September 30th 2016

Clinics on or near college campuses can expect students to stroll in with postweekend partying blues or exam stress. Retail health clinicians treat everything from nail fungus picked up in dorm showers to upper respiratory infections. They also counsel students whose first intimate sexual experiences have left them with genital ulcers or urinary tract infections.

Clinics on or near college campuses can expect students to stroll in with postweekend partying blues or exam stress. Retail health clinicians treat everything from nail fungus picked up in dorm showers to upper respiratory infections. They also counsel students whose first intimate sexual experiences have left them with genital ulcers or urinary tract infections.

Some students’ chief complaints may omit serious, stigma-filled problems—scars you might miss on a quick physical exam.

Studies conducted at American universities reveal that nearly 1 in 5 women has been a victim of attempted or completed rape during freshman year. These acts may occur by force or while they were incapacitated due to alcohol or drugs.

A September 2015 survey commissioned by the Association of American Universities found that more than 27% of female college seniors experienced some form of unwanted sexual contact since entering college. Although the studies were small, the body of evidence suggests a similar pattern on most campuses.

Physical, mental, and spiritual effects following sexual assault and rape are difficult to manage. Many students will avoid admitting abuse out of fear. It’s common for sexual violence survivors to experience a range of feelings that may be confusing and can produce more anxiety, such as anger, distrust, and feeling unsafe.

When those college students visit clinics, retail health care providers can help. Consider fashioning questions about sexual history, drinking, and emotional stressors into every visit. Stay impartial and refrain from passing judgment—the last thing any clinician wants to do is exacerbate a difficult situation.

Ask the following open-ended questions to every patient—male or female—at each and every visit, and give them an opportunity to answer:

· How many sexual partners have you had? Have they been consensual? What type of protection did you use?

· Rather than asking how many drinks they have a week, ask: How many drinks do you have per day? When is the last time you do not remember the details from a night of drinking?

If a student reports sexual assault to you, follow these steps:

Physical Aftercare

First, explain that the medical exam is a way to preserve physical evidence of a sexual assault, and refer them to the emergency room for a rape kit if they wish to report the event. A police report may help regain a sense of personal power and control. All states require you to report child or elder abuse, and you should be familiar with your state’s specific requirements.

Consider preventive pregnancy treatment where appropriate. Sexual assault can cause bruising, bleeding (vaginal or anal), difficulty walking, soreness, and broken or dislocated bones. Possible prolonged physical effects can include sexually transmitted infections and diseases. Treat these problems with empathy and acknowledge any feelings brought up when exploring best options for self-care.

Follow-up Care and Testing

Laboratory testing for pregnancy, chlamydia, gonorrhea, trichomonas, hepatitis B, and HIV are often appropriate. If you suspect that the patient was given a “date rape drug,” take a urine sample or refer the patient to a clinic that does. Drugs, such as Rohypnol and GHB, are more likely to be detected in urine than in blood.

Emotional Aftercare

Connect with local specialists and know what resources to recommend locally. Students may have access to free services through on-campus counseling centers. Many of these resources don’t require insurance.

Support is important immediately after the incident and can lessen aftereffects years later. The healing process takes time. Many victims are reluctant to seek help because of their fear that thinking or talking about their experience will be too painful. However, most victims find counseling helpful in the process of recovering and moving on with their life.

A patient surviving assault can experience chronic fatigue, shortness of breath, muscle tension, involuntary shaking, changes in eating and sleeping patterns, and even sexual dysfunction. Small activities that trigger peace or joy—such as daily mediation, painting, or cooking—can make a large difference. Early treatment may help to reduce risk of long-term problems with depression, anxiety, or posttraumatic stress disorder.

Some Helpful Resources:

· Learn about the different forms of psychotherapy from the American Psychological Association and National Institute of Mental Health.

· Contact the Substance Abuse and Mental Health Services Administration Treatment Referral Helpline at 1-800-662-HELP (4357), or search for a local treatment center using their locator tool.

· Crisis centers like the Rape, Abuse, & Incest National Network (1-800-656-HOPE [4673]) offer information about resources and qualified providers in your area. Some hotlines offer a trained crisis counselor to accompany victims to the hospital.

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