Addressing Human Papillomavirus Prevention During Pediatric Acute Sexual Assault Care

Deutsch, Stephanie Anne; Benyo, Sarah; Xie, Sherlly; Carlin, Eileen; Andalaro, Bridgett; Clagg, Bernadette; Jong, Allan De

doi:10.1097/jfn.0000000000000209

Cited by 5 publications

(5 citation statements)

References 9 publications

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“… 71 , 75 , 81 , 82 , 86 , 91 , 95 , 97 , 99 , 101 , 107 , 109 – 111 , 113 , 115 , 117 , 119 , 127 About 22 (31%) studies focused specifically on child sexual assault cases, 70 , 79 , 80 , 96 , 98 , 106 , 112 , 116 , 118 , 120 , 123 , 125 , 130 , 132 , 133 , 141 with six of these studies looking at sexually transmitted infection (STI) and pregnancy testing, STI prophylaxis, and the use of sexual assault nurse examiners. 77 , 78 , 121 , 122 , 140 , 150 Two of three review publications focused on screening, 154 , 155 with one publication focusing on improving the ED workflow for suspected or confirmed child abuse cases. 156 …”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Current Social Emergency Medicine Research

Shah

Porta

Leung

et al. 2021

WestJEM

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Introduction: Social emergency medicine (EM) is an emerging field that examines the intersection of emergency care and social factors that influence health outcomes. We conducted a scoping review to explore the breadth and content of existing research pertaining to social EM to identify potential areas where future social EM research efforts should be directed. Methods: We conducted a comprehensive PubMed search using Medical Subject Heading terms and phrases pertaining to social EM topic areas (e.g., “homelessness,” “housing instability”) based on previously published expert consensus. For searches that yielded fewer than 100 total publications, we used the PubMed “similar publications” tool to expand the search and ensure no relevant publications were missed. Studies were independently abstracted by two investigators and classified as relevant if they were conducted in US or Canadian emergency departments (ED). We classified relevant publications by study design type (observational or interventional research, systematic review, or commentary), publication site, and year. Discrepancies in relevant publications or classification were reviewed by a third investigator. Results: Our search strategy yielded 1,571 publications, of which 590 (38%) were relevant to social EM; among relevant publications, 58 (10%) were interventional studies, 410 (69%) were observational studies, 26 (4%) were systematic reviews, and 96 (16%) were commentaries. The majority (68%) of studies were published between 2010–2020. Firearm research and lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research in particular grew rapidly over the last five years. The human trafficking topic area had the highest percentage (21%) of interventional studies. A significant portion of publications -- as high as 42% in the firearm violence topic area – included observational data or interventions related to children or the pediatric ED. Areas with more search results often included many publications describing disparities known to predispose ED patients to adverse outcomes (e.g., socioeconomic or racial disparities), or the influence of social determinants on ED utilization. Conclusion: Social emergency medicine research has been growing over the past 10 years, although areas such as firearm violence and LGBTQ health have had more research activity than other topics. The field would benefit from a consensus-driven research agenda.

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Section: Resultsmentioning

confidence: 99%

A Scoping Review of Current Social Emergency Medicine Research

Shah

Porta

Leung

et al. 2021

WestJEM

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“…Data collection in two studies was in-depth interviews with children and their parents [ 37 , 39 ]. Although most contents included all medical, psychological, forensic, and legal services for victims of sexual abuse, some addressed only one of the psychological [ 37 ], forensic [ 33 ], or HPV (Human Papilloma Virus) vaccination measures [ 36 ]. The quality of evidence was relatively good as can be seen in Tables 1 and 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, the national clinical practice guidelines suggested HPV vaccination is needed after child sexual abuse [ 29 ]. Two studies on child victims of sexual abuse also showed the effectiveness and importance of the HPV vaccine in post-rape care [ 36 , 40 ]. HPV vaccination should be given to children between the ages of 9–14 years [ 2 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, new studies reported that effective time in preventing unwanted pregnancies in female victims has increased from less than 72 h to 120 h after rape [ 2 , 22 , 25 , 26 , 35 ]. Likewise, whereasolder studies only focused on tetanus and hepatitis B vaccination, newer studies emphasize HPV vaccination in sexually abused children and adolescents [ 2 , 29 , 36 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Health care providers’ responses to sexually abused children and adolescents: a systematic review

Rahnavardi

Shahali

Montazeri

et al. 2022

BMC Health Serv Res

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Background Sexual abuse of children and adolescents is a significant health concern worldwide. Appropriate and timely health services for victims can prevent severe and long-term consequences. This study identified and categorized diagnostic and treatment services needed for sexually abused children and adolescents. Methods Several databases, including MEDLINE, Web of Science, Scopus, Science Direct, ProQuest, and Google Scholar, were searched to retrieve studies on the topic and clinical guidelines in English covering the literature from 2010 to 2020 using search terms. Primary studies and guidelines were reviewed to identify treatment strategies and medical interventions related to sexually abused children and adolescents. Results Twenty-one studies and guidelines were selected and analyzed narratively. The quality of evidence was relatively good. We identified that effective health care systems for sexually abused children include the following: interview and obtain medical history, physical and anogenital examination, collecting forensic and DNA evidence, documenting all the findings, prevention and termination of pregnancy, diagnostic tests, prophylaxis for HIV and other STIs, vaccinations, and psychological intervention. Conclusions This review provides up-to-date evidence about adequate health care services for children and adolescent victims of sexual abuse. We conclude that recent studies have focused more on prophylaxis against HIV and other STIs, studies on vaccinating against HPV for victims are still limited, and future research in this area is needed.

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“…24 Among adult women who suffer sexual violence, the incidence of human papillomavirus (HPV) varies between 2% and 40%. 8,18,25 A longitudinal study, controlled and randomized with 665 young American women who had suffered sexual violence in the previous 12 months, showed a 4.5 times greater chance of testing positive for HPV 16 or 18 in the cervix, suggesting sexual violence as a risk factor for infection. 26 The current 2015 Centers for Disease Control and Prevention (CDC) has updated their recommendations for sexually assaulted patients to now receive the HPV vaccine.…”

Section: Discussionmentioning

confidence: 99%

Sexually Transmitted Infections Among Adolescent and Adult Women Victims of Sexual Violence in the Metropolitan Region of São Paulo, Brazil

Drezett¹,

Bessa²,

Valenti³

et al. 2020

Hum. Reprod. Arch.

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Background: Sexual violence is a serious violation of human rights that mainly affects women. Among the impacts on health, sexually transmitted infections (STIs) are important due to their high prevalence and possible reproductive harm. Objective: To check and compare the incidence of STIs in adolescent and adult women victims of sexual violence. Method: Retrospective cohort study with 135 adolescents (10-19 years) and 154 adult women (≥20 years) attending the Pérola Byington Hospital, São Paulo, Brazil, with vaginal and/or anal unprotected exposure during the sexual crime, with ingression between 72 hours and 10 days of the violence, who did not receive prophylaxis for STIs, hepatitis B or HIV. Cases with earlier STIs, pregnant women and violence from an intimate partner were excluded. The outcome was the occurrence of STIs in the two groups. Data were introduced in the program Epi Info6, version 6.04b, with statistical analysis by chi-square test. Results: The diagnosis of STIs occurred for 32.6% of adolescents and 31.1% of adult women. The median age was 21.0±5.8 years. Adolescents were more vulnerable to the related and known aggressors. Ninety-two patients with STIs (31.8%) were found along with 120 infections among the 289 women, distributed between HPV (16.9%), trichomoniasis (6.6%), chlamydia (3.8%), herpes (2.4%), hepatitis B (2.4%), syphilis (2.1%), gonorrhea (1.7%) pelvic inflammatory disease (1.7%), hepatitis C (1.4%), HIV (1.4%) and HTLV I and II (1.0%). Conclusion: The incidence and distribution of STIs show no differences in the two groups, suggesting similar risk for adolescent and adult women when submitted to the same forms of exposure during sexual crime.

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Addressing Human Papillomavirus Prevention During Pediatric Acute Sexual Assault Care

Abstract: Significant barriers to addressing HPV in the ED setting exist, most significantly reliance on caregiver recall to guide vaccination administration, raising concern for overvaccination and undervaccination.

Cited by 5 publications

References 9 publications

A Scoping Review of Current Social Emergency Medicine Research

A Scoping Review of Current Social Emergency Medicine Research

Health care providers’ responses to sexually abused children and adolescents: a systematic review

Sexually Transmitted Infections Among Adolescent and Adult Women Victims of Sexual Violence in the Metropolitan Region of São Paulo, Brazil

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