Access to acute medical and forensic care for adolescents and adults who have experienced sexual assault: a systematic scoping review

BACKGROUND: People who have experienced sexual assault have both medical and forensic care needs; however, help-seeking rates after sexual assault are low. Levesque's conceptual framework of access conceptualises supply and demand-side factors potentially impacting help-seeking. METHODS: We conducted a scoping review of access to acute medical and forensic care after sexual assault using Levesque's framework. The methodology was guided by the JBI guidelines for scoping reviews. Three databases (Embase, Medline and CINAHL) were searched for studies that included the population of adults and adolescents aged ≥14 years who had experienced sexual assault, the context of acute medical and forensic care, and the concept of access. Studies based in Australia, New Zealand, the UK and Ireland, published in English between 2015 and 1 February 2024 were included. Articles went through two screening stages and data extraction. RESULTS: A total of 3801 studies underwent title and abstract screening, with 283 articles progressing to full text review. Data were extracted from 21 studies. Most studies were based in the UK, with some studies from Australia and Ireland. Some access domains were relatively well represented (such as approachability and appropriateness), whereas others did not have any representation (ability to pay and affordability). Key findings were reported for four domains: ability to perceive (one study), approachability (five studies), availability and accommodation (seven studies), and ability to reach (three studies). CONCLUSIONS: Qualitative studies that focus on the patient perspective, and within Levesque's domains impacting perception of healthcare need and healthcare utilisation, are limited and warrant further research.