Incidence and distribution of pain symptoms after sexual assault

Women with a history of sexual assault commonly report chronic pain. However no prospective studies have examined onset of pain symptoms following sexual assault among survivors. We are conducting an ongoing prospective study examining the incidence and distribution of pain symptoms among women presenting for Sexual Assault Nurse Examiner (SANE) care within 72 hours of sexual assault. Research study sites include a network of 12 SANE programs in North Carolina, South Carolina, and Virginia. Consenting survivors complete initial symptom assessment at the time of SANE exam. Survivors subsequently consenting to the full study receive follow-up interview assessments 1 week, 6 weeks, 3 months, and 6 months after assault. Assessments include reported pain intensity (0-10 numerical rating scale [NRS]) in 8 body regions. Those with NRS ≥4 in ≥ 1 body region were defined as being in moderate or severe pain. To date, thirty one survivors (mean(SD) age = 26(7.0)) have completed enrollment and received at least one follow-up assessment. Eighty four percent (26/31) of survivors had moderate or severe pain at the time of initial evaluation (most commonly in genital (52%), head and face (39%), and neck (26%) regions). No (0/31) survivors were prescribed pain medication at the time of SANE discharge. Seventy-one percent (22/31) of survivors had moderate or severe pain 1 week after assault (most commonly in abdomen (52%), genital (45%), and head and face (26%) regions). Fifty percent (12/24) of survivors continued to have moderate or severe pain 6 weeks after assault (most commonly in abdomen (25%), genital (21%), and neck (21%) regions). Only 13% (2/16) of patients with continued moderate or severe pain at 6 weeks were receiving pain medication. More research is needed examining pain incidence and distribution and optimal treatments for pain in sexual assault survivors.