SAQ 237 – Sexual Health – adolescent sexual assault

Question 8. adolescent sexual assault.

a. Risk-assessment history

• Specifics of the assault, including genital, rectal, perineal, or other contact.
• Body-fluid exposure and infection risk.
• Pregnancy-prevention methods and menstrual history.
• Other trauma, including strangulation, head injury, or fractures.
• Associated drug use.
• Psychological development, developmental delay, or psychiatric history.
• Social circumstances and safeguarding risk.

b. Emergency contraception

• Assess pregnancy risk according to timing in the menstrual cycle.
• Consider contraindications and relevant thromboembolic history.
• Earlier treatment is more effective, ideally within 72 hours.
• Provide antiemetic advice or prophylaxis.
• Discuss reduced efficacy at higher body weight or BMI.
• Arrange follow-up pregnancy testing and counselling.

c. Immediate STI prophylaxis

• Multiple offenders.
• Genital injury increasing blood-borne-virus exposure.
• Offender from an HIV-endemic area.
• High risk of failure to follow up.
• Offender known to have an STI.