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Immediate medical care after sexual assault

机译：性侵犯后立即就医

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Immediate needs after sexual assault include safety and privacy in the first instance, followed by treatment of injuries and prevention of unwanted pregnancy and sexually transmitted infections, including human immunodeficiency virus. Management should include risk identification of self-harm and suicide, as well as safeguarding children and vulnerable adults. Pregnancy prevention can be achieved through oral or mechanical methods of emergency contraception. Availability of emergency contraception may vary between districts and countries, depending on local laws and cultural or religious beliefs. Sexually transmitted infections, including gonorrhoea, chlamydia, hepatitis B and human immunodeficiency virus, represent an important part of management of victims of sexual assault. They can be prevented immediately by offering bacterial and viral prophylaxis followed by sexual health screening 2 weeks later unless symptomatic. In deciding what antibiotics to use as prophylaxis, local prevalence of infections and resistance to antibiotics should be considered. Prophylaxis against human immunodeficiency virus infection after sexual exposure should be discussed and offered in high-risk cases for up to 72 h after exposure. This should be accompanied by baseline human immunodeficiency virus test and referral for follow up. In high prevalence areas, prophylaxis against human immunodeficiency virus infection after sexual exposure should be offered as a routine. Psychosocial support and risk assessment of vulnerabilities, including self-harm or domestic violence and practical support should be addressed and acted on depending on identified needs. ? 2012 Elsevier Ltd. All rights reserved.
机译：性攻击后的紧迫需要首先包括安全和隐私，其次是受伤的治疗以及防止意外怀孕和包括人类免疫缺陷病毒在内的性传播感染。管理应包括识别自我伤害和自杀的风险，以及保护儿童和脆弱的成年人。可以通过口服或机械紧急避孕方法来预防怀孕。紧急避孕的可用性可能因地区和国家而异，具体取决于当地法律和文化或宗教信仰。性传播感染，包括淋病，衣原体，乙型肝炎和人类免疫缺陷病毒，是管理性侵犯受害者的重要组成部分。除非有症状，否则可通过提供细菌和病毒预防措施立即进行预防，然后在2周后进行性健康筛查。在决定使用哪种抗生素进行预防时，应考虑感染的局部患病率和对抗生素的耐药性。高危病例应在性接触后长达72小时内讨论预防性接触人类免疫缺陷病毒的方法，并提供预防措施。这应伴随基线人类免疫缺陷病毒测试并转诊以进行随访。在高流行地区，应提供预防性接触后预防人类免疫缺陷病毒感染的措施。应对社会心理支持和脆弱性（包括自残或家庭暴力）风险评估和实际支持，并根据已确定的需求采取行动。 ？ 2012 Elsevier Ltd.保留所有权利。

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