Severe pain is common but rarely treated in the immediate aftermath of sexual assault

National epidemiological data indicate that 17-25% of women experience rape or attempted rape in their adult lifetimes. When rape survivors seek help in the acute aftermath of the assault, they are likely to turn to the medical system, specifically, Sexual Assault Nurse Examiner (SANE) programs. SANE programs are most commonly located in hospital emergency departments, but may also be located in free-standing clinics or community centers. Rates of survivor treatment with medications to prevent sexually transmitted infection and pregnancy have previously been reported; however, to our knowledge the incidence and treatment of pain symptoms in the acute aftermath of sexual assault has not been assessed. We enrolled 79 [mean(SD) age = 26(7.5)] sexual assault survivors presenting for SANE care to one of 11 SANE treatment centers located in NC, SC, VA, or MD. Study assessments included an evaluation of survivor pain symptoms (0-10 numeric rating scale [NRS] in each of eight body regions) performed by a research assistant at the time of the initial SANE evaluation. Medical records were subsequently reviewed (hospital chart, SANE record) to determine pain medication treatment during SANE care and pain medication prescription at the time of discharge. Pain severity was categorized as follows: 1-3 = mild, 4-7 =moderate, 8-10 =severe. Survivors reported the following pain severity in one or more body regions: no pain [3/79 (4%)], mild pain [7/79 (9%)], moderate pain [27/79 (34%)], severe pain [42/79 (53%)]. Among survivors with severe pain, only 21% (9/42) received any pain medication at the time of SANE exam, and only 2% (1/42) received a pain medication prescription at discharge. These results suggest that severe pain is common in sexual assault survivors receiving SANE care, and that many survivors with severe pain do not receive pain medication treatment.