Patients presenting after recent sexual assault
First aid, safety and forensic referral, HIV PEP under the 2025 ASHM guideline, hepatitis B, STI testing windows, and choosing between the copper IUD, ulipristal and levonorgestrel for emergency contraception.
Tier 2Approach to a presentation
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- First priorities are injuries and safety: head injury, non-fatal strangulation and suicidality come before swabs.
- The patient decides about police and forensic examination. Refer to the local Sexual Assault Response Team (SART) for evidence collection, usually within 72 hours; some services accept later presentations, so ring and check.
- Time-critical drugs: HIV PEP within 72 hours, emergency contraception within 120 hours, and hepatitis B immunoglobulin within 14 days when the assailant is HBsAg positive.
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Sources
- Australian STI Management Guidelines for Use in Primary Care: Adult sexual assaultAU/NZAustralasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), Online, accessed November 2026
- National Guidelines for Post-Exposure Prophylaxis after Non-Occupational and Occupational Exposure to HIV (4th edition)AU/NZASHM, 2025
- Therapeutic Guidelines: Sexual and Reproductive Health (emergency contraception)AU/NZTherapeutic Guidelines Limited
- Emergency contraception (fact sheet)AU/NZSexual Health Quarters (Family Planning Association of Western Australia), May 2026
- Australian Immunisation Handbook: Hepatitis B (post-exposure prophylaxis)AU/NZAustralian Technical Advisory Group on Immunisation, Australian Government, Online edition, accessed November 2026
- Mazza D et al. Emergency contraception: an overview. Aust Prescr 2026;49(3)AU/NZAustralian Prescriber, 2026
- FSRH Clinical Guideline: Emergency ContraceptionCollege of Sexual and Reproductive Healthcare (CoSRH, formerly FSRH), UK, March 2017, amended July 2023
- ellaOne (ulipristal acetate 30 mg) summary of product characteristics: concomitant levonorgestrel, breastfeedingEuropean Medicines Agency, EPAR product information, accessed November 2026
- Domestic and Family Violence Act 2007 (NT), section 124A Reporting domestic violenceAU/NZNorthern Territory Legislation, Current reprint, accessed November 2026
- Isentress (raltegravir) prescribing information: dosing with rifampinUS Food and Drug Administration (DailyMed), Accessed November 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback