A victim's immediate concerns after a sexual assault should be their health and safety. The VERY first thing to do is get medical attention. In the past, the only place to go was to your local hospital. Now, more and more cities have sexual assault centers that can provide advanced treatment to victims in a more private and much less hectic setting. Call your local rape crisis center - they can help arrange for transportation and get the ball rolling to get specially trained nurse examiners on the way to assist you. You can always decide later whether or not to file a police report, but you absolutely MUST get medical care as soon as possible because:

• you may need immediate medical attention due to injuries you can't feel
• tests for pregnancy, venereal disease, and AIDS should be done
• medical evidence is extremely helpful IF you decide to prosecute and this is your ONLY time to collect it

A medical history will be necessary in order medical personnel to identify any medical conditions that could affect your treatment. This will include allergies, prescription and non-prescription medications, major illnesses; and for women, any use of birth control, a gynecological history, menstrual status and date of last period.

You may choose to request a rape exam, which is a thorough exam including the collection of forensic evidence. If you think that you might want to pursue legal action either immediately or in the future, such as prosecution, it is in your best interest to request a rape exam so that physical evidence can be collected in a timely fashion. If you do not want the rape exam, you can request that only a medical exam be performed.

Recovering From Rape
Linda E. Ledray holds a Ph.D. in clinical psychology and personality research and is a registered nurse. A licensed psychologist and fellow of the American Academy of Nursing, she is the founder and director of the Minneapolis Sexual Assault Resource Service and has been working with rape survivors for twenty years. The book offers practical advice on overcoming the trauma and coping with police, hospitals, and the courts - for the survivors of sexual assault and their families, lovers, and friends.

Since most of the evidence for prosecution of a sexual assault is medical evidence obtained from the victim, it is most important that the victim gets medical treatment as soon as possible and does not bathe, shower, douche, or change clothes until given permission by medical personnel. If possible, it is also very helpful if the victim refrains from using the bathroom, gargling or drinking.

Upon arrival at the medical facility, the assigned registered nurse will accompany the victim to a private room for the initial interview, and a sexual assault counselor will be notified. The registered nurse will then ask the victim about the rape and women will be asked about their current gynecological status. The nurse will also document the victim's medical history as well as any sexual history, allergies, current medications, menstrual cycle, use of contraceptives, and any current or past illnesses. The nurse will then determine if the victim has made or desires to make a police report (exactly when the police report is made can vary). If the victim desires to make a police report, the nurse then contacts the police.

The medical part of the exam is done by a registered nurse who has received specialized training in how to spot, identify and collect forensic evidence. (This is called SANE-SART training: Sexual Assault Nurse Examiner - Sexual Assault Response Team). Their background is entirely medical, however, their participation is important as they act as a sort of crime scene technician by collecting evidence from the victim, marking and certifying the evidence.

To collect medical evidence for the police, medical personnel use a "Sexual Assault Kit" (often referred to as a "rape kit"). Evidence is collected and a pelvic exam is done. The steps involved in evidence collection are:

• The nurse explains the hospital's HIV testing procedure and why HIV testing is beneficial. The victim then decides whether or not to permit HIV testing. In many states, there is no charge to the victim for these services.
• Routine blood collection is done (to check for pregnancy or sexually transmitted diseases)
• The nurse documents any evidence of torn clothing or external injuries and takes photographs.
• The victim's clothing is collected and new clothes are provided.
• Any physical evidence from the rape scene (such as grass or leaves) is also collected.
• Hairs are collected: the nurse collects any loose hairs or debris in the pelvic area (looking for pubic hairs of the assailant). In some cases, some of the victim's pubic hairs are needed and 15-20 of the victim's head hairs (to differentiate the victim's hairs from the assailant's).
• Fingernail scrapings are collected for detection of blood or tissue.
• The nurse then examines the victim for evidence of semen and, if detected, it is collected.
• Several slides are made and swabs taken from the vaginal, anal, and oral areas to check for semen, sexually transmitted diseases, and infections.
• The hospital provides the victim with any preventive medicine necessary (for tetanus, sexually transmitted diseases, pregnancy, etc.).
• Medical personnel perform the pelvic exam. The victim may request to have the examination done by a female. Unfortunately, this request cannot always be granted because a female physician may not be available at the time, but generally speaking every effort is made to do whatever can be done to make the victim more comfortable during this traumatic time.

The sexual assault kit is then locked in a box at the hospital until given to the police for further laboratory analysis. The nurse will discuss with the victim what follow-up tests and blood work need to be done. The sexual assault counselor provides the victim with hotline numbers and follow-up appointments. The victim should also receive an application for the victim's assistance program (which pays certain compensation and medical benefits to victims of crime. See Crime Victims Compensation Act). Victims usually receive a follow-up phone call within 72 hours after the exam from an Emergency department nurse.

Sexual Assault: The Medical Legal Examination
The first comprehensive professional book of its kind, this combination text and atlas features the most up-to-date information on the evaluation of adult and adolescent sexual assault victims. It can serve as a complete reference manual. Author is a Sexual Assault Nurse Examiner and a Pediatric SART Examiner, Santa Cruz, CA. Discusses performing a thorough assessment of the adult and adolescent sexual assault victim. Covers the role of the professionals, variables that exist in rape, forensics, medical-legal exam, evidence, behaviors, and more.

Once the medical exam is completed, the victim is interviewed by the police. A victim always has the right to refuse to talk with them, but the police will not be able to continue the investigation and prosecution cannot proceed without the cooperation of the victim. The interviewing officer will ask for a recounting of the assault, including what force, threats, or weapons the assailant may have used. The officer will also inquire about everything said or done by any participant in the crime and anything that would aid in identifying the offender. Questions about what happened before and after the assault may also be asked. Sometimes the questions may seem harsh, invasive or insensitive, but they are often necessary for investigating the crime. If the victim has any doubts or suspicions about the appropriateness or necessity of any police question, it's ok to ask why the question is being asked. The officer should be able to provide a reason for every question asked. The victim may request to have the sexual assault counselor present during the interview, but this is allowed at the officer's discretion. It is important that the victim answer all questions honestly and completely, even if the questions are embarrassing or appear to weaken the case. If all details are not given to the police (and later to the prosecuting attorney), it may give the assailant's attorney an opportunity to argue that the victim should not be believed because facts were concealed, so BE TRUTHFUL!

For future reference, the victim should write down the interviewing officer's name, badge number, how to contact him/her and the case number.

In addition to medical evidence collected from the victim, the police collect physical evidence from the crime scene. It is extremely important that the victim refrain from moving or altering anything at the scene of the crime. If a struggle occurred and the crime scene is later altered, the credibility of the victim's story may be questioned.

The physical evidence collected includes fingerprints, hair, clothing fibers, body fluids, and items such as bed sheets or couch cushions that may contain trace evidence linking the assailant to the scene. The victim should try to remember anything the assailant might have touched, such as glass, windows, tabletops, etc. This will aid in the detection of fingerprints. The police will interview the first person who spoke with the victim after the sexual assault. The police will also interview any eye witnesses or others who may be able to confirm the victim's description of the assault. Statements from the victim and witnesses, and all medical and physical evidence are used to develop the legal case for prosecution. The police then prepare the written reports for the prosecuting attorney who then takes over the case.

Policing Sexual Assault
Through an examination of police recording and crime classification practices and drawing on interviews with women who have reported sexual assault, police and prosecution service, this book provides a detailed account of current police practice within the context of a wider evaluation of theoretical debate with the areas of domestic and sexual violence.

A sexual assault is considered an offense against the state. The prosecuting attorney prosecutes sexual assault cases in criminal court. The victim is a witness for the state. The state, and not the victim, is the prosecuting party. The prosecuting attorney makes all critical decisions about the case and will ordinarily consult with the victim about these decisions.

One of the most important roles of the prosecuting attorney is to determine what action should be taken in criminal cases. The prosecuting attorney learns whether the victim is willing to participate in the prosecution, evaluates the victim as a potential witness, and evaluates the evidence to determine whether guilt could be proven beyond a reasonable doubt. The prosecuting attorney is not required to automatically prosecute a crime. He or she may decide to begin a criminal prosecution, order further investigation, take an alternative to formal prosecution, or not even proceed with the case at all.

The decision about whether to prosecute is made several times during the progression of the case. The factors considered include whether there is enough evidence to convict, the probability of conviction, and the nature of the crime.