Sexual assault centers: attendance rates, and differences between early and late presenting cases.

Objective: Sexual assault centers (SACs) aim at assisting victims and to provide forensic medical examination (FME). This study explores the gap between assaults actually occurring and those seen at SAC; and the characteristics of cases presented in time/too late for FME (early and late cohorts).
Design: Retrograde descriptive study.
Setting and Sample: A two-year series from a self-referral SAC; characteristics of victims, assaults, use of services.
Methods: Chi-quadrate, uni- and multivariate logistic regression analyses.
Main Outcome Measures: Number of female victims seen/female at-risk population (attendance rates). Case and service profiles in the two cohorts. Adjusted odds for late presentation.
Results: Attendance rates for females were 0.12% (14-55 years); an estimated 4-7% of sexually assaulted females in the catchment area. Two hundred and seventy eight victims arrived in time for FME, 76 later; 6% males. Assaults in the early cohort were more often performed by strangers. Two hundred and thirty-eight victims underwent FME, 55% complied with follow-up, 55% reported to the police. The late cohort contained more adolescent victims, more acquainted/partner perpetrators, more verbal coercion; 45% medically examined, 80% follow-up compliance; 34% reported to police. Further referrals occurred equally often in both cohorts; 12% to somatic and 39% to psychiatric services. Among victims seen, 5% died within 7 years of consultation.
Conclusion: Cases seen at SAC are strongly selected. The late cohort seems more representative of the commonly occurring assaults; young victims, known assailants. Even late presenters are in need of a multidisciplinary approach.