The primary health care provider's role in sexual assault prevention

Abstract

The prevention of sexual assault has traditionally been considered a criminal justice issue, but current epidemiologic and medical research has identified risk factors and sequelae that warrant greater attention from the medical community. Population-based research over the past decade has identified a much higher incidence of sexual victimization than was previously described in government reports. Furthermore, the perpetrator is often known to the victim. Recent research has also confirmed that the sequelae of victimization have far-reaching effects on the physical, psychological, and behavioral functioning of victims, their families, and partners. The definition of sexual assault has expanded to encompass a variety of forced sexual activity including childhood sexual abuse, date rape, marital rape, as well as sexual assault by an acquaintance or stranger. While the medical community has addressed the importance of identifying women with a history of abuse or assault, little attention has been directed toward sexual assault prevention. Standard preventive medicine principles provide the framework within which guidelines and recommendations may be established to aid the primary care provider in primary, secondary, and tertiary prevention of sexual assault. This article describes current findings regarding the scope of sexual assault, rationale for using a preventive approach, and recommendations for prevention efforts that can be implemented by the primary care provider.