Different Nordic facilities for victims of sexual assault: a comparative study.

BACKGROUND: Open multidisciplinary centers were operated in the mid 1990s for victims of sexual assaults in Oslo and Reykjavik. However, in Copenhagen and Helsinki forensic medical examination was only available to victims who reported directly to the police. One of the main aims of this study was to compare the effect of these different service facilities in four Nordic capitals on the victims' frequency to seek help and report sexual assaults to the police. METHODS: The age and attendance profile of 380 individuals, seeking support after sexual assault, was compared for the four capitals over a period of 1 year. The circumstances and consequences of assault, frequency and time lag of reporting were also compared. RESULTS: Open centers received several times more victims, especially in younger age groups, including more reported cases, when compared with the population at risk than forensic institutes. Victims were seen earlier for examination at forensic institutes that dealt with a more limited spectrum of sexual assaults than the open centers. The proportion of rape was higher amongst victims brought to forensic institutes whereas a higher proportion of victims received at open centers had been exposed to less violent assaults. The frequency of visits was higher at weekends, between 50% and 70% of victims reported consumption of alcohol, and one-third were attacked while sleeping. In the majority of cases only one perpetrator was involved, most often unknown or peripherally known to the victim. CONCLUSION: Open multidisciplinary centers receive and assist considerably more victims, reporting and not reporting sexual assaults than forensic institutes.

[Sexually transmitted infections and sexual violence against women. Guidelines for examination, prophylactic treatment and follow-up]. / Seksuelt overførte infektioner og seksuel vold mod kvinder. Forslag til undersøgelse, profylaktisk behandling og opfølgning.

Based upon a literature search, but also considering the situation in Denmark, guidelines for examination, prophylactic treatment and follow-up of female victims of sexual assault have been prepared. A pragmatic attitude, looking upon the victim's situation and fear of having acquired a sexually transmitted infection, has been prevailing in order to avoid unnecessary examinations and treatments. The guidelines are directed towards female victims in whom the assault has included vaginal, oral, and/or anal penetration or attempt of penetration. It is concluded that all victims should be screened for and offered prophylactic treatment for chlamydia. Screening for gonorrhea initially and at follow-up is recommended but treatment only if an infection has been established. All victims should be screened for hepatitis B initially and again after three months and vaccination offered if any information indicates that the assailant has an increased risk of hepatitis B. All victims should be screened for HIV initially and again after one and three months. In single cases antiviral HIV prophylaxis must be considered.

Diagnosis of urogenital Chlamydia trachomatis infections by home-obtained, mailed samples: do we need a telephone hotline for information and advice?

This study evaluates the use of dedicated telephone hotlines to provide advice to young individuals who were offered the chance to be tested for Chlamydia trachomatis by means of home-obtained samples that were mailed directly to a testing laboratory. In a school-based screening study, a population-based screening study and a partner-tracing study we established hotlines and registered the calls. The target groups for the 3 studies comprised 8,909, 9,000 and 4,622 individuals and 0.1% (8/8,909), 0.7% (66/9,000) and 2.7% (124/4,622) of the populations, respectively took the opportunity to call anonymously to receive advice. The number of calls per opening hour of the hotlines varied between 0.2 (8 calls/40 opening hours) and 0.4 (124 calls/300 opening hours). Major reasons for calling the hotlines included requests for more information about chlamydial infections, questions relating to the study and emotional concerns (e.g. problems relating to partner tracing, adultery or anxiety concerning infertility). Although only a small fraction of the target populations used the hotlines we conclude that there is a need for advice and counseling in connection with strategies involving home-obtained samples for C. trachomatis testing. The optimal setting for this, however, remains to be determined.