Follow-Up Health CareSexually Transmitted Diseases (STD's)
It is important that you be tested for sexually transmitted diseases regardless
of whether or not you choose to report the assault to the police, as there
is a 40% probability of contracting some form of STD from a sexual assault.
Tests done for STD's immediately after you were assaulted will only determine
whether you had a disease before the assault. This information can be helpful
if you go to court, but for your health's sake, you need to have follow-up
tests done two weeks and six weeks after the assault. You may choose to
be tested for gonorrhea, chlamydia and syphilis.
Gonorrhea:
It is possible to contract gonorrhea through oral, anal, or vaginal penetration,
so it is important that you advise the nurse or physician of the nature
of the assault. Cervical, anal, or throat swabs will be done in order to
test for this disease. The incubation period is from two to ten days, and
test results are available in three to ten days. Gonorrhea shows few, if
any, early symptoms in women; in men there may be a burning pain on urination
and/or a discharge from the urethra, although many men also show no early
signs. Gonorrhea is easily treated with antibiotics in its early stages,
but can have serious long-term effects if left untreated.
Chlamydia: This is the most prevalent sexually transmitted disease in the United States; it is similar to gonorrhea, but far more common. Since it is possible to contract chlamydia through vaginal or anal penetration, cervical or anal swabs will be done to test for this disease. There are rarely any symptoms in its early stages; when symptoms do occur, they are usually pain on urination and/or discharge from the urethra. The incubation period is 7 to 21 days, and test results are available in 2 weeks. Chlamydia, like gonorrhea, is easily treated with antibiotics in its early stages, but has serious long-term effects if untreated.
Syphilis: It is possible to contract syphilis through oral, anal, or vaginal penetration. Testing for this disease is done through a blood test. The incubation period is three weeks to three months, and test results are usually available in five to ten days. The primary symptom, the chancre, is a usually painless sore which appears where the syphilis bacteria first entered the body, usually on the mucous membranes of the genitals or mouth. It may or may not be noticeable to you. Syphilis is uncommon in Dane County; it is easily treated in its early stages -- usually with penicillin.
Aids: Aids stands for acquired immunodeficiency syndrome. Aids refers to a group of illnesses caused by HIV, the human immunodeficiency virus. People who are infected with HIV often have no symptoms and look healthy. It can take up to 10 years or more for a person who is infected with the virus to become ill with aids.
There are three major ways a person could become
infected with HIV.
These are:
1. Through unprotected anal, vaginal or oral sexual
intercourse.
2. Through the exchange of blood, primarily by sharing needles during drug
use.
3. From an infected woman to her fetus during pregnancy or birth.
Remember, it is impossible to contract HIV from a sexual assault if the assailant is not carrying the virus.
Testing for HIV is done via a blood test. It takes 3 to 12 months after an exposure for HIV antibodies to show up on a blood test. Therefore, testing at the time of the assault will only indicate your HIV status prior to the assault (baseline test).
Sexual assault survivors who have questions about
their possible exposure to HIV, or who are considering HIV testing can contact
the Wisconsin AIDS hotline 1-800-334-2437 for referrals to test sites
which provide confidential and/or anonymous testing as well as pre and post
test counseling so a survivor can make an informed choice regarding testing.
The Rape Crisis Center can provide an advocate to support a survivor in
making decisions about testing, and who can accompany a survivor for counseling
and testing.
In cases where there is a significant risk of exposure the law allows for
a defendant to be tested for the presence of the HIV virus, and for those
results to be disclosed to a physician designated by the victim.
The Rape Crisis Center recommends the following:
1. Sexual assault victims should not be HIV tested as part of a rape examination conducted at the hospital since the test results would become part of the medical record which could be evidence in a criminal trial.
2. If sexual assault survivors choose to be hiv tested they should have both pre and post test counseling for HIV testing whether seeking the test soon after an assault (baseline) or at 3, 6, and 12 month intervals following an assault (to test for exposure from the assault).
Herpes simplex: If you experience painful sores or blisters around your genitals or mouth, you should also be tested for herpes simplex. The test for herpes is an examination of fluid from the blisters, and blood test to distinguish herpes from syphilis. You can only be tested for herpes when the blisters appear, which can be weeks or months after the assault. If you have herpes you can be given pain relievers; in addition, Acyclovir is a treatment that can diminish the intensity of the symptoms. While a cure for herpes has not yet been developed, you should discuss treatment options with your physician.
Pregnancy: Fear of pregnancy as a result of sexual assault is a legitimate concern for many women; however, the fear often outweighs the actual risk of getting pregnant. There is only a ten percent chance of pregnancy during ovulation, and a four percent chance during the rest of the menstrual cycle, therefore the risk of becoming pregnant as the result of a sexual assault is considerably less than the risk of contracting a sexually transmitted disease.
A pregnancy test done at the hospital immediately following the assault will only determine if you were pregnant before the assault. If you were not using birth control pills or an IUD, and you were at a high-risk point in your cycle when you were assaulted, there are post-coital medications that can be taken to prevent pregnancy. These are estrogen compounds that must be taken within 72 hours, ideally within 24 hours, following the intercourse to be effective. Ovral is frequently prescribed. It may be a better choice of post-coital medication than DES, which carries the risk of many serious side effects. Ovral can be given in only two doses (as opposed to five doses of DES) and is generally tolerated better by the woman taking it.
All post-coital medications may cause serious defects in a fetus if the woman is already pregnant when she takes the medication; the medications will not cause miscarriage of the fetus. If a woman who has taken post-coital medication discovers that she is pregnant, she may wish to consider a therapeutic abortion. If you are considering taking a post-coital medication such as DES or Ovral, make certain that your health care provider explains the risks and side effects to you so that you can make an informed decision.
The earliest symptom of pregnancy is usually a missed menstrual period. Keep in mind that the trauma of a sexual assault may have caused a disruption in your menstrual cycle.
There are two types of pregnancy tests: blood tests, which first become accurate when taken 7 to 21 days following the intercourse suspected of having caused pregnancy; and urine tests, which can be done two weeks following the intercourse suspected of having caused pregnancy. Positive pregnancy tests are usually correct, but negative ones should be repeated for accuracy.
If you are pregnant as the result of a sexual assault, there are a number of options available to you, and you can call the Rape Crisis Center for support and referral to an agency that can assist you.
Physical trauma: It is not unusual to have muscle soreness and stiffness following an assault. If bruises begin to show up on your body, if you experience pain, or if you have vaginal or rectal bleeding, consult a physician immediately. If you seek medical care related to the assault, and the assault was reported, you should also contact the investigator handling your case, and let her/him know about this. Any medical examination concerning injuries received during the assault is relevant to your case. Also, if you have bruises, whether or not they require medical attention, the investigator may want them photographed to provide evidence in court.
Psychological reactions: There is no "right way" for a victim to behave in the immediate aftermath of a sexual assault: you may feel and appear numb and dazed; you may be calm and controlled: or you may react by expressing intense emotions. All of these reactions are normal. Following an assault, it is not unusual to experience intrusive thoughts and feelings, confusion, sleep disturbances, loss of appetite, nausea and gagging, uncontrolled crying or laughing, and emotions such as fear, guilt, anger, and distrust. You may withdraw from family and friends, feel a loss of the ability to have fun, lose interest in your usual pursuits, and you may avoid intimate contact and be unable to experience sexual pleasure. These reactions may continue for days, weeks, or months; they may reappear at a later date, possibly because some incident reminds you of the assault. You may react to the assault immediately, or you may have a delayed reaction. How you are affected, and for how long, will depend on many factors: the circumstances and nature of the assault, the identity of the assailant, the response of relatives and friends, your life experience, and the way you feel about yourself.
It may be helpful for you to talk about your feelings with someone who can provide support and understand what you've been through. Who you talk to is a matter of choice -- it could be a supportive friend or relative, a health-care provider, a counselor, or anyone with whom you feel comfortable. Through the Rape Crisis Center, you can call and discuss your feelings and situation anonymously with a telephone counselor, or you can meet with an advocate/counselor for short-term counseling, or you can attend a support group to meet with other survivors of sexual assault. Many victims find support and discover their strengths by being able to talk about their experiences.
