Rape

It is recommended that a rape victim go to the hospital immediately after the rape occurs, without changing clothes, showering, douching, or urinating, because such activities may alter or destroy evidence helpful in identifying and prosecuting the rapist.

text continues below

Treatment focuses upon providing sufficient emotional support while attempting to collect adequate objective evidence to verify the victim's complaint of rape. If the victim has a support person she wants present, efforts should be made to make that possible; otherwise someone (such as a nurse) should be "assigned" to stay with the victim throughout the interviews and examination.

The victim should not be left alone unless she wishes to be. She should be offered the choice of being initially interviewed in street clothes rather than being directed to disrobe and put on a patient gown.

The examination and collection of specimens should be fully explained beforehand to the victim, and whenever possible, the victim should be given choices in an attempt to regain a sense of control. Maintaining a supportive environment, free from any judgmental statements, may encourage the victim to express whatever feelings arise.

Treatment includes addressing any potential for pregnancy or sexually transmitted diseases, offering information pertinent to those possibilities, and providing care for the immediate physical and emotional trauma incurred as well as planning follow-up care.

If there is a chance that the rapist is HIV-infected, post-exposure prophylaxis (PEP, a way to reduce the odds of infection by immediate use of antiretroviral medications) should be explained and offered. Referral to a local rape crisis center may be helpful for the victim to receive peer support and advice necessary for adequate healing from the trauma.

OUTLOOK

Recovery from a rape typically includes the acute phase (immediate period of physical pain and wound healing, emotional reactions and coping mechanisms put into action) and the reorganization phase (occurring about one week after the rape and lasting months to years, as the victim attempts to restructure and "get on with life").

Group psychotherapy with other rape survivors as been show to be the most effective treatment.

COMPLICATIONS

Some women are never fully able to emotionally recover from a rape. Posttraumatic stress disorder (PTSD) is a common complication. Symptoms include recurrent nightmares or intrusive memories (flashbacks) of the event, social withdrawal, depression, anxiety, and numbing of emotions. Cognitive psychotherapy and antidepressant medications have been shown to be effective treatments for PTSD.