Factors associated with sexual assault and time to presentation

Objective. Delay to medical care after sexual assault can be associated with adverse consequences for the assault survivor. Few studies examine factors associated with timely presentation to care after sexual assault. Using data from the Massachusetts Sexual Assault Nurse Examiner (SANE) program, we examine sexual assault and survivor characteristics and their association with time to presentation after sexual assault. Method. Cross-sectional data were collected during forensic exam for all patients presenting to 24 SANE-affiliated hospitals in Massachusetts between July 2003 and June 2005. Data included patient demographics, assailant information, and assault characteristics. A Cox proportional hazards model described factors associated with delayed presentation for post-assault care. Results. 478 females presented to SANE hospitals over two years. 66% were white, non-Hispanic; 14% Hispanic and 13% black: 39% were between 18 and 24 years old. The median time from onset of assault to presentation was 16 h. In multivariable analysis, assault by a known assailant was associated with delayed presentation (hazard ratio = 0.71, 95% confidence interval = 0.57, 0.88). Conclusion. Most women who present for exam following sexual assault do so expeditiously. If an assailant is a family member or date, a woman is more likely to delay post-assault care. These findings can inform public health interventions. (C) 2009 Elsevier Inc. All rights reserved.