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The specific legal definition of sexual assault varies from state to state. Generally, sexual assault is forced sexual contact without consent. Sexual assault occurs along a continuum from unwanted touching and fondling of sex organs to forced penetration (oral, anal, or vaginal). Fingers or objects (such as broomsticks, bottles, or knives) could be used instead of, or in addition to, a penis as a weapon of choice. Drugs such as gamma-hydroxybutyric acid (GHB), Rohypnol (flunitrazepam), or ketamine are known as date rape or club drugs. They can be used to disable the victim prior to a sexual assault. Alcohol has also been used as a date rape drug.

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Recent studies show that 13 to 18 percent of women and 3 percent of men have experienced an attempted or completed sexual assault in their lifetime.1 FBI and crime statistics grossly underestimate the incidence since only 16 percent of sexual assaults are reported to police.1 Approximately 300,000 to 700,000 adult women are victims of sexual assault annually in the United States, with 40,000 victims treated in Emergency Departments.1,2

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Sexual assault is not generally a crime among strangers. Most women (78 to 82 percent) are sexually assaulted by someone known to them.1,3,4 The assailant may include a spouse, boyfriend, family member, coworker, or neighbor. More than 50 percent of rape victims over the age of 30 are sexually assaulted by an intimate partner.5 The offender may be someone the victim knows less well, such as a contractor or package delivery person.

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There is not a typical profile of a victim, although adolescent girls and young women face particularly high rates of sexual assault.6 Victims have been reported in all age groups. Sexual assault occurs across all socioeconomic groups, all racial backgrounds, and all ethnic backgrounds. Up to 39 percent of women will be raped more than once during their lifetime.1

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Some victims will not identify themselves as victims of sexual assault. They may be ashamed or fearful to disclose what happened. They also may be experiencing the rape trauma syndrome, a special category of posttraumatic stress disorder. The use of screening questions, as used for domestic violence, and a high index of suspicion is necessary in identifying these patients. There is a significant increase in the utilization of medical resources after a sexual assault.7

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The Emergency Department visit of a sexual assault victim plays a vital role in assuring proper medical care, evidence collection, and treatment. The proper follow-up plans and referrals to local rape crisis centers and/or hotlines are crucial to the mental and physical recovery of victims. The initial treatment in the Emergency Department will strongly influence whether the patient will get follow-up care and pursue the case through legal avenues. It is critical to not revictimize the patient and make them feel responsible for the sexual assault....

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