used earlier due to cancer caused by HPV. The second dose comes after 6 months after the first doses.
Gonorrhea, (male and female adults and adolescents),
Ceftriaxone 250 mg inter-muscular, single dose;
plus Azithromycin, 1 g, orally, single dose;
Chlamydia (male and female adults and adolescents),
Azithromycin, 1 g, orally, single dose
or Doxycycline, 100 mg, orally, twice a day for 7 days.
Trichomonas (female adults and adolescents),
Metronidazole, 2 g, orally, single dose
or Tinidazole, 2 g, orally, single dose
4. Administer contraceptives
It is the role of every medical facility to provide an Emergency Contraceptive (EC) to all rape survivors. WHO recommends ulipristal acetate, levonorgestrel, or combined oral contraceptives (COCs) consisting of Ethinyl estradiol plus levonorgestrel.
5. Follow up. The mainstay of the follow-up is to observe the psychological improvement of the patient and also to monitor and address any Adverse Drug event, especially from the post-exposure prophylaxis.
Above all, It also gives avenues ent or help. It can go a long way to save the patient from potential harm.
