Risk Assessment of Sexually Transmitted Infections in Sexual Assault Victims

Objective: Sexual assault is a global problem presenting with medical and legal sequelae, and accompanying risks have been increasing as young women are exposed to more sexual violence in emerging online communities. Sexual assault victims are at risk of acquiring Sexually Transmitted Infections (STIs); therefore, proper management is essential. This study aimed to assess the risks of STIs among sexual assault victims and develop a standardized protocol to provide appropriate care.

Methods: This was a prospective, single-center study of alleged female sexual assault victims aged ≥ 19 years who visited the Seoul South District Sunflower Center. The investigation included documentation of history, laboratory evaluation, and testing for STIs at the time of the first visit, 1- month after the assault (second visit), and 6-months after the assault (third visit). The primary outcomes included the presence of STIs, Gram staining, and culture from vaginal excretion. The variables were analyzed using Fisher’s exact test and Firth’s logistic regression, and a two-sided P<0.05 was considered statistically significant. Data were analyzed using SPSS 26.0.

Results: From a total of 117 alleged sexual assault victims initially enrolled in the study, 63 completed both the 1st and 6th months follow up. In univariate analysis, victims with a previous experience in sexual intercourse showed a higher risk of positive vaginal Gram staining and culture results at the initial visit than those with no previous experience (P=0.028). The use of prophylactic antibiotics at the initial visit did not result in a lower risk of STIs and bacterial vaginitis at the second and third visit.

Conclusion: The use of prophylactic antibiotics at the initial visit did not reduce the risk of future STIs among sexual assault victims. Although prophylactic antibiotic administration at the the initial visit is not a risk factor for STIs, it is important in maintaining the health of sexual assault victims.