Sexual Assault Medical Forensic Examinations

The Examination Process > STI Evaluation and Care

STI Evaluation and Care

Recommendations at a glance for health care providers to facilitate evaluation and treatment of STIs:

Offer patients information about the risks of STIs (including HIV), symptoms, what to do if symptoms occur, testing and treatment options, followup care, and referrals.
Consider the need for testing patients for STIs during the initial exam on a case-by-case basis. If testing is done, follow the guidelines of the Centers for Disease Control and Prevention (CDC).
Encourage patients to accept prophylaxis against STIs at the time of the initial exam. If accepted, provide care that meets or exceeds CDC guidelines. If declined, it is medically prudent to obtain cultures and arrange for a followup examination and testing.Obtain informed consent of patients for treatment, according to exam facility policy.
Encourage followup STI examinations, testing, immunizations, and treatment as directed.
Concerns about HIV infection. Offer postexposure prophylaxis for HIV to patients at high risk for exposure, particularly when it is known that suspects have HIV/AIDS. Meet or exceed guidelines recommended by the CDC. Discuss risks and benefits of the prophylaxis with patients prior to their decision to accept/decline treatment. Careful monitoring and followup by a health care provider or agency experienced in HIV issues is required.

Contracting a sexually transmitted infection (STI), also commonly known as a sexually transmitted disease or STD, from assailants is typically a significant concern of sexual assault patients. Because of this concern, it should be addressed as part of the medical forensic exam. Mechanisms should be in place in any setting where these patients are examined for STIs to ensure continuity of care (including timely review of test results) and monitor compliance with and adverse reactions to any therapeutic or prophylactic regimens.[1]

[1] Sexually Transmitted Diseases Treatment Guidelines, Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, May 10, 2002, 51(RR-6), p. 69. Available at www.cdc.gov/std/treatment/default.htm (CDC general phone: 800–311–3435). Much of the information in this chapter was drawn from these guidelines. Note that the guidelines are updated periodically. In addition to the guidelines, the CDC Web site at www.cdc.gov offers information on related research, news, and Internet links.

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