Forensic Evidence Collection and Physical Examination of a Sexual Assault Victim

Session Objective: To inform Peace Corps SSCs and SARLS about the components of a Sexual Assault
Forensic Exam (SAFE) who may need to provide support to the Volunteer before, during, and after the
exam performed in-country.
The purpose of a SAFE is to collect evidence. Each country has its own set of regulations on how and
what evidence is collected for a sexual assault.
**IMPORTANT** Todays demonstration is modeled after a U.S. sexual assault examination. The
SSC, SARL, and PCMO must understand the SAFE in their country in order to prepare a Volunteer
for the exam in-country. It may be different from what is demonstrated during todays session.

A. SAFE Components
1. Consent
Must give written consent for the exam. May need help understanding the components. May
need to understand the ramifications of the exam according to local law.

2. History
In-depth personal sexual history and discussion about the traumatic event
Details of the sexual contact (oral, vaginal, or anal intercourse, ejaculation or urination by
the assailant)
Type of physical abuse (use of weapons or restraints, drugs, alcohol)
Victims activities after the assault (change of clothing, bathing, douching, urination or
defecation)
Gyn history: last menstrual period, pregnancies, contraception use, last voluntary sexual
experience, recent infections

3. Focused Exam and Diagnostic testing (according to history of event; can take several
hours)

Body: Cuts, bruises, bite marks, choking/restraint marks, sperm detection on skin w/ UV
lamp
Mouth: Secretions, Injuries resulting from oral penetration, swab for sperm
Genital inspection/photos
Pubic and Head Hair combing
Hair sample for DNA (20 pulled head hairs, 20 pulled pubic hairs)
Vaginal secretions (sperm can found up to 72 hrs)
Check for vaginal trauma and foreign objects (swelling, cuts, bruising, bleeding)
Check for rectal trauma to look for swelling, lacerations, bruising, bleeding
Swabs of skin suspected of sperm or saliva for DNA
Vaginal, rectal, throat cultures for sexually transmitted infections
Blood tests for DNA, HIV, Pregnancy, Syphilis
Urine test for drug screen (if applicable)
4. Common sexual assault wounds
Bitemarks
Bruising
Bruising behind ears (from grabbing/holding ears)
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Forensic Evidence Collection and Physical Examination of a Sexual Assault Victim

Bloodshot eyes/eyelids (from shaking trauma or strangulation)

Strangulation marks on neck
Vaginal tears
Anal tears
abrasions, redness, swelling

5. Forensic Evidence Collection Tips

Volunteers body is a crime scene.
Need written permission from Volunteer to collect evidence and photos
All specimens need to be dry before packaging.
Wetness, heat, wind or sun can destroy collected evidence.
Never use plastic bags as these trap moisture and can spoil specimens.
Label each specimen with date, time, Volunteers name, area from which specimen
collected.
A. AFTER the SAFE (This treatment is provided by the PCMO)
1. Potential Treatment
1) Plan B One-Step (pregnancy prevention) given up to 5 days after event; extremely
nauseating
2) HIV PEP (HIV prevention) doses daily for 4 weeks; extremely nauseating
3) STI Prevention (Chlamydia, gonorrhea, trichomonas) Three different large-dose
antibiotics given on day one. Extremely nauseating.
4) Injections for Hep A, Hep B, Tetanus (depending upon history)
2. Post Assault Follow Up
At 1 week :
HIV drugs evaluation and tolerance (if PEP given)
Review of laboratory results (serum and cultures)
Assess mental and physical health
At 2 weeks:
Repeat Pregnancy and other lab work
Assess mental and physical health
At 4 weeks:
Assess Mental Health. Can be by phone
At 8 weeks:
Repeat lab work if abnormal at 2 weeks
Assess mental and physical health
At 3 Months:
Test for Syphilis and HIV
Assess mental and physical health
At 6 Months:
HIV test and Hepatitis C Test
Assess mental and physical health

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