Half of Rape Survivors Do Not Receive Recommended Medical Treatment

Half of all women who are sexually assaulted in the United States each year do not receive the recommended medical treatment to prevent pregnancy or sexually transmitted diseases, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health. The results of the study show that 20 percent of rape survivors receive emergency contraception to prevent pregnancy and 58 percent are screened for sexually transmitted diseases or given prophylactic medication. The report, which appears in the June 2002 edition of the Annals of Emergency Medicine, suggests there is an increased need for hospital emergency rooms to develop better programs for treating victims of sexual assault.

"Sexual assault survivors suffer tremendous psychological and emotional trauma as well as physical trauma. Our study examines the medical treatment of survivors, and the results indicate that many survivors are not receiving the recommended care," says co-author David Bishai, MD, PhD, assistant professor of population and family health sciences at the Johns Hopkins Bloomberg School of Public Health.

"Previous studies have looked at the medical care of rape survivors, but our study is one of the first to examine the scope of the issue on a national level," adds co-author Annette Amey, MS, a researcher with the Abell Foundation and a student at the Johns Hopkins Bloomberg School of Public Health.

For the study, Bishai and Amey analyzed the medical care of sexual assault survivors using emergency room data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) for the years 1992 to 1998. Using this data, they created a nationally representative sample of rape survivors and calculated that 91,974 rapes occur in the United States each year. The findings were consistent with the 97,000 rapes annually reported by the Federal Bureau of Investigation (FBI) using information reported to law enforcement authorities.

Overall, the study found that 42 percent of sexual assault survivors were not tested for sexually transmitted diseases and did not receive prophylactic medications. In addition, rape survivors over the age 18 were more likely to be screened for sexually transmitted diseases than those under 18. The results showed survivors over 18 were tested 49 percent of the time, compared to 23 percent of those under 18.

According to the study, 60 percent of the rape survivors received some form of medication during treatment. Only 34 percent, however, were given or prescribed a medication recommended by the Centers for Disease Control and Prevention (CDC) for the treatment of sexually transmitted diseases. The study found race to be a factor in treatment as well. Forty-eight percent of white women received neither screening nor treatment, compared to 25 percent of African American women.

"Based on our evidence, there is a significant number of adult women who do not receive proper screening and treatment to prevent pregnancy and sexually transmitted diseases following a sexual assault,” explains Dr. Bishai. "This points to a need for hospital emergency rooms to develop better programs for medical management of sexual assault patients or to refer patients to other hospitals that have developed this expertise."

"Measuring the Quality of Medical Care for Woman Who Experience Sexual Assault Using Data from the National Hospital Ambulatory Medical Care Survey," was written by Annette L. Amey, MS, and David Bishai, MD, PhD, and is published in the June 2002 edition of the Annals of Emergency Medicine.

Funding was provided by the Hopkins Population Center and the Johns Hopkins Bloomberg School of Public Health.