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Because of the potential legal implications of evidence collection in sexual assault cases, physicians are cautioned against making their own rape kit, unless absolutely necessary.Drug-facilitated sexual assault should be considered when the survivor reports amnesia (partial or total) or the sense that “something sexual happened.”7 The presence of drugs or alcohol may be used as an excuse by the perpetrator and to blame the woman for the sexual assault.27 The substance most commonly associated with sexual assault is alcohol, often combined with over-the-counter, prescription, or illegal drugs.If the survivor decides to report the assault, the local law enforcement agency should be contacted.6).

Prevention of sexual assault is societal and should focus on public health education.

It occurs worldwide and affects up to one third of women over a lifetime.1 Sexual assault includes vaginal, oral, and anal penetration and is more broadly conceived than the legal definition of rape as nonconsensual penetration by a penis.

Sexual assault is underreported, and the wide range in estimated lifetime prevalence reflects the method of data collection, with lower rates (12 to 20 percent) reported in persons presenting for medical care and higher rates (20 to 30 percent) reported in community surveys.2 Fifty to 80 percent of sexual assaults are committed by a person known to the survivor.1A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series.

HELEN LUCE, DO, Wausau Family Medicine Residency Program, Wausau, Wisconsin SARINA SCHRAGER, MD, MS, and VALERIE GILCHRIST, MD, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Am Fam Physician. Related Editorial Sexual violence affects up to one third of women during their lifetime.

Sexual assault is underreported, and more than one half of assaults are committed by someone known to the survivor.

The decision to refer should be based on: (1) the availability of another site for assessment; (2) time available to complete the evaluation (30 to 60 minutes for the actual visit, with further time for coordination of legal, social, and psychological care)6 ; (3) experience with evaluation and treatment of sexual assault survivors; and (4) the ability to collect and preserve appropriate evidence (e.g., having the contents of a “rape kit” available [6]).

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