The Effectiveness of Sexual Assault Nurse Examiner (SANE) Programs

Rape survivors encounter significant difficulties seeking post-assault health care and medical forensic evidence collection. Numerous studies have found that less than half of survivors treated in hospital emergency departments receive basic services, such as information about the risk of pregnancy, emergency contraception to prevent pregnancy, and information on the risk of STDs/HIV (Amey & Bishai, 2002; Campbell, Wasco, Ahrens, Sefl, & Barnes, 2001; National Victim Survey, 1992; Uttley & Petraitis, 2000). Emergency department personnel often regard the needs of the rape victims as less urgent than other patients, and due to this low priority, it is not uncommon for survivors to wait four to ten hours for the exam to be performed (Littel, 2001; Taylor, 2002). During this wait, victims are not allowed to eat, drink, or urinate so as not to destroy physical evidence of the assault (Littel, 2001; Taylor, 2002). Further complicating matters, emergency department personnel often lack training in medical forensic evidence collection, and those with training often do not perform forensic exams frequently enough to maintain their proficiency (Littel, 2001). Moreover, emergency department physicians are often reluctant to do evidence collection because if subpoenaed to testify they would be challenged on their qualifications, training, experience, and ability to conduct the exam (Littel, 2001). In light of these problems, it is not surprising that emerging research suggests that many victims characterize their interactions with hospital emergency department staff as upsetting and distressing, and they feel they have been "re-raped" (Campbell et al., 1999; Campbell et al., 2001; Ullman, 1996).