Care in the Aftermath: A Scoping Review of Acute Sexual Assault Response Models and Their Documented Effects

This review examines acute sexual assault response systems designed to meet survivors' immediate medical, forensic, psychological, social, and legal needs following an assault. These systems operate at the intersection of health, justice, and psychosocial domains. By mapping service models and synthesising evidence on their structure and reported outcomes, the review highlights how current approaches address, or fail to address, holistic, survivor-centred care. The analysis aims to inform improvements in accessibility, quality, and responsiveness within acute sexual assault services. A scoping review was conducted following PRISMA-ScR guidelines. Systematic searches of MEDLINE, PsycINFO, and CINAHL (2000-2023) identified peer-reviewed studies describing and/or evaluating acute sexual assault responses for adults (≥18 years). Data were extracted on service components (e.g., medical, forensic, psychological, and advocacy), delivery models, and reported outcomes. Twenty-nine studies were included. Medical care (93%) and forensic examinations (79%) were most frequently described; psychological support (66%) and advocacy (28%) were less common. Only nine studies (31%) evaluated services, with psychological support most assessed (n = 7). Advocacy, though rarely reported, showed strong benefits (e.g., reduced secondary victimisation). Survivor experiences were underrepresented, and studies emphasised procedural compliance over trauma-informed outcomes. Acute sexual assault care remains dominated by medico-legal priorities, with limited evaluation of holistic models. The lack of outcome data, especially for psychological support and advocacy, signals a critical evidence gap. Future research should prioritise multi-site evaluations and survivor-defined outcomes to align services with survivors' needs.