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Sexual assault affects women of all ages and all cultural, ethnic, and economic backgrounds. About 20%–25% of all adult women, 15% of college women, and 12% of adolescent girls report having experienced sexual abuse and/or assault during their lifetimes, and these rates are higher for African American women. Each year, more than 1.5 million women in the United States are physically and/or sexually abused by an intimate partner, and women are 10 times more likely than men to be killed by an intimate sexual partner. Despite the serious negative impact of sexual assault on physical and psychological well-being, only 10% of women who are assaulted seek professional help. In addition to physical symptoms such as tremulousness and cold sweats, initial psychological reactions to sexual assault include shock, numbness, withdrawal, and denial. Prolonged symptoms may include startle reactions, disturbed sleep, extreme fatigue, and somatic complaints. Although symptoms tend to dissipate over time, they often return intermittently over the course of ensuing months and even years. Long-term negative sequelae may include sexual dysfunction and aversion, impaired ability to establish healthy interpersonal relationships, and feelings of helplessness, shame, vulnerability, and depression. Posttraumatic stress disorder is particularly common and intense when there is a history of abuse.

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Table Reference Number
TABLE 39–15. Special considerations in the evaluation and treatment of women who have been sexually assaulted

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