Monitoring

A follow-up visit for <1 week should be arranged if testing was performed at the initial exam.[46]​ A repeat medical evaluation is required at 1 to 2 weeks after assault to assess for interim development of anogenital lesions, and to test for Neisseria gonorrhoeae, Chlamydia trachomatis, syphilis, and HIV. Patients at risk for HIV and syphilis infection require repeated serologic tests at the following additional time points: 4 to 6 weeks and 3 months (syphilis), and 6 weeks and 3 months (HIV).​[46]

Patients receiving HIV postexposure prophylaxis (PEP) should be evaluated for medication compliance and tolerance at 3 to 5 days after initiating medications. The prophylaxis medications have significant side effects including reducing the effectiveness of hormonal contraception. Patients taking PEP should be referred to an infectious disease specialist for guidance on follow-up testing.

All patients should be carefully followed by a mental health professional for potential complications such as depression and post-traumatic stress disorder.[78] People with post-traumatic stress disorder should be offered trauma-focused psychological treatment (e.g., cognitive behavioral therapy).[74][Evidence B][Evidence C]

Test of cure is recommended 7 to 14 days after treatment of pharyngeal gonorrhea, although testing at 7 days may result in an increased likelihood of false-positive tests.[46] No test of cure is otherwise recommended for N gonorrhoeae or C trachomatis unless therapeutic adherence is in question, symptoms persist, or reinfection is suspected. To prevent further transmission of infection or reinfection of index patients, sexual partners should be referred for evaluation and treatment.[46]

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