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Some groups are particularly vulnerable, including adolescents; survivors of childhood sexual or physical abuse; persons who are disabled; persons with substance abuse problems; sex workers; persons who are poor or homeless; and persons living in prisons, institutions, or areas of military conflict.15 This article reviews treatment of women who have been sexually assaulted and the long-term sequelae of sexual assault.Reference to the American Academy of Family Physicians policy statement on sexual assault can be found in Immediate treatment of a woman who has been sexually assaulted should address three areas: legal, medical, and psychosocial.Although both men and women can be sexually assaulted, women are at greatest risk.

Evidence to be collected includes: the patient's clothing; fingernail scrapings; head and pubic hair combings; plucked hair from the patient; swabs of the oropharynx, vagina, and rectum; and blood samples.6 Patient discharge information includes local community resources and follow-up plans.Most women who have been sexually assaulted will present to the emergency department.If a woman presents to the family physician's office, the physician should determine if he or she can evaluate the patient appropriately and, if necessary, discuss referral with her.The decision to refer should be based on: (1) the availability of another site for assessment; (2) time available to complete the evaluation (30 to 60 minutes for the actual visit, with further time for coordination of legal, social, and psychological care)6 ; (3) experience with evaluation and treatment of sexual assault survivors; and (4) the ability to collect and preserve appropriate evidence (e.g., having the contents of a “rape kit” available [6]).The benefits of seeing the woman in the family physician's office include a less intimidating environment and an established relationship with the physician.For information about the SORT evidence rating system, go to https://org/A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series.For information about the SORT evidence rating system, go to https://org/Sexual violence is an act of aggression by the powerful against the less powerful.HELEN LUCE, DO, Wausau Family Medicine Residency Program, Wausau, Wisconsin SARINA SCHRAGER, MD, MS, and VALERIE GILCHRIST, MD, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Am Fam Physician. Related Editorial Sexual violence affects up to one third of women during their lifetime.Sexual assault is underreported, and more than one half of assaults are committed by someone known to the survivor.Presentations to the family physician may include self-destructive behaviors, chronic pelvic pain, and difficulty with pelvic examinations.Prevention of sexual assault is societal and should focus on public health education.

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