Sexual assault: health checks you should have
Depending on the nature of the sexual assault you have experienced, you may be concerned about contracting a sexually transmitted infection (STI) or becoming pregnant.
History shows that your risk of catching an STI from a sexual assault is, in fact, quite low. However, the only way to be certain is to be tested. Unfortunately, testing directly after the assault will not usually be helpful in determining whether you have been exposed to an STI. You have to wait 2 weeks to detect infections such as chlamydia and gonorrhoea, at least 3 months for hepatitis and HIV infection, and almost as long for syphilis.
For some STIs, your doctor can prescribe prophylaxis (preventive treatment). However, like all medical treatments, prophylaxis can have side effects, so it is important to weigh up the risks and benefits in your specific case. Your doctor may discuss with you the risk of your having been exposed to an STI and offer you the appropriate prophylaxis.
Also, if there is a chance you could have become pregnant from the assault, your doctor may recommend the 'morning-after pill' and a follow-up pregnancy test in 2 weeks.
Until you get the all-clear from the 2-week and 3-month tests for an STI, it is recommended you practise safe sex, such as using condoms, to protect your partner.
Gonorrhoea and chlamydia
Depending on the risk the attacker has an STI and the nature of the assault, your doctor may offer you antibiotics to prevent chlamydia and gonorrhoea.
If you have not received antibiotic treatment, you can be tested for both these infections after 2 weeks. These days, this is usually done by means of a simple urine test, although it can also be done via a swab of the vagina or penis.
It is important to be tested for these diseases as they can remain 'silent', with no symptoms for many years, potentially causing serious consequences, such as fertility problems in women. Both gonorrhoea and chlamydia can be treated effectively with antibiotics.
You should also have a swab taken at this time if you have any unusual vaginal discharge or discomfort. Another STI, trichomonas, can be detected and is readily treatable, as are other infections that are not necessarily sexually transmitted, such as bacterial vaginosis and candidiasis (also known as thrush).
HIV, hepatitis B and syphilis
Although many people are particularly concerned about contracting HIV, the risk of developing HIV after a sexual assault in Australia is very low. However, if you are considered to be at high risk of contracting HIV, you may be offered post-exposure prophylaxis (PEP).
For HIV, PEP is a combination of drugs that may help to prevent HIV infection from developing. However, these drugs can have serious and unpleasant side effects, so you need to discuss the risks and benefits with your doctor.
For hepatitis B, if you have not already been immunised and the assault is likely to have put you at risk, your doctor may offer you an injection of immunoglobulin. Your doctor may also offer you an injection of hepatitis B vaccine, the first in a course of three. Subsequent booster vaccinations will be needed at one and 6 months after the initial shot to ensure full immunity.
Depending on your risk of exposure to syphilis, your doctor may offer you PEP with an antibiotic.
After 3 months, you can have a blood test to check for infection with HIV, hepatitis B and syphilis.
Genital warts and genital herpes
Finally, there are some STIs for which testing is not reliable, in particular genital warts and genital herpes.
It is estimated that 80 per cent of all adults have blood evidence of having been exposed to the wart virus (human papillomavirus), so blood tests are unlikely to be helpful. There is also a highly variable latency period, which means the virus can be present for many years before showing symptoms. Hence, it is often a case of wait and see, and your doctor may prescribe treatment if a problem arises.
For women, certain strains of wart virus can lead to cancer of the cervix, so it is important to have regular Pap smears to detect any changes early. A vaccine against the wart virus is also available and is now routinely recommended for young women.
The best test for genital herpes is a swab of the blisters that occur when the disease is active. Unfortunately, there is no cure for herpes, but medication is available to manage the symptoms and prevent outbreaks.
Last Reviewed: 08 September 2010
