Evidence Collection After Sexual Assault

If you’ve experienced sexual assault, it’s important to know that there are resources available to help protect your health, document evidence, and support you in making decisions about next steps. One of the resources available is the SANE exam—a detailed examination by a Sexual Assault Nurse Examiner that includes evidence collection. This web page provides information about the SANE exam, what happens during the process, your rights, and the resources available to Boston University students.

What Is a SANE Exam?

A SANE (Sexual Assault Nurse Examiner) exam is a medical exam performed by a specially trained nurse or clinician. During the exam, evidence related to the assault may be collected, and you may receive medical care for injuries, sexually transmitted infections (STIs), and other health concerns. The exam can be an important part of your decision to pursue justice, but it is not required in order to receive medical care or other resources.

Why Would I Want a SANE Exam?

A SANE exam is often called a rape kit or forensic exam. It’s a way to gather physical evidence that may be helpful if you decide to pursue legal action in the future. Here’s why you might want to consider getting a SANE exam:

• Preserves evidence: The exam can gather physical evidence from your body, clothing, and other materials that could help in a criminal investigation.
• Helps with medical care: The exam also includes a general medical assessment to address any injuries, infections, or other health concerns.
• Confidentiality: You can have the exam performed without reporting to the police. The evidence will be stored for at least 15 years, giving you time to decide if you want to pursue a criminal investigation.
• Evidence may help build a stronger case: If you choose to report the assault to the police later, the evidence collected could be important in building your case.

What Happens During the SANE Exam?

The SANE exam is a 16-step process, and it’s important to know that you are in control throughout the process. You can decline any part of the process, and by initiating it, all care associated with the assault will be covered by the Massachusetts Victims Compensation Fund. Here’s what you can expect:

1. Initial Discussion:
   1. The nurse will explain the process, answer any questions you have, and ask if you would like someone to accompany you (e.g., a support person or advocate).
   2. You will be asked to describe the assault and provide any relevant details that might help with evidence collection.
2. Physical Examination:
   1. The SANE will examine you for any physical injuries and may take photographs to document any visible injuries (e.g., bruises, scratches, etc.).
   2. Evidence may be collected from your body using cotton swabs and other tools. This is done gently, and you can stop the exam at any point if you feel uncomfortable.
3. Evidence Collection:
   1. Clothing: If your clothes have evidence (e.g., semen, blood, fibers), they may be taken as part of the exam. You may be provided with hospital clothing to wear afterward.
   2. Swabs: The SANE will use swabs to collect evidence from areas of your body that may have been touched or penetrated during the assault.
   3. Blood and Urine Samples: If you suspect you were drugged, a toxicology test (blood and/or urine) can be done to detect the presence of any substances that may have been used to impair you during the assault.
4. Other Tests:
   1. You may be given medication to prevent sexually transmitted infections (STIs) or pregnancy.
   2. If you are concerned about being exposed to HIV, you may be offered PEP (Post-Exposure Prophylaxis), which can prevent HIV infection if started within 72 hours of exposure.
5. After the Exam:
   1. The evidence collected will be stored in a rape kit at the hospital for at least 15 years, even if you choose not to report the assault to the police immediately.
   2. You can choose to report the assault to the police at any time in the future, and the evidence can be used in an investigation if you decide to proceed with legal action.

What Are My Rights During a SANE Exam?

You have the right to make decisions about your care during a SANE exam. You can:

• Choose to have a support person (a friend, family member, or advocate) with you during the exam.
• Decide if you want to report the assault to the police or remain anonymous.
• Stop the exam at any time. You are in control of the process and can choose not to complete any part of the exam if you are uncomfortable.
• Refuse any tests or portions of the exam if you do not want to participate.

The SANE nurse will explain each step of the exam and ensure that you understand what is happening. You will never be forced to undergo any part of the exam that you do not consent to.

Can you give an example of what this could look like?

1. We recommend going to Beth Israel emergency room, where you will tell the front desk that you have been sexually assaulted and are there for a SANE exam. 
2. A nurse should come to get you right away to get your information and take you to a private room. The medical resident will come to make sure you do not have any injuries that need immediate attention, then will clear you for the SANE exam. 
3. The SANE nurse will be called. This is someone who is on-call, meaning they are not already in the hospital. It could take up to 45 minutes for them to arrive. 
4. Once they arrive, they will review the process with you and confirm you wish to initiate the exam. 
5. They will open the SANE kit, once this is opened the nurse cannot leave the kit alone, but you can decline any part of the exam and take breaks as needed. 
6. The nurse will prescribe any medications you need, the hospital should be able to give them to you directly, as they will be covered by victim’s compensation. 
7. You might be asked for your insurance, do NOT give it. Remind them that this is covered by victim’s compensation. 
8. You will be given the tracking info for your SANE Kit and toxicology screen (if taken). And given info about follow-up care. 
9. You are now free to leave. Please take care of yourself for the rest of the day/ night and call for support if needed.

What Happens to the Evidence?

• If you report to the police: The rape kit and any other collected evidence will be sent to a crime lab for analysis.
• If you do not report to the police: The evidence will be stored securely for up to 15 years, giving you time to decide if you want to report the assault. If you decide to report it later, the evidence can still be analyzed.

Important note: The evidence is stored confidentially. You will be given information to track the location of your evidence, and you can choose to have the evidence destroyed at any time, should you decide not to pursue legal action.

Where Can I Get a SANE Exam in Boston?

We often recommend student’s go to Beth Israel Hospital; however, you can also get a SANE exam at:

SANE-designated hospitals

• Beth Israel Deaconess Medical Center
• Boston Medical Center
• Brigham and Women’s Hospital
• Cambridge Hospital
• Children’s Hospital
• Massachusetts General Hospital
• Newton-Wellesley Hospital

Non-SANE hospitals

If you go to an emergency room that is not part of the SANE program, the hospital can call BARCC’s hotline for a medical advocate.

• Beth Israel Deaconess Hospital – Needham 
• Carney Hospital
• CHA Everett Hospital
• Emerson Hospital
• Faulkner Hospital
• Lahey Clinic-Burlington
• Melrose-Wakefield Hospital
• Mt. Auburn Hospital
• New England Medical Center (NEMC)/Tufts Medical Center 
• St. Elizabeth’s Medical Center
• Winchester Hospital

What If I Don’t Want to Report to the Police?

You do not need to report the assault to the police in order to receive a SANE exam or have evidence collected. You can choose to have the exam and collect evidence anonymously, giving you time to decide whether or not you want to pursue legal action.

• Evidence will be stored confidentially for at least 15 years.
• If you decide later that you want to report the assault, the evidence can be sent to law enforcement at that time.

Support Resources

If you’re considering a SANE exam or need support, there are confidential resources available to you:

• Boston University Survivor Advocacy Response and Prevention Center (SARP)
• • • Phone: (617) 353-7277
    • Website: BU SASS
    • SASS offers confidential support, resources, and guidance for students affected by sexual assault.
• Boston Area Rape Crisis Center (BARCC)
• • • Phone: (617) 492-7273 or 1-800-841-8371 (24-hour hotline)
    • BARCC provides confidential support and advocacy for survivors of sexual assault.
• RAINN (Rape, Abuse & Incest National Network)
• • • Phone: 1-800-656-HOPE (4673)
    • 24-hour confidential support for survivors of sexual assault.

Frequently Asked Questions (FAQs)