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RESEARCH ARTICLE (Open Access)
Contents Vol 21(3)

Management of acute sexual assault presenting to a large Australian sexual health clinic in 2012–2021: a retrospective clinical audit

Aleah Kink https://orcid.org/0000-0002-6034-2833 A B * , Janet M. Towns https://orcid.org/0000-0003-2714-4680 A C , Christopher K. Fairley https://orcid.org/0000-0001-9081-1664 A C , Tiffany R. Phillips https://orcid.org/0000-0001-6920-7710 A C , Catriona S. Bradshaw https://orcid.org/0000-0002-6643-5678 A C D and Eric P. F. Chow https://orcid.org/0000-0003-1766-0657 A C D
+ Author Affiliations
- Author Affiliations

A Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia.

B Melbourne Medical School, The University of Melbourne, Melbourne, Vic., Australia.

C School of Translational Medicine, Monash University, Melbourne, Vic., Australia.

D Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia.

* Correspondence to: aleah.kink@outlook.com

Handling Editor: Weiming Tang

Sexual Health 21, SH23175 https://doi.org/10.1071/SH23175
Submitted: 10 October 2023  Accepted: 21 March 2024  Published: 11 April 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

The incidence of sexual assault continues to rise in Australia. This study aimed to describe the nature of assault, HIV/STI positivity, and its management at a sexual health clinic.

Methods

We performed a chart review of 516 sexual assault cases presenting to Melbourne Sexual Health Centre between 2012 and 2021, collecting data on victim demographics, details of assault, HIV/STI testing and positivity, police involvement, and offer of counselling.

Results

We included 516 cases: 124 males (24.0%); 384 females (74.4%); and eight transgender (1.6%) victims. The proportion of assault cases presenting to Melbourne Sexual Health Centre increased from 0.1% (37/37,070) in 2012 to 0.2% (56/36,514) in 2021 (Ptrend = 0.006). HIV post-exposure prophylaxis was prescribed for 64.5% (80/124) of males and 12.5% (48/384) of females. Among victims, 69.4% (358/516) were tested for HIV and no one tested positive, while 71.9% (371/516) were tested for syphilis, with 1.6% (6/371) positive. Gonorrhoea and chlamydia were tested at the oropharynx (44.8% [231/516] vs 28.7% [148/516]), genitals (83.7% [432/516] vs 92.4% [477/516]) and anorectum (35.3% [182/516] vs 35.3% [182/516]). Positivity for gonorrhoea and chlamydia were: 2.6% (6/231) vs 2.0% (3/148) at oropharynx, 1.4% (6/432) vs 2.9% (14/477) at genitals, and 5.5% (10/182) vs 7.1% (13/182) at anorectum. According to clinical records, 25.2% (130/516) of victims sought police involvement, and 71.7% (370/516) were offered counselling.

Conclusions

Sexual assault was an uncommon presentation at Melbourne Sexual Health Centre, with diverse circumstances surrounding assault; however, clinical documentation varied, indicating a need for a standard primary care protocol for clients presenting with acute sexual assault.

Keywords: human immunodeficiency virus, primary care, rape, sexual assault, sexual harassment, sexual violence, sexually transmitted infection, violence exposure.

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