Adult sexual assault

Discuss cases of sexual assault with the relevant sexual assault referral service to guide appropriate management. For cases involving children, seek paediatric and forensic expert advice – see also STIs in children.

Investigations for sexually transmissible infections (STIs), pregnancy and forensic purposes should be performed on a case-by-case basis. Sample collection for forensic evidence should be undertaken by an experienced professional following established local protocols.

Offer baseline and follow-up screening to adults who have been sexually assaulted. Screen for the following sexually transmissible pathogens: Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum (syphilis), hepatitis B virus (HBV) and HIV. Do not screen for herpes simplex virus (HSV), Mycoplasma or Ureaplasma species. For more information about testing recommendations and management of adults who have been sexually assaulted, see the Australian STI Management Guidelines for Use in Primary Care.

Presumptive antimicrobial therapy for adults who have been sexually assaulted is generally not required. The identification of a sexually transmissible pathogen following sexual assault usually indicates a pre-existing infection. If a pathogen is identified, treat the relevant infection; see:

• Hepatitis B
• HIV
• Chlamydia trachomatis infection
• Neisseria gonorrhoeae infection
• Trichomoniasis
• Syphilis.

For information about postexposure prophylaxis (PEP) against HIV and hepatitis B virus following sexual assault, see Postexposure prophylaxis against bloodborne viruses.

Offer emergency contraception to females¹ of reproductive age presenting within 5 days of a sexual assault.