Fast Five Quiz: Addressing Sexual Assault

Richard H. Sinert, DO

Disclosures

May 08, 2019

Decisions to perform baseline STD testing should be made on an individual basis. An initial examination might include the following procedures:

  • NAAT for Chlamydia trachomatis and Neisseria gonorrhoeae is preferred for the diagnostic evaluation of adolescent or adult sexual assault survivors.

  • NAAT from a urine or vaginal specimen or point-of-care testing (ie, DNA probes) from a vaginal specimen for Trichomonas vaginalis may be indicated. Point-of-care testing and/or wet mount with measurement of vaginal pH and KOH application for the whiff test from vaginal secretions should be performed to identify evidence of bacterial vaginosis and candidiasis, especially if vaginal discharge, malodor, or itching is present.

  • A serum sample for evaluation of HIV, hepatitis B, and syphilis infections may also be performed.

All patients should be offered antibiotic prophylaxis, regardless of results from preliminary STD screening. Cultures of exposed body sites (eg, oral, throat, vaginal, rectal) are recommended as appropriate. According to the CDC, US Food and Drug Administration (FDA)–approved NAATs are an acceptable substitute for culture, as long as positive test results are confirmed by a second study. Other tests (eg, EIA, nonamplified probes, direct fluorescent antibody tests) are not considered acceptable alternatives by the CDC because of unacceptable false-negative and false-positive result rates.

Read more on STD testing in patients who have experienced sexual assault.

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