Initial Reactions
No two victims react to sexual assault in
exactly the same way. Feelings can range from anger, frustration, fear, shame and guilt to
numbness. These are all normal feelings.
Demands placed on you to make important medical and legal decisions, only a short time
after the crime, may intensify these feelings.
Even the most well-meaning, supportive family and friends may not comprehend the situation
or your emotional state right away.
While family, friends and even you may wish to review the crime to determine how it might
have been prevented-this can be an unnecessary and painful experience. Remember, it you
are alive, you did something right! Rape can and does happen to
anyone.
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Whether or not you wish to report the crime
to the police, it is very important that you seek medical attention immediately. Sexual
assault victims can sustain internal injuries which may not be visible or painful for some
time.
Initial Medical Examination
Depending on the type of attack you
experience, a pelvic examination may be necessary to check for injury and to confirm
penetration. This examination is held in a private room in the Emergency Department of the
Governor Juan Francisco Luis Hospital.
You will be allowed to have a relative or an Advocate for Women in Crisis with you during
the examination as long as she/he does not interfere with medical procedures.
A medical examination at the hospital is performed by a physician and includes the
following:
- Emergency treatment of your injuries.
Depending upon the type of injury, you may require follow-up care by a private physician.
- A blood test and vaginal fluid smear will be
taken to see if you had a sexually transmitted disease (STD) prior to the attack. Medical
personnel will take a blood sample to determine pre-assault pregnancy. Pregnancy from the
attack cannot be detected at this time.
Supplemental Medical Attention
Neither pregnancy nor STD resulting from
the assault will be detectable at the time of your initial medical examination. You will
need to visit a private physician or health clinic for the following tests:
- A week after the assault, you should have a
vaginal smear (sample of vagina fluid lifted on a cotton swab) taken to test for
gonorrhea.
- Six weeks after the assault, a blood test
should be taken for syphilis. This test is called an RPR.
- If you miss your next menstrual period, you
need to wait two weeks, then go for a pregnancy test. A urine or blood test may be given.
Many women have no symptoms when they develop an infection. Untreated, gonorrhea,
syphilis, or chlamydia can spread up the reproductive tract and cause pelvic inflammatory
disease (PID). PID can lead to serious complications, including infertility. Follow-up
examinations are essential to insure adequate treatment.
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- Antibiotics can be given to prevent
bacterial infections which may have been passed on to you by your assailant. If you wish
to be treated, you should ask the physician to prescribe medication to prevent gonorrhea
and syphilis, as well as chlamydia, the most common STD.
- In order to prevent pregnancy from the
assailant, there is the option of taking the "Morning After Pill." Up to
72 hours following your assault, and preferably less than 24, you may choose to take the
Morning After Pill. The Morning After Pill treatment actually consists of four pills, two
taken initially and two more taken twelve hours after the initial dosage. This is not a
form of contraception. Each of the pills contains a high dosage of the synthetic hormones
estrogen and/or progesterone. The pills prevent implantation of a fertilized egg in the
uterus. Some women may experience side effects including headache, nausea and vomiting.
More serious side effects may occur, and those women who are advised against using birth
control pills are advised not to use the morning after pill.
- Some physicians recommend a drug called
Diethylstilbestrol (DES), or another pregnancy preventing drug. This drug prevents
pregnancy if you begin taking it within 48 hours after the rape and continue the
medication for the next 5 days. DES has potential side effects, the most common being
cramps and vomiting. Ask the doctor what you can expect when taking the drug, so you can
decide if it makes sense to you.
- There is a REMOTE possibility that your
assailant could have been infected with HIV, the virus which causes AIDS. While this is
highly unlikely, you may wish to be tested for HIV. If so, the test should be taken 3
months after the assault and repeated again at 6 months if negative.
- Testing is confidential, but not anonymous.
You should be prepared to give a false name as well as any other information requested
until test results are available. You will need to decide about utilizing safer sex
techniques to prevent the possible transmission of any STD that may have been passed on to
you, including HIV infection.
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The results of the tests taken during the
medical exam are available at the STD Clinic. Please call for an appointment.
- For follow-up pregnancy tests contact the
GYN Clinic on the 2nd Floor of the Governor Juan F. Luis Hopsital. Telephone: 778-6311.
If you develop symptoms of an infection, such as vaginal discharge, burning on urination,
abdominal pain, fever, genital sores or warts, please contact your private physician, the
GYN Clinic, or the STD Clinic at the Hospital for examination and treatment.
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At the Medical Medical Examination
As an extended part of the medical
examination, an Evidence Collection Kit will be used to make sure that the evidence needed
to build a strong court case is found and preserved in the correct way.
Medical Procedures
In order to collect evidence of the assault
and gain information about the assailant, the medical staff will perform the following
procedures:
- The medical doctor will make note of any
internal or external signs of injury. A color-photograph of injuries may be taken as
evidence. The doctor will collect evidence to show force and/or penetration. She/he will
also take vaginal fluid samples to determine presence of sperm cells. Anal and/or oral
fluid samples may be needed, depending on the type of assault.
- The doctor will comb your head and pubic
hairs to remove the loose hairs and fibers. Pulled head and pubic hairs are also needed.
- You will be asked to provide a saliva
sample. This is done by saturating filter paper.
- A blood sample will be taken to determine
your blood type.
- The doctor will clip or scrape under your
finger nails to collect any assailant tissue or blood. If you scratched the assailant
during the assault, this tissue or blood may help to identify him later.
- Your clothing and underwear will be
collected and bagged individually. It is hoped that evidence pointing to the identity of
the assailant can be obtained from your clothing.
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At some time before or after the physical
examination, a police detective will ask you to give a detailed account of the assault -
which he/she will write down. If you wish, the WCSC volunteer may accompany you during
this interview.
The interview is an important step in the investigation of sexual assault cases, because
the victim is usually the only witness to the crime. If some of the detective's questions
seem confusing, trivial, or embarrassing, remember that the purpose of the in-depth
interview is to prepare the best possible case for trial. Most officers are sensitive to
your state of mind and will repeat questions, explain questions you do not understand, and
proceed at a pace which is comfortable for you.
You may find this experience difficult, but your cooperation in responding fully to these
questions is essential to the investigation.
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The WCSC Advocate or crisis Counselor can
provide information and support to victims pursuing police or medical follow-up, assailant
identification, prosecution, (that is accompany her to police station, courtroom, etc.),
as well as assist victims with concrete needs like shelter, financial assistance, medical
care and clothing. Call the Women's Coalition at 773-9272 for assistance.
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The assault and its aftermath can be
disruptive to the victim's lifestyle in many ways. A crisis period may extend for several
months or may recur years later. Sexual assault victims often find it helpful to talkover
their concerns with a counselor during these times. Counseling is available through Mental
Health at the victim's and/or family's request. Call 773-1311.
The Women's Coalition would like to be of assistance to you in any way. Please do not
hesitate to contact the Women's Coalition Office, at 773-9272 or 773-WCSC or your
advocate.
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