Sexual Assault Flashcards
What is undertaken at a forensic medical examination?
- Swabs for DNA
- Injuries documented
- Emergency contraception
- HIV prophylaxis
- Hep B vaccination
Where do FMEs take place?
At SARCs - sexual assault referral centres
What are the timelines for up till which DNA can be detected from different sites?
- Vaginal = 7 days
- Anal = 3 days
- Oral = 2 days
- Digital penetration = 12 hours
What should you advise an individual if they present immediately after the assualt?
Advise not to shower, bathe, brush teeth or wash their clothes.
All clothes should be kept along with any pads or tampons worn at the time of the assault as they may provide evidence.
What is important to assess for in sexual assault victims apart from medical management?
- Psychological wellbeing and any symptoms of PTSD. Any evidence of self-harm or suicidal ideation.
- Is it safe for the individual to go home or if emergency accommodation is required
- Are any ongoing child or vulnerable adult protection issues present
Up till when may Hepatitis vaccinations be given following an assault?
6 weeks
When are hepatitis vaccinations considered following sexual assault?
- Assailant known to be Hep B carrier
- Assailant has risk factor(s), for example, IVDU or MSM
- Anal assault
- Trauma and bleeding following the assault
- Multiple assailants
- Client wishes to have vaccination
What are the vaccination regimes for hepatitis B?
- Day 0, 7 and 21
- Day 0, 1 month and 2 months
- Either regime followed by a booster at 1 year
Within what time frame should PEP be considered?
If presenting within 72 hours of assault
What ARTs are currently used for PEP?
Raltegravir and Truvada (tenofovir disoproxil and emtricitabine) for 28 days
In which situations is PEP recommended?
Source HIV positive:
- Receptive or Insertive anal sex and HIV VL unknown/detectable
- Receptive vaginal sex and HIV VL unknown/detectable
- Sharing of injecting equiment and HIV VL unknown/detectable
(PEP not remommended if source has HIV undetectable load)
Source unknown HIV status:
- Receptive anal sex and source from high prevalence country/risk group
In what situations is PEP considered?
Source HIV positive:
- Insertive vaginal sex if HIV VL unknown/detectable
Source HIV status unknown:
- IAI or RAI if source from high prevalence country/risk group
- Insertive vaginal sex if source from high prevalence country/risk group
- Sharing of injecting equipment if source from high prevalence country/risk group
When should HIV and STS tests be repeated?
In 3 months
When should GC and CT tests be repeated?
In 2 weeks
