Seeking Medical Care

I feel OK physically. Do I need a medical exam?

It is very important to have a thorough medical examination immediately after a sexual assault, even if you do not have any apparent physical injuries.

You may have injuries of which you are not aware. Most sexual assault survivors do not have serious or life-threatening injuries. Many survivors do not even have visible minor injuries. However, you should still be examined by a doctor or a nurse. You may be in shock, and you may have internal injuries of which you are not aware. You may also have minor injuries, such as scratches or bruises. A doctor or nurse can treat these injuries. The doctor or nurse can also document any injuries you have sustained so that if you decide to take any kind of legal action, such as participating in the prosecution of your assailant, you will have a record of what happened to you.

A medical examination enables you to identify and preserve physical evidence of the assault. During a medical examination, the doctor or nurse can look for and collect physical evidence of a sexual assault, such as sperm samples and stains on your body or clothing. This evidence may be present immediately after the assault but will deteriorate as time passes.

You can receive treatment to prevent sexually transmitted diseases (STDs). A sexual assault can place you at risk for getting STDs. A doctor or nurse can help you evaluate your risk of contracting various STDs and advise you about ways to protect yourself against these risks. One of the benefits of obtaining medical care very soon after a sexual assault is that immediate evaluation and medication can prevent some STDs.

You can receive information about the risk of pregnancy resulting from a sexual assault. If you are a female sexual assault victim, the doctor or nurse can help you determine the likelihood that you could become pregnant as a result of the assault and can advise you about the alternatives available to you.

Should I have a medical exam and evidence collection even if I am unsure about making a police report?

Yes. Even if you are undecided about whether you want to make a police report and unsure about whether you want your assailant prosecuted, you should have evidence collected as soon as possible after a sexual assault. This is the best way to keep your options open for the future. Physical evidence is very important in sexual assault cases. Physical evidence that is present immediately after an assault will deteriorate as time passes. If you do not have an examination soon after the assault, the evidence will be lost forever.

In NH, you can consent to a medical examination and the collection of evidence and still withhold consent to release the evidence to the police. The evidence will remain on file for 3 months, and you will be given a serial number that correlates with your evidence. At the end of the 3 months, if you have not chosen to report the rape, your evidence will be discarded.

Where can I get medical care?

The best place to receive the type of specialized care you need is a hospital emergency department. At most NH hospitals, you will have access to a SANE nurse, a nurse who has received special training in ways to treat victims of sexual assault. They should be sensitive to your needs and able to answer your questions about the physical and emotional effects of the assault.

Can I go to my regular doctor?

You can always consult with your own physician or other regular medical care provider. However, many doctors in private practice and many community clinics recommend that people who have been sexually assaulted seek the specialized services of a hospital ER.

What happens during a sexual assault medical examination?

The doctor or nurse examiner will usually begin by asking questions about your general health. If you are a female, you will be asked about your menstrual history and your use of contraception. You will also be asked specific questions about the assault. It may be difficult to recall some of the details, and it may be emotionally painful to remember and talk about what happened. Medical personnel ask specific questions to find out what to look for when they examine you. The information you give helps them conduct a thorough physical evaluation. For female victims, this usually includes a pelvic exam.

The doctor or nurse will look for injuries and any other signs that force was used, such as tender areas, marks on your skin, and bruises. Although many sexual assault victims do not appear to sustain physical injuries, it is still important to be examined by a health care provider. If you do have visible injuries, you may be asked to give your consent to have photographs taken. Photographing injuries is important because by the time your assailant is prosecuted in a court hearing, the injuries may have healed.

In addition to checking you for injuries, the doctor or nurse can collect other evidence of the sexual assault. Depending on the types of sexual contact that occurred, the search for physical evidence may include taking samples from the vagina, mouth, or rectum to test for sperm cells and semen (the fluid around the sperm). Other evidence may be obtained from fingernail scrapings, foreign matter on your body, and the clothes you were wearing at the time of the assault. (Hospital staff should not take your clothing as evidence if it is not the clothing you were wearing at the time of the assault).

After the examination is completed, the doctor or nurse examiner will document the findings in a medical record. The written record can later be subpoenaed to assist in the legal process.

Can I have someone I know (a support person) stay with me during the examination?

You can have a support person (or persons) of your choice, such as a sexual assault victim counselor, a friend, or a family member, accompany you throughout the examination.

Do I have to pay for the medial exam and evidence collection kit?

The State of NH is responsible for the payment of sexual assault medical examinations not covered by insurance, when the examination is conducted for the purpose of collecting evidence. The Attorney General's Office will cover the cost of all exams, even if the crime is not reported to law enforcement.

Can I get a sexually transmitted disease (STD) as a result of a sexual assault?

The likelihood of getting an STD as a result of a sexual assault depends upon a number of factors, including the type(s) of sexual contact that occurred, the number of assailants, and whether or not an assailant was infected with an STD at the time of the assault.

A number of STDs can be contracted during sexual contact, including hepatitis B, gonorrhea, syphilis, herpes, chlamydia, genital warts, and vaginitis. Immediate and effective treatment options are available for some of these STDs.

Most medical care providers offer sexual assault victims two choices for dealing with the risks of STDs. You may choose to reduce the risk of contracting certain STDs by taking medication immediately as a preventive measure. Or you may wish to wait to see if you actually contracted any disease(s) before taking medication. Whichever treatment option you choose, you should be re-examined and tested within a specific time period to be certain that you do not have an STD.

Do I need to be checked for STDs after a sexual assault, even if I have no symptoms?

Even if you do not have any symptoms of an infection, you should be tested for STDs following a sexual assault. Unfortunately, it is possible to have STDs and not have any physical symptoms. If left untreated, most STDs can cause serious medical problems. Even if you choose not to have an evidentiary examination immediately after a sexual assault, you should see a health care provider for STD testing and information about the treatment options available to you.

What are my chances of contracting HIV as a result of the assault? Should I be tested?

The probability of contracting HIV (the virus that causes AIDS) through sexual assault is unlikely. For you to be at risk, your attacker would have had to be infected with the virus. You should discuss with your doctor or nurse examiner how to deal with the unlikely event of your contracting HIV as a result of a sexual assault.

Most medical care providers recommend, for your own peace of mind and the protection of your sexual partner, that you be tested for the disease. In the unlikely event of transmission of HIV, it may be several months before the virus can be detected in a blood test. A doctor or nurse examiner can talk with you about where and when to be tested and about special precautions you should take to protect your sexual partners.

Can I get pregnant as a result of a sexual assault?

Your personal risk of becoming pregnant from a sexual assault depends on many factors, including the time in your menstrual cycle when the assault occurred, your current use of contraceptives, your fertility, the fertility of the assailant, and whether or not the assailant ejaculated in or near your vagina. A doctor or a nurse examiner can help you evaluate your personal risk of pregnancy.

If you are at risk for becoming pregnant as a result of a sexual assault, a medical care provider can explain the various treatment options available to you. If you choose to have immediate treatment to prevent the risk of a pregnancy, the options are most effective if you seek care within 72 hours after the assault.

You may also decide to wait to see if you become pregnant as a result of a sexual assault. If you do become pregnant, a health care provider can discuss your options with you.