Getting medical care is a major step toward recovery and healing. We encourage you to take advantage of whatever informed and sensitive medical care is available in your community.
By law, all health care providers are required to report any crime including sexual assault to law enforcement. You can seek medical attention for “unprotected intercourse” without having the assault reported to law enforcement, just know medical personnel are required to report if they suspect injury is due to a weapon (See statute 26-23a-1:Injury Reporting by Health Care Providers).
In some communities, a victim advocate can be with you during this process, regardless of whether or not you decide to provide law enforcement with a statement. A victim advocate can provide emotional support during the examination and report-taking. Your advocate can help explain medical procedures and the process of evidence collection. This person may also counsel friends or family members who may be at the hospital or clinic. An advocate may assist you with follow-up medical and counseling appointments and provide support through the criminal justice process. If you have any questions before or after seeking medical treatment, call the statewide toll-free rape crisis and information hotline at 1.888.421.1100.
The Sexual Assault Medical Forensic Examination
The purpose of the sexual assault medical forensic examination is to collect forensic evidence, provide timely and compassionate care for a sexual assault victim, and to provide preventative treatment for STIs and pregnancy. The exam will be given only after any other urgent medical concerns are treated.
If you are planning to have a sexual assault exam, please try not to urinate, eat or drink until the nurse examiner can collect a few basic samples from you.
Before the exam begins, the examiner must obtain your consent to collect samples and take photographs. Next, the examiner will ask general questions about your health history as well as specific questions about the sexual assault. These questions may be difficult but are necessary to help the examiner locate any evidence. You can request to have any person of your choice in with you during the entire exam, including family members, friends, or victim advocates. Please keep in mind, that additional support people may be limited due to COVID restrictions.
You are in control of the exam process. You can ask any questions you may have about any aspect of your care. All procedures should be explained so that you understand why and how they are done; if not, it’s okay to ask the nurse or doctor to explain what they are doing. They may help you maintain some feeling of control during the medical procedures.
The examiner will look for any signs of injury and collect any physical evidence. Part, or all, of your clothing may be taken into evidence, the clothes/items taken will not be given back as they are evidence. If you can, bring a change of clothing to the hospital with you. Most victim advocate programs can provide clothing for you to wear home from the hospital. The examiner will take samples from different areas of your body including your hair, your genitals, and swabs of any other area the perpetrator may have come into contact with. A careful exam of your genital area will also be done to look for any injury and evidence. Other samples, such as your blood and urine, will also be collected. The final part of the exam is to offer medications to prevent STI’s and pregnancy, and to provide referrals for follow up medical care and counseling, if desired.
Evidence collected in the hospital will be released to law enforcement following the examination. The law enforcement agency responsible for investigating the crime may hold this evidence and send your kit to the state crime lab to be processed, although, how long law enforcement will hold this evidence will vary. Contact the detective in charge of your case, or the law enforcement victim advocate, to find out the length of time evidence is held. You have the right to your property when the investigation is completed, however, it may be destroyed when the crime lab processes it.
BY LAW, YOU ARE NOT RESPONSIBLE FOR THE COST OF THE SEXUAL ASSAULT EXAMINATION. In all cases, the hospital examination, clinician’s fee, antibiotics, and oral contraceptive series can be paid for by Crime Victim Reparations (CVR).
CVR may also reimburse you for follow-up medical care as a result of the assault; relocating, if necessary as a result of the crime; counseling; lost wages; and other costs. Depending on your case, you may need to cooperate with law enforcement efforts, in order for CVR to consider your claim to pay for these out-of-pocket expenses. Your victim advocate can help you apply for CVR funds, and give you more information on what CVR may be able to reimburse. For more information, visit the Utah Office for Victims of Crime.
Sexually Transmitted Infections
Sexually Transmitted Infections (STI’s) are infections spread during sexual activity; many can be prevented if treated as soon as possible following a sexual assault. If you receive a forensic exam, you should be given preventive medications, if needed. It is strongly recommended that all survivors get STI tests at two to four weeks, three months, and six months after the assault. It is also recommended you get a gynecologic exam, PAP smear, and HIV test at one year following the assault.
Antibiotics can effectively treat most STI’s. (Please advise the clinician of any allergies.) If such medications are prescribed for you, it is important to carefully follow the prescription directions. Please remember that it is virtually impossible to tell immediately after a sexual assault if you have contracted any STI’s. This is why the tests for STI’s need to be repeated weeks and even months after the assault in order to get reliable results.
If you experience any of the following symptoms, contact your health care provider immediately:
- Burning, itching, unusual discharge
- Sores on your mouth, anal area or genitals
- Milky or foul discharge from vagina or penis
- Bleeding with intercourse
- Burning or bleeding with urination
You should call 911 immediately if you experience any of the following symptoms as you may be having a reaction to the antibiotics given at the time of the exam:
- Itching or hives on various parts of your body
- Difficulty breathing, swelling of the tongue or breathing tubes
The risk of contracting HIV/AIDS from a single sexual assault is the same as the risk of contracting it from a single sexual contact. This risk is extremely low. If you were low risk before the sexual assault, a one-time assault does not greatly increase your risk; however, multiple assaults do increase the risk. Regardless of risk level, we recommend that all survivors seek HIV testing. Following a rape or sexual assault, it is important to be aware of the correct procedures in dealing with HIV/AIDS. Much like STIs, an HIV test given immediately following the rape would indicate only if you were infected prior to the assault. Since you do not necessarily know if your assailant has HIV, it is recommended that you consider a baseline HIV antibody test about two weeks after the assault and obtain more information about HIV infection. Be aware that this test is not given at the hospital as part of the sexual assault exam.
Follow-up testing for HIV is recommended at three months, at six months, and again at one year after the assault. You can be tested confidentially through your primary health care provider or anonymously at any State Health Department clinic. Please ask your health care provider about the differences between confidential and anonymous testing if you need more information. It is strongly encouraged to practice safe sex with your partner for a six-month period until the final STI and HIV/AIDS test results are known.
Also note that Utah law gives you the right, in certain cases, to request that your assailant be tested for HIV, with the results reported to you. Victims have the right to request mandatory testing for HIV for the convicted sex offender within six months of the conviction. This issue is complicated and should be considered carefully. You can discuss this issue with an HIV counselor, a sexual assault victim advocate, a doctor or an attorney. (Please see HB0459) Keep in mind that the best source of information about whether you have been infected with HIV is for you to be tested yourself.
Survivors should tell their medical provider if they are pregnant or might be pregnant. It is also important to discuss any type of birth control you are using as well as any recent sexual activity. Statistics indicate that the chances of becoming pregnant as a result of sexual assault are less than 10%. The survivor may want to discuss with a clinician various tests and treatments in regard to pregnancy. A pregnancy test is routinely given as part of the forensic exam. This will only determine if you were pregnant before the exam, but will not tell you if you are pregnant as a result of the sexual assault. It is recommended to get a follow-up pregnancy test two to four weeks after your assault. Medication can be given to prevent pregnancy, but should be taken within 72 hours of your assault to be the most effective and can be taken within 5 days and still be effective. Survivors may be offered emergency contraception, commonly called EC or the “Morning after Pill.” This oral contraceptive contains the same hormones found in birth control and can prevent pregnancy from occurring. Typical side effects can be nausea and vomiting, call your health care provider if you vomit within four hours of taking the emergency contraception as you may need to receive another dose. EC is offered to all victims as part of the protocol of the forensic exam; if you do not get offered EC please ask your health care provider.
After an assault, if you do not have your period on your due date, you may want to contact your health care provider for an additional pregnancy test. At that time you can discuss the options available to you regarding your particular situation.
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