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# Sexual violence: the nurse's role in Colombia's care protocol (first contact, urgency, prophylaxis and evidence)

- Safe practice

Sexual violence is a medical emergency: the nurse receives the person at once, protects her, supports prophylaxis and evidence and activates the routes.

Updated Nov 13, 2026

## Key points

- Every case of sexual violence is a medical emergency; triage priority I in the first 72 hours.
- After 72 hours it may be priority II, unless there is suicidal ideation, severe bleeding, severe pain or other signs of high risk.
- Emergency contraception always within 72 hours (exceptionally up to 120 h); STI and HIV prophylaxis by protocol.
- No complaint, insurance or authorisation is ever required to start care.
- Health activates protection (ICBF for under-18s, Comisaría de Familia for adult women) and justice (Fiscalía, judicial police) at the same time.

## What it is

Colombia's protocol for victims of sexual violence (Resolución 459 de 2012, Ministerio de Salud) is binding on insurers and providers. It treats every case as a medical emergency, with triage priority I in the first 72 hours. Care has no barriers: no complaint, insurance or prior authorisation is needed. Nursing receives the person, gives emotional first aid, helps with the examination and the evidence, makes sure prophylaxis and emergency contraception are offered in time and activates the protection and justice routes with the team. Partner-violence screening is on its own page.

## What it requires

- The protocol has 15 steps, from preparing the community and the service to closing the case.
- Rights of victims (Ley 360 de 1997, in the protocol): dignity, privacy and respect; information; free counselling; free examination and treatment for STIs and HIV, physical and emotional trauma, and collection of medico-legal evidence.
- Pregnancy from sexual violence: IVE counselling is part of care, and a complaint is never a requirement (Res. 051 de 2023).
- Sexual intercourse with a child under 14 is always presumed to be sexual violence.
- Each case is reported in public health surveillance and recorded in the clinical record.

## Components

- Urgent care and start of mental and physical health care.
- Clinical and laboratory diagnosis by type of violence.
- Prophylaxis and treatment for STIs and HIV; emergency contraception; IVE counselling.
- Evidence collection with chain of custody, guidance to the family, follow-up and referral to protection and justice.

## How it is applied (and why)

- Receive the person at once and take her to the emergency service or the dedicated service, without requirements — delay costs prophylaxis time.
- First check for danger to life and stabilise — the rest of the protocol follows a stable patient.
- Give emotional first aid: believe her, do not blame her, do not press for details — it prepares her emotional recovery.
- Explain her rights and obtain consent for comprehensive care — consent comes before the examination.
- Keep the alleged aggressor out of the care area and check that an informant is not the aggressor — this protects the victim.
- Help with the examination and record washing, change of clothes, urination or pad use since the assault — these acts affect the evidence.
- Collect, label and seal evidence and keep the chain of custody per protocol — a broken chain can lose the evidence.
- Make sure emergency contraception and STI, hepatitis B and HIV prophylaxis are offered within their time limits — they work best when started early.
- With the team, activate protection and justice and fill in the surveillance notification — health must report even without a complaint.
- Plan the follow-up visits for tests, vaccines and mental health — care continues after the emergency visit.

## In nursing practice

- Questions are open; for children under 3, information comes from a protective adult, never a direct interview.
- A specialised mental health consultation is part of the initial care; emotional first aid never replaces it.
- Ask about contraception in use at the time of the assault, but its use does not rule out emergency contraception.
- Follow-up: repeat tests for STIs, syphilis and HIV and complete vaccines per protocol (CDC lists repeat HIV tests at 6 weeks and 3 months).

## Common mistakes

- Asking for a complaint or an authorisation before care.
- Sending her home to bathe or change before the examination.
- Waiting for the doctor's shift while the 72 hours run out.
- Questioning her repeatedly or in front of other people.
- Not activating protection and justice because she has not filed a complaint.

## Test yourself

Think of the answer, then tap the question to see it.

## What triage priority does Res. 459 de 2012 give to sexual violence in the first 72 hours?

Priority I. After 72 hours it may be priority II, unless there are signs of high risk such as suicidal ideation or severe bleeding.

## Within what time does the protocol give emergency contraception?

Always within 72 hours, exceptionally up to 120 hours after the assault.

## Which routes does health activate in a case of sexual violence against an adult woman?

At the same time, protection through the Comisaría de Familia and justice through the Fiscalía or the judicial police.

## Why should the nurse record whether the person washed or changed clothes?

Washing, changing clothes, urinating or using pads after the assault have medico-legal implications for the evidence.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/sexual-violence-the-nurse-s-role-in-colombia-s-care-protocol/)

## Elsewhere in DurgiPedia

- [Resolution 459 of 2012: the health-care protocol for sexual violence](https://durgical.com/en/forensic-medicine/resolution-459-of-2012-the-health-care-protocol-for-sexual-violence/)
- [The forensic exam after sexual violence](https://durgical.com/en/forensic-medicine/the-forensic-exam-after-sexual-violence/)
- [Sexual violence: samples and evidence](https://durgical.com/en/forensic-medicine/sexual-violence-samples-and-evidence/)

## Connections

## Related 2

- [Gender-based and intimate-partner violence: asking, safety planning and activating the care route](https://durgical.com/en/nursing/gender-based-and-intimate-partner-violence-asking-safety-planning-and-activating/)
- [Abortion care in Colombia from the nursing side: rights and routes, care during and after, and post-abortion contraception](https://durgical.com/en/nursing/abortion-care-in-colombia-from-the-nursing-side-rights-and-routes-care-during-an/)

## Related conditions 1

- [Sexual violence (care of the survivor)](https://durgical.com/en/conditions/sexual-violence/)

[← All of nursing](https://durgical.com/en/nursing/)

Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Resolución 459 de 2012: Protocolo y Modelo de Atención Integral en Salud para Víctimas de Violencia Sexual](https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/Resolucion-0459-de-2012.PDF) (Ministerio de Salud y Protección Social de Colombia, 2012); [Sexual assault and abuse and STIs: adolescents and adults (STI Treatment Guidelines)](https://www.cdc.gov/std/treatment-guidelines/sexual-assault-adults.htm) (Centers for Disease Control and Prevention, 2021); [Violence against women (fact sheet)](https://www.who.int/news-room/fact-sheets/detail/violence-against-women) (World Health Organization, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/nursing/sexual-violence-the-nurse-s-role-in-colombia-s-care-protocol/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/sexual-violence-the-nurse-s-role-in-colombia-s-care-protocol/