FOLLOW-UP OF SEXUAL ASSAULT VICTIMS

OBJECTIVES: Our goal was to describe medical findings and health-relat ed concerns of sexual assault victims who returned for follow-up and t o assess demographic and assault characteristics of victims who used f ollow-up services compared to those who did not. STUDY DESIGN: This st udy is a retrospective cohort analysis involving records from two sour ces: the acute sexual assault evidentiary examination and the SAFE (Se xual Assault Follow-up Evaluation) Clinic visit. Data were extracted f rom the records of 389 adolescent and adult victims who reported an ac ute sexual assault and underwent a complete evidentiary examination be tween January 1, 1995, and June 30, 1997. Descriptive statistics were generated on demographic and historical information, assault character istics, and medical and laboratory findings. For the subgroup that pre sented for follow-up, additional descriptive statistics were generated to describe their interim history, concerns, medical outcomes, treatm ents, and psychosocial functioning, chi(2) analyses were used to ident ify differences in the group that returned for follow-up compared with the group that did not. Statistical significance was defined as P < . 05. RESULTS: There were no differences in age, race, or perpetrator fa ctors between patients who used follow-up services and patients who di d not return to the SAFE Clinic. Similarly, there were no other assaul t characteristics, relationships, or physical examination findings tha t were associated with follow-up patterns. A total of 31% (n = 122) of all sexual assault victims returned for a follow-up visit. Physical c omplaints were reported by 42.6%, but 98.0% had normal findings at a g eneral examination, and 94.8% had a normal result of gynecologic exami nation. Pregnancy and sexually transmitted diseases, including human i mmunodeficiency virus. were identified through the follow-up clinic. S ince the assault, 49.2% had been sexually active, 10% with multiple pa rtners and 73.3% without consistent condom use. Disturbances in sleep, sexual function, and appetite were commonly reported among victims at follow-up. Numerous assault-related fears were reported. CONCLUSIONS: Among recent rape victims, follow-up rates are low, and there are no factors that correlate with the use of follow-up services. Those who d o come in for follow-up have physical complaints and health-related co ncerns that are related to their recent assault, but most have normal physical findings. Efforts to reach sexual assault Victims will requir e aggressive and innovative strategies to remain in contact with women and girls after rape.