This study examined why adult sexual assault victims seek medical forensic exams (MFEs).
Sexual assault victims are advised to have a medical forensic exam (MFE) to address post-assault health concerns (e.g., injuries, sexually transmitted infections, pregnancy) and a sexual assault kit (SAK) collected to preserve forensic evidence of the crime. Since these exams were created in the 1980s, there has been more focus on the utility of MFEs for the work of police and prosecutors, but which may not be consistent with survivors’ needs. The current study partnered with all state-funded sexual assault nurse examiner programs in a midwestern state to collect prospective data for 9 months. Forensic nurses recorded information about all adult sexual assault patients (N = 783) who sought care regarding (a) their stated reasons for seeking an MFE, (b) their post-assault disclosures, and (c) their decisions to have sexual assault kits collected and released to law enforcement. K-mode clustering identified three subgroups of sexual assault patients defined by their reasons for seeking an MFE. Cluster 1 (50.9 percent of the sample) sought care for primarily health-focused reasons; Cluster 2 (37.2 percent) sought MFEs because they wanted to pursue criminal investigation and prosecution; and Cluster 3 (12.4 percent) sought care because they were unsure whether they had been sexually assaulted. The study concluded that the extent to which MFEs are framed as a component of criminal investigations, there is a substantial risk of losing the opportunity to provide post-assault health care to a large subpopulation of sexual assault survivors. (publisher abstract modified)