Rape (sexual assault) - overview
Rape is defined as sexual intercourse that is forced on a person without his or her permission. It may involve physical force or the threat of force. It may also be done against someone who is unable to give consent.
Sexual intercourse may be vaginal, anal, or oral. It may involve the use of a body part or an object.
Sex and rape; Date rape; Sexual assault
Most estimates say that 80 - 90% of rapes are not reported to police. Current trends project that 1 in 3 American women will be sexually assaulted at some point during their life.
The typical rape victim is a 16- to 24-year-old woman. Anyone, however -- man or woman, adult or child -- can be the victim of rape. In most cases, the victim knows the rapist.
Other important facts about rape include:
- Most commonly, the rapist is a 25- to 44-year-old man who plans his attack. He most often chooses a woman of the same race.
- Alcohol is involved in more than 1 in 3 rapes.
- Rape may occur between members of the same sex. This is more common in places such as prisons, military settings, and single-sex schools.
- People with physical or mental disabilities or limited language skills are also at higher risk. Prostitutes are at higher risk, too.
- More than one-half of rapes occur in the victim's home.
Date rape occurs when someone forces another person they are dating or spending time with to have sex. Date rape may involve the use of drugs such as flunitrazepam (Rohypnol).
The best response when being attacked will depend on the victim, the attacker, and the situation.
- Trying to get away and yelling for help are good first steps in most situations.
- The decision to fight back may depend on the size and behavior of the attacker, as well as whether a weapon is involved.
AFTER A RAPE HAS OCCURRED
The victim may know, or even live or work with a person who sexually assaulted them. It is very important that rape victims get help to find a place where they feel safe after the attack.
People who are raped may not be able to say they were raped or seek help. Some may get medical help for a different reason, such as headaches, eating problems, pain, or sleep problems.
Emotional reactions can vary from person to person. Reactions may include:
- Anger or hostility
- Crying or feeling numb
- Loss of emotional control
- Nervousness or inappropriate laughter
- Not eating or sleeping well
- Tightly controlled behavior
- Withdrawal from family or friends
Victims of rape should be helped to understand that what happened was not their fault. Nothing that they did should have allowed someone to have sex with them against their will. This includes dressing suggestively, or even kissing or other physical intimacy. The fault or blame is solely on the rapist.
The health care providers will:
- Discuss methods of emergency contraception if a woman who was raped could be pregnant from the rape.
- Explain ways to reduce the odds of HIV infection if the rapist may have had HIV. This includes immediate use of medicines used to treat HIV. The process is called post-exposure prophylaxis (PEP).
- Treat the person who was raped for other sexually-transmitted infections, if needed.
After a sexual assault, it is very important that the person get support and information to begin the process of healing. This includes:
- Information about rape and sexual assault should be provided in a safe and supportive environment.
- Ongoing emotional support, including talk therapy
- Rape, Abuse & Incest National Network - www.rainn.org
Slaughter L. Sexual assault. In Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 67.
Cowley D, Lentz GM. Emotional aspects of gynecology. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 9.
Linden JA. Care of the adult patient after sexual assault. N Engl J Med. 2011;365:834-841.
Centers for Disease Control and Prevention (CDC). Sexual assault and STDs. In: Sexually transmitted diseases treatment guidelines. 2010. MMWR Recomm Rep. 2010:17(59)(RR-12):90-95.
Last reviewed 2/24/2014 by Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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