Assistance to Victims of Sexual Violence in a Referral Service: A 10-Year Experience

Abstract

Objective To evaluate the assistance provided to women victims of sexual violence and their participation in the follow-up treatment after the traumatic event, presenting a sociodemographic profile, gynecological background, and circumstances of the event, and reporting the results, acceptance, and side effects of prophylaxis for sexually transmitted infections (STIs) and pregnancy. Methods A retrospective cohort study comprising the period between 2007 and 2016. All women receiving medical care and clinical follow-up after a severe episode of sexual violence were included. Records of domestic violence, male victims, children, and adolescents who reported consensual sexual activity were excluded. The present study included descriptive statistics as frequencies and percentages. Results A total of 867 medical records were reviewed and 444 cases of sexual violence were included. The age of the victims ranged from 10 to 77 years old, most of them self-declared white, with between 4 and 8 years of education, and denying having a sexual partner. Sexual violence occurred predominantly at night, on public thoroughfare, being committed by an unknown offender. Most victims were assisted at the referral service center within 72 hours after the violence, enabling the recommended prophylaxis. There was high acceptance of antiretroviral therapy (ART), although half of the users reported side effects. Seroconversion to human immunodeficiency virus (HIV) or to hepatitis B virus (HBV) was not detected in women undergoing prophylaxis. Conclusion In the present cohort, the profile of victims of sexual violence was low-educated, young, white women. The traumatic event occurred predominantly at night, on public thoroughfare, being committed by an unknown offender. Assistance within the first 72 hours after sexual violence enables the healthcare center to provide prophylactic interventions against STIs and unwanted pregnancies.

Adolescent Female Victims of Sexual Violence: Analysis of Loss of Follow-up after Emergency Care and Outpatient Follow-up

“…14 Another Brazilian retrospective study, conducted between 2007 and 2016, that aimed to assess the care provided to female survivors of SV aged 11 to 77 years reported that 167/444 (37.6%) women did not return within the 1st month, and 284/444 (64%) discontinued before completing the follow-up of 90 days. 18 The lower loss to follow-up found in our study compared to those mentioned was probably due to differences between the samples. While our study included only adolescent females up to 18 years of age, the others included populations of survivors of different ages.…”

“…14 Another Brazilian retrospective study, conducted between 2007 and 2016, that aimed to assess the care provided to female survivors of SV aged 11 to 77 years reported that 167/444 (37.6%) women did not return within the 1st month, and 284/444 (64%) discontinued before completing the follow-up of 90 days. 18…”

“…Other studies of survivors of SV have shown higher rates of discontinuation before the age of 6 months. [13][14][15][16][17][18] A prospective study carried out from 1988 to 1990 in a university service in Vancouver, Canada, with women aged over 16 years treated in emergency care after SV reported that only 61/296 (21%) could be traced to 6 months. 13 A retrospective study analyzed data from 1,695 adult victims of sexual abuse treated in emergency care in Barcelona during the period from 2006 to 2015 and reported that, among the 883 who received prophylactic treatment for HIV, only 284 (32%) completed the 6-month follow-up.…”

“…12 Although this care contributes to lessening SV-related harm, studies have described low adherence rates both for treatment in the 1st month and for subsequent outpatient follow-up of up to 6 months. [13][14][15][16][17][18] Few studies have specifically evaluated the adherence of surviving adolescents to these protocols. 15,16,19 A study evaluated female survivors of SV aged 12 to 19 years and described that 44/131 (33.6%) completed treatment within the 1st month.…”

“…12 Although this care contributes to lessening SV-related harm, studies have described low adherence rates both for treatment in the 1st month and for subsequent outpatient follow-up of up to 6 months. 13 14 15 16 17 18…”