“I need emergency contraception and an STI test — something happened at work”

Sex workers face high rates of violence and barriers to care; a non-judgemental, trauma-informed approach is essential. Non-consensual condom removal can constitute rape in English law (consent conditional on condom use). Clarify timing and cycle: emergency contraception — the copper IUD is the most effective method and can be fitted up to 5 days after unprotected intercourse (or up to 5 days after the earliest likely ovulation); oral ulipristal 30 mg (up to 120 hours) is more effective than levonorgestrel around ovulation; give oral EC when an IUD cannot be fitted immediately; wait 5 days after ulipristal before starting hormonal contraception. HIV PEP must start within 72 hours (ideally within 24): refer the same day to a sexual health clinic or SARC for risk assessment, hepatitis B vaccination (accelerated course), STI testing (repeat at window periods: chlamydia and gonorrhoea at 2 weeks, HIV at 45 days, syphilis at 12 weeks). Offer SARC forensic examination and support (self-referral, no police required), explain police reporting is her choice, and mention anonymous reporting schemes (National Ugly Mums). Screen injuries (head, strangulation), safety, coercion, mood and alcohol. Confidentiality: GMC duties apply; no disclosure to her university; information is shared without consent only where there is a serious risk of harm to others or required by law.