Medical Concerns

Receiving immediate and follow-up medical attention is one of the most important things that you can do for yourself if you have been sexually assaulted. You may have injuries that need to be treated, and you may want to be tested for pregnancy and sexually transmitted infections (STIs).

  • If You Were Assaulted Recently Expand dropdown
    • You are encouraged to go to an emergency room of your choosing. The most important reason to do this is to check for injuries. Shock, and general aches and pains from the assault may be difficult to distinguish from a serious injury. Although it will not be easy, an exam may help set your mind at ease. You will also be given important information about STIs and pregnancy.
    • If you are not already using contraception, you may want to ask your doctor or nurse about emergency contraception, known as “the morning after pill.” This treatment is a high dose of estrogen that has proven effective as in pregnancy prevention if taken within 72 hours of the assault. Your doctor or nurse will be able to discuss the risk and benefits of such a treatment. The hospital may also give you antibiotics for gonorrhea and chlamydia. You may be started on a vaccination series for the prevention of hepatitis B and referred for testing for HIV and syphilis. If base-line tests for pregnancy and STIs are completed, they will only tell you if you were infected or pregnant before the assault.
    • Another important reason to receive immediate medical attention is to collect physical evidence for a criminal investigation. Under Michigan law, every hospital emergency department is required to offer a Sexual Assault Evidence Collection Kit, if the assault happened within the previous 96 hours. Evidence is best collected within six hours of the assault. You are not required to have the kit completed, and the hospital cannot refuse to use the kit if you are undecided about prosecuting your perpetrator.
    • Both the St. Joseph Mercy Hospital and the University of Michigan emergency rooms have a Sexual Assault Nurse Examiner program available for treatment, testing and evidence collection. Specially trained staff at hospital emergency departments or nurse examiner programs can complete a sexual assault evidence collection exam. This standardized exam is a series of lab tests that are designed to collect physical evidence for use in the prosecution of a sexual assault. Your nurse, doctor or SafeHouse Center advocate can explain exactly what the exam entails.
    • Who pays for the hospital visit? The Michigan SAFE Response program, (effective January 2009) ensures that sexual assault victims are never directly billed for medical forensic exams. The SAFE Response program will pay for the exam whether or not the victim chooses to report the assault to law enforcement. If the victim has medical insurance which would cover the cost of the exam, the SAFE Response legislation requires that insurance be used to pay for the exam, unless the victim believes that billing insurance will substantially interfere with his/her personal privacy or safety. As a safeguard, the legislation requires that the victim’s written permission must be obtained before insurance is billed. SAFE Response will pay for an exam if a patient who is a victim of sexual assault had no insurance, or the patient believes that billing insurance will substantially interfere with his/her personal privacy or safety. SAFE Response will also pay costs that the patient’s insurance company will not pay, like co-pays or deductibles. SAFE Response will pay up to $600 for any one exam, as follows: up to $400 for the use of an emergency room, clinic, or examination room, and the sexual assault medical forensic examination and related procedures other than laboratory services and dispensing pharmaceutical items related to the sexual assault; up to $125 for laboratory service; and up to $75 for dispensing pharmaceutical items related to the sexual assault. See Chapter 4 of this handbook for more information about the Crime Victim’s Compensation Board.
    • The following link contains additional information about the Crime Victim’s Compensation Board and a downloadable SAFE Response Claim form: http://www.michigan.gov/mdch/0,1607,7-132-54783_54853--- ,00.html Will I need to make a police report? Many hospitals interpret the law mandating hospitals and physicians to report all injuries due to violence as a mandate to report all sexual assault to the police. Being treated at an emergency department or having a sexual assault evidence collection kit completed does not mean that you have to talk to the police. You can choose not to speak to the officers. If you are currently unsure about participating in criminal prosecution, having the sexual assault evidence collection kit completed will help keep your options open. Typically, evidence may be kept for a few weeks as you consider your options. Hospital personnel should inform you of how long the evidence will be stored prior to destruction. The sexual assault evidence collection kit cannot be released to the police without your signature on an authorization form.
    • “Rape Drugs” Some assailants use drugs (such as Rohypnol, also known as Roofies; Gamma hydroxybutyric acid, also known as GHB; or Ketamine also known as Special K; to name a few) to physically control their victim and render them defenseless. If you believe you were drugged, inform your doctor. Blood or urine tests may detect the drug in your system. Testing should be done as soon as possible as some drugs can only be detected within 12 hours of ingestion.
    • What about a private doctor? Although you may feel more comfortable with your family doctor, he or she will likely not be available 24 hours a day, and will most likely send you to the hospital to have the sexual assault evidence collection exam completed. Private doctors do not have access to the kit. The hospital that treats you after the assault can send your discharge information to your private doctor and you can complete your follow- up care with her or him.
    • What about University Health Service (UHS)? If you are considering reporting what happened to you, you may want an evidence collection kit. UHS does not gather evidence for kits. They refer to St. Joseph Mercy Hospital for this procedure. If you would simply like antibiotics, Plan B, and a medical exam, UHS should be able to assist you during their regular business hours.
  • If You Were Assaulted in the Past Expand dropdown
    It is still very important to receive medical attention. You may want to have pregnancy and STI tests done. Although a sexual assault evidence collection exam can be performed at any time, the chances of collecting evidence decreases significantly when more than a few days have gone by. However, you can still report the crime to the police and prosecution is still possible.
  • Follow-up Medical Care Expand dropdown
    • A follow-up test for pregnancy is recommended. Even if you were given preventative medication it is very important that you are re-tested a few weeks after the assault. A follow-up exam will also give you the opportunity to check your injuries and discuss any new physical symptoms that may have developed since the assault. Also, any sexually transmitted infections that you may have contracted from the offender will not show up until later.
    • The hospital that treated you after the assault will have sent the hospital discharge paper to your doctor or given you the option to return to the hospital for a follow-up exam. The follow-up exam may bring back memories of the assault. This may be difficult for you and you may want extra support and counseling. If you are uninsured or have financial concerns, you can get pregnancy and STI tests at University Health Service (UHS) (734-487-1122), Planned Parenthood or the health department. UHS accepts the EMU Student Insurance Plan and accepts regular forms of payment (cash, check, credit). Planned Parenthood will charge you based on your ability to pay.
  • Common Sexually Transmitted Infections (STI) Expand dropdown
     
  • EMU’s Resources to STI Testing and HIV Counseling Expand dropdown

    HIV/STI testing offered here at EMU.
    Location: 352 Student Center
    When is this offered: The 2nd and 4th Monday of every month from 4-6pm.
    Services are offered by Unified, who offers several community health support services in the
    area.
    Check out the link for more information about Unified Services. (Link:
    https://miunified.org/Services/Care)

    Testing for STIs
    You may want to keep track of STIs for which you have been tested or treated. Ask your doctor
    or nurse exactly which tests are being completed. It may take several years for the symptoms of
    some STIs to show up. Information and testing could potentially save your life. The tables on the
    following page contain information about the eight most common STIs. Ask your healthcare
    professional for more information.

  • HIV/AIDS Expand dropdown
    • While sexual assault survivors are at low risk for HIV infection, an HIV test may help you feel more comfortable. It is recommended that you get tested 2-6 weeks following the assault and again at 3, 6 and 12 months following the assault. University Health Services and the county health department will have information about free, anonymous HIV testing. You can ask a health care professional or sexual assault counselor for more information.
    • If it is determined by your doctor that you are at high-risk for HIV infection (i.e. your assailant is HIV positive or engages in high-risk behaviors such as injecting drugs) you may be a good candidate for HIV post exposure antiretroviral therapy. Your doctor will be able to discuss the risks, potential benefits and cost of this treatment with you. Assailants may be charged with a felony if they know that they have been diagnosed with HIV, or know they are HIV positive and engage in sexual penetration with another person without having first informed them of their own HIV/AIDS diagnosis. [MCL 333.5210 Public Health Code].
  • STI and HIV Testing of the Defendant Expand dropdown
    • During the criminal proceedings, if a defendant is bound over to circuit court for a violation of a criminal sexual conduct offense and the district court determines there is a reason to believe that the violation involved sexual penetration or exposure to a bodily fluid of the defendant, the court shall order the defendant to be examined and tested for Sexually Transmitted Diseases (STIs), Hepatitis B infection, Hepatitis C infection or for the presence of HIV or an antibody to HIV.
    • With the victim’s consent the court will forward the victim’s name, address and phone number to the medical facility that conducts the defendant’s testing. The medical provider will immediately notify the victim of the test results. [MCL 333.5129]. As a resource for more information on sexually transmitted diseases and infections please visit the Center for Diseases and Control website on Sexually Transmitted Diseases. (Link: https://www.cdc.gov/std/default.htm )

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