Central Health Clinic, The Bridge Sexual Assault Referral Centre, Tower Hill, Bristol BS 2 0JD, UK.
Best Pract Res Clin Obstet Gynaecol. 2013 Feb;27(1):141-9. doi: 10.1016/j.bpobgyn.2012.08.013. Epub 2012 Nov 29.
Immediate needs after sexual assault include safety and privacy in the first instance, followed by treatment of injuries and prevention of unwanted pregnancy and sexually transmitted infections, including human immunodeficiency virus. Management should include risk identification of self-harm and suicide, as well as safeguarding children and vulnerable adults. Pregnancy prevention can be achieved through oral or mechanical methods of emergency contraception. Availability of emergency contraception may vary between districts and countries, depending on local laws and cultural or religious beliefs. Sexually transmitted infections, including gonorrhoea, chlamydia, hepatitis B and human immunodeficiency virus, represent an important part of management of victims of sexual assault. They can be prevented immediately by offering bacterial and viral prophylaxis followed by sexual health screening 2 weeks later unless symptomatic. In deciding what antibiotics to use as prophylaxis, local prevalence of infections and resistance to antibiotics should be considered. Prophylaxis against human immunodeficiency virus infection after sexual exposure should be discussed and offered in high-risk cases for up to 72 h after exposure. This should be accompanied by baseline human immunodeficiency virus test and referral for follow up. In high prevalence areas, prophylaxis against human immunodeficiency virus infection after sexual exposure should be offered as a routine. Psychosocial support and risk assessment of vulnerabilities, including self-harm or domestic violence and practical support should be addressed and acted on depending on identified needs.
性侵犯后立即需要的是安全和隐私保护，其次是治疗伤害、预防意外怀孕和性传播感染，包括人类免疫缺陷病毒。管理应包括识别自我伤害和自杀风险，以及保护儿童和弱势成年人。可以通过口服或机械方法紧急避孕来预防怀孕。紧急避孕的可用性可能因地区和国家而异，取决于当地法律以及文化或宗教信仰。性传播感染，包括淋病、衣原体、乙型肝炎和人类免疫缺陷病毒，是性侵犯受害者管理的重要组成部分。可以通过提供细菌和病毒预防措施并在 2 周后进行性健康筛查来立即预防这些感染，除非出现症状。在决定使用哪种抗生素作为预防措施时，应考虑当地感染的流行情况和抗生素耐药性。对于高危情况，应在性接触后 72 小时内讨论并提供预防人类免疫缺陷病毒感染的措施，同时应进行人类免疫缺陷病毒基线检测并进行后续转介。在高流行地区，应常规提供性接触后预防人类免疫缺陷病毒感染的措施。应根据需要提供社会心理支持和脆弱性风险评估，包括自我伤害或家庭暴力以及实际支持，并采取相应措施。
