If you need help right now
- In immediate danger or seriously hurt: call 911.
- National Sexual Assault Hotline (RAINN): call 800-656-HOPE (4673), text HOPE to 64673, or chat online at rainn.org/hotline. It's free, confidential, and available 24/7, in English and Spanish.
- If the assault was within the last 72 hours: HIV prevention medicine (PEP) and evidence collection are time-sensitive. A hospital emergency department is usually the fastest place for both. A hotline advocate can help you find one with trained staff.
Key takeaways
- You decide what happens next, including whether to have an exam, get tested, or report to police. You can stop or skip any part of care.
- CDC says HIV PEP should start as soon as possible, and within 72 hours after the assault, when it's recommended.
- A forensic exam can include preventive treatment for STIs and emergency contraception. RAINN says you shouldn't be charged for the exam and don't have to report to police to get one.
- CDC describes optional preventive antibiotics, hepatitis B and HPV vaccination, and follow-up testing at about 1–2 weeks, 6 weeks, and 3 months.
- Support is available whenever you're ready, whether that's today or months from now.
What happened wasn't your fault. There's no single right way to respond, and you don't have to decide everything at once. This page lays out the medical options, especially those connected to sexually transmitted infections, so you can choose what feels right. Take breaks whenever you need to. If you'd rather talk it through with someone, a trained RAINN advocate can explain these same options by phone, text, or chat.
The first hours and days: what's time-sensitive
Most decisions can wait. A few medical options work best soon after an assault:
| Option | Timing | What it does |
|---|---|---|
| HIV PEP | As soon as possible, within 72 hours | A 28-day course of HIV medicines that can prevent infection after exposure |
| Emergency contraception | As soon as possible | Lowers the chance of pregnancy, if pregnancy is possible |
| Forensic evidence collection | RAINN notes DNA evidence generally needs collection within 72 hours | Preserves evidence in case you decide to report, now or later |
| Preventive STI antibiotics | Usually offered at the first visit | Treats possible chlamydia, gonorrhea, and trichomoniasis before tests could detect them |
| Hepatitis B vaccine | Started at the first visit, if you're not already vaccinated | Helps prevent hepatitis B after exposure |
If more than 72 hours have passed, care is still worth getting. Testing, vaccination, treatment, and support are all still available.
Where to go
- Hospital emergency department: usually the best place for PEP, emergency contraception, injuries, and a forensic exam, often by a Sexual Assault Nurse Examiner (SANE).
- A hotline advocate can help you find a facility with trained examiners and may be able to meet you there or connect you with a local advocate.
- Your own clinician, a sexual health clinic, or a health department: good options for follow-up testing, vaccines, and care if you don't want or need an emergency visit.
About the forensic exam
A sexual assault forensic exam, sometimes called a "rape kit," combines medical care with optional evidence collection. According to RAINN's guide to the exam:
- You don't have to report to the police to have an exam. Evidence can be kept so you can decide later.
- You shouldn't be charged for the exam. RAINN notes the Violence Against Women Act requires states to provide these exams free of charge to keep certain federal funding. If you get a bill, a local sexual assault service provider can help.
- You're in control. You can stop, pause, or skip any step at any time.
- It can include medical care, such as preventive treatment for STIs and emergency contraception.
If you're thinking about an exam, it can help to avoid bathing, changing clothes, or using the toilet beforehand when possible. Don't let that stop you from getting care, though. You can still have an exam if you've done any of these things.
Medical care CDC describes for survivors
CDC's STI Treatment Guidelines for adolescents and adults after sexual assault describe the care clinicians can offer. All of it is optional.
Initial testing (if you want it)
- NAAT testing for chlamydia and gonorrhea at sites of penetration or attempted penetration.
- For women, testing for trichomoniasis.
- A blood sample for HIV, hepatitis B, and syphilis.
Testing at the first visit mostly shows infections that were already present. It can't yet detect infections from the assault. Some survivors choose this testing and some don't. Either choice is valid.
Preventive treatment
CDC describes preventive antibiotics that cover gonorrhea, chlamydia, and (for women) trichomoniasis, so you don't have to wait for test results.
HIV PEP
CDC says PEP decisions are made case by case, based on the details of the assault. When PEP is used, it should start as soon as possible and within 72 hours. Starting sooner improves the chance it works.
Vaccines
- Hepatitis B: recommended if you're not already vaccinated, with follow-up doses at 1–2 and 4–6 months.
- HPV: recommended for survivors aged 9–26 who aren't fully vaccinated, ideally starting at the first visit.
Pregnancy
CDC says survivors who could become pregnant should be offered a pregnancy test and emergency contraception.
Follow-up testing schedule
If you'd like follow-up testing, CDC describes this timeline:
| When | What |
|---|---|
| Within about 1 week | Review initial results and treat anything found |
| 1–2 weeks after the assault | Repeat STI testing, if you didn't receive preventive treatment |
| 4–6 weeks and 3 months | Syphilis blood testing, if infection in the assailant can't be ruled out |
| 6 weeks and 3 months | HIV testing |
| 1–2 and 4–6 months | Hepatitis B vaccine doses, if you started the series |
If an at-home or clinic test is easier for some of these follow-ups, that's fine. Our window periods guide and HIV test types guide explain timing. If cost is a barrier, see free STD testing.
Testing is your choice
Some survivors want every test as soon as possible. Others want time first, or decide not to test. Some prefer preventive treatment so they don't have to wait for results. There's no wrong choice. A clinician or advocate can help you weigh the options without pressure.
Reporting is a separate decision
Medical care and reporting to police are separate decisions. You can get medical care without reporting. You can have evidence collected and decide later. An advocate can explain how reporting works where you live.
Emotional support
Reactions after sexual assault vary widely. Numbness, fear, anger, sleep problems, and feeling fine at first are all common. Support is available whether the assault was yesterday or years ago:
- National Sexual Assault Hotline: 800-656-HOPE (4673), text HOPE to 64673, or chat at rainn.org/hotline.
- If you're thinking about harming yourself: call or text 988 to reach the 988 Suicide & Crisis Lifeline.
- Local sexual assault service providers can offer counseling, advocacy, and accompaniment to medical or legal appointments.
If you're supporting a survivor
Believe them, let them lead, and offer practical help like a ride, company at an appointment, or help finding the hotline number. Don't push them toward any particular choice, including testing or reporting. If the assault was recent, gently mention that some medical options are time-sensitive, and let them decide.
If the exposure was consensual but you're worried about timing, our guide to testing after unprotected sex covers that situation.
Frequently asked questions
Do I have to report to the police to get a forensic exam?
No. RAINN says you don't need to report to have an exam. Evidence can be kept so you can decide later.
How soon do I need to start HIV PEP after an assault?
CDC says PEP, when recommended, should start as soon as possible and within 72 hours after the assault. Starting sooner works better.
Will I have to pay for a sexual assault forensic exam?
RAINN says you shouldn't be charged for the exam, because federal law ties certain funding to states covering it. If you get a bill, a local sexual assault service provider can help.
When should I get tested for STIs after a sexual assault?
CDC describes follow-up testing at about 1–2 weeks if you didn't get preventive treatment, HIV testing at 6 weeks and 3 months, and syphilis testing at 4–6 weeks and 3 months when needed. Whether and when to test is your choice.
Can I still get care if more than 72 hours have passed?
Yes. PEP and some evidence collection are time-sensitive, but testing, vaccines, treatment, and support are still available and worthwhile.
Who can I talk to confidentially?
The National Sexual Assault Hotline at 800-656-HOPE (4673), by text (HOPE to 64673), or by online chat at rainn.org/hotline. It's free, confidential, and available 24/7.
Sources
- CDC STI Treatment Guidelines: Sexual Assault and Abuse and STIs (Adolescents and Adults)
- RAINN: National Sexual Assault Hotline
- RAINN: What is a sexual assault forensic exam?
- CDC: PEP guidance for clinicians
Guidance changes. When timing or treatment matters, check the current linked guidance or ask a clinician.
Disclaimer: This article is for informational purposes only and isn't a substitute for medical or legal advice. If you're in danger, call 911. For confidential support, contact the National Sexual Assault Hotline at 800-656-HOPE (4673).