Medical care post-sexual assault for u.s. servicewomen: A retrospective cross-sectional study

Two parallel studies investigating the antecedent risks and subsequent health consequences of sexual assault in servicewomen during Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) were conducted. 205 of 1,339 servicewomen experienced at least one sexual assault while serving in-military (SAIM). Only 16% (n=33) reported receiving medical care for any SAIM, even though 26% reported being physically injured and 18% reported vaginal injuries. The primary reason for not seeking post-assault care was that women did not think care was needed (72%). When care was received, it was most likely obtained at a military base (67%) or civilian care provider (39%), not mutually exclusive. Few women were examined with a forensic rape-kit (n=17), offered a pregnancy test (n=22), a ‘morning after pill' (n=14), assessed for sexually transmitted infections (STIs) (n=21), offered medication to prevent HIV (n=6). Only those examined with a rape-kit were offered medication to prevent HIV (6/17). Among those who experienced a completed SAIM, only 4% (n=5) received care that addressed all of the following: pregnancy, STIs, and HIV. Stigma associated with sexual assault may present a barrier to seeking needed medical care, which in turn may significantly delay receiving any physical and/or mental health care following a sexual assault. Best practices for post-sexual assault medical care include treatment of injuries and prevention of unwanted pregnancy, sexually transmitted infections, and human immunodeficiency virus. Ways to facilitate immediate access to post-sexual medical care are warranted and ensuring those who experience sexual assault have access to best practices is essential.