Emergency department care for victims of sexual offense

Emergency department (ED) care for sexual offense victims was studied and compared with national treatment guidelines.

This retrospective study analyzed data from the 2003 National Hospital Ambulatory Medical Care Survey. ED visits were selected based on the reason for the patient's visit, diagnosis, and cause of visit. ED visits were evaluated as two subgroups: rape or sexual assault and molestation or other sexual offense. Data were analyzed to determine whether certain screening procedures were performed, including pregnancy testing, HIV serology testing, urinalysis, cervical or urethral culture, and urine culture. Medication codes for each patient visit were examined to determine if antibiotics, antiretrovirals, emergency contraceptives, anxiolytics, analgesics, or antiemetics were provided.

In 2003, there were 251,762 ED visits for a sexual offense; 179,149 of these were for sexual assault or rape and 72,613 for molestation or other sexual offense. Nearly 70% of visits did not involve the prescribing of antibiotic therapy, and during only 6.7% of visits was appropriate antibiotic prophylaxis, as recommended by the Centers for Disease Control and Prevention, provided. For female victims age 12 years or older, pregnancy tests were performed during 36.7% of visits for sexual assault or rape and 6.7% of visits for molestation or other sex crimes. Only 13% of sexual assault or rape victims received HIV serology testing. Sufficient care was provided during only 20.4% of all visits for sexual offense victims.

The majority of victims of a sexual offense in the United States in 2003 did not receive sufficient care in the ED in accordance with national treatment guidelines.