Rape (sexual assault) - overview

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Definition

Rape is defined as a sexual act forced on a person against his or her will. 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.

Alternative Names

Sex and rape; Date rape; Sexual assault

Information

Most estimates say that 80% to 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
  • Confusion
  • Crying or feeling numb
  • Fear
  • 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.

TREATMENT

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 PREVENTION

The most useful tool to prevent rape is to be more aware of the issue. Always trust your instincts if you are somewhere or with someone that does not feel safe and comfortable.

RESOURCES:

References

Cowley D, Lentz GM. Emotional aspects of gynecology. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 9.

Linden JA. Clinical practice. Care of the adult patient after sexual assault. N Engl J Med. 2011;365(9):834-841. PMID: 21879901 www.ncbi.nlm.nih.gov/pubmed/21879901.

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: Elsevier Saunders; 2014:chap 67.

Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137. PMID: 26042815 www.ncbi.nlm.nih.gov/pubmed/26042815.

Version Info

  • Last reviewed on 4/5/2016
  • Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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