Auditors: Defense Department slow to develop sexual-assault policies Required refresher training for health-care professionals is not always done, for example, leaving some unfamiliar with how to treat injuries sustained during an assault and how to protect their confidentiality, the report said. GAO auditors found that the Office of the Assistant Secretary of Defense for Health Affairs, which tells the services how to respond to sexual assaults, has failed to communicate enough information to medical professionals in the field. "Left unaddressed . . . limited health-care guidance and first responders" inconsistent knowledge about available resources . . . can undermine DOD's efforts to address the problem of sexual assault in the military by eroding servicemembers" confidence in the department's programs and decreasing the likelihood that victims will . . . seek care and treatment when needed," auditors wrote. They noted that sexual violence is a crime that requires a specialized level of care - making sure forensic evidence is properly collected, medical care is given in a way that minimizes the risk of another assault and helping victims make a confidential report. "As a consequence, sexual assault victims who want to keep their case confidential may be reluctant to seek medical care," the report found. It did not address the prevalence of sexual violence in the military. Defense officials told auditors that they disagreed with their conclusions, although they agreed that they need to step up compliance with annual refresher training on sexual-assault prevention and response. Officials have spoken openly about the problems in its ranks. A recent report, for example, focused on inappropriate conduct by trainees at Lackland Air Force Base in Texas, which said at least 48 female students were victims of sexual assault or inappropriate conduct by instructors between October 2010 and June 2011. Defense officials said they have been working for two years on procedures to improve the military's prevention and response to sexual assaults. But they did not provide any details, auditors said. The audit, and another released Tuesday by the GAO assessing whether female servicemembers in the Army are medically prepared to deploy, found that most installations provide adequate health care for women. Routine services including breast exams, pap smears, pregnancy tests and contraceptives were available at 27 domestic installations auditors surveyed. Specialized services - including radiation for breast, ovarian and other cancers and treatment for abnormal pap smears - varied, but women were referred to civilian doctors or other bases. But policies for responding to sexual assault - or a lack of them - remains troubling, auditors said. The issue is likely to get more attention as hundreds of thousands of front-line jobs open up to women. Roles for women in the military have been expanding and evolving to combat support, counterinsurgency operations and combat despite an official restriction on artillery, armor, infantry and other roles. The services have taken various approaches to sexual assault, which the Pentagon has reported. At one clinic auditors visited, the written policy did not address when and where examinations should be done, how evidence should be given to police, and how to label the evidence so victims" names are kept confidential. The Defense Department reported that in 2011, the Army trained just 6,000 of the more than 17,000 medical personnel serving as victim advocates or assigned to respond to sexual violence, the audit said.