Factors Associated With Forensic Nurses Offering HIV nPEP Status Post Sexual Assault

Draughon, Jessica E.; Hauda, William E.; Price, Bonnie; Rotolo, Sue; Austin, Kim Wieczorek; Sheridan, Daniel J.

doi:10.1177/0193945914530192

Cited by 14 publications

(19 citation statements)

References 31 publications

(64 reference statements)

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“…Site 1 further stipulated that a break in skin be present in order to recommend nPEP (Wieczorek, 2010). nPEP was to be offered for oral penetration at Site 3, if there was oral penetration with ejaculation at Site 2, or if there was oral penetration was a break in skin integrity at Site 1 (Draughon et al, 2015; Wieczorek, 2010). Despite the differences in site protocols, we hypothesized that site would not have an effect on patients’ accepting nPEP.…”

Section: Methodsmentioning

confidence: 99%

“…Retrospective chart review was completed at two of the three recruitment sites (Draughon et al, 2015). Records were abstracted for all adult, sexual assault forensic examinations conducted between January 1, 2011 through December 31, 2011 at Site 1, and from May 19, 2011 through April 30, 2012 at Site 2.…”

Section: Methodsmentioning

confidence: 99%

“…All variables were explicitly defined a priori (see Draughon et al, 2015). The same spreadsheet abstraction tool created a priori was used for both retrospective and prospective charts.…”

Section: Methodsmentioning

confidence: 99%

“…Please see Draughon et al (2015) for greater detail regarding the following abstracted variables: Demographic characteristics: sex/gender, age, and race/ethnicity. Patient race/ethnicity was categorized as “White and non-White” due to low prevalence in the sample of Black, mixed race, Asian, Hispanic, or Middle Eastern ethnicities.…”

Section: Methodsmentioning

confidence: 99%

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Nonoccupational Postexposure Human Immunodeficiency Virus Prophylaxis

et al. 2016

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Background Nonoccupational postexposure prophylaxis (nPEP) for HIV following sexual assault may decrease the likelihood of HIV transmission. Objective The purpose of this exploratory chart review study was to examine factors associated with patients accepting postsexual assault nPEP at three forensic nurse examiner programs in urban settings. Methods Forensic nursing charts of patients presenting for acute, sexual assault care were reviewed as part of a mixed-methods study. Results Patients assaulted by more than one or an unknown number of assailants were over 12 times more likely to accept the offer of nPEP (aOR 12.66; 95%CI [2.77, 57.82]). In cases where no condom was used (aOR = 8.57; 95%CI [1.59, 46.10]), or when any injury to the anus or genitalia was noted (aOR = 4.10; 95%CI [1.57, 10.75]), patients were more likely to accept nPEP. Patients with any injury to the face or head were less likely to initiate nPEP (aOR = 0.32; 95%CI [0.11, 0.97]). Discussion This study is an important first step in understanding factors associated with nPEP acceptance after sexual assault.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…All variables were explicitly defined a priori (see Draughon et al, 2015). The same spreadsheet abstraction tool created a priori was used for both retrospective and prospective charts.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Nonoccupational Postexposure Human Immunodeficiency Virus Prophylaxis

et al. 2016

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“…Despite known risk factors for SA individuals and the need for PEP, there are often noted disparities in healthcare delivery and outcomes. In a recent study, only 18% of SA individuals received PEP from forensic medical specialists (Ebert, Sperhake, Degen, & Schröder, 2018) Draughon et al (2015), found differences in the number of forensic nurses that offer PEP associated with practice location and policies (Draughon et al, 2015) only 69.4% of emergency departments offer PEP to female SA patients (Patel et al, 2013). In addition, there is a serious issue of poor adherence to the 28-day supply of PEP that has been identified as a priority area for research among SA individuals .…”

Section: Introductionmentioning

confidence: 99%

Exploring the issues of HIV post-exposure prophylaxis and sexually assaulted individuals

Scannell¹

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I first would like to acknowledge my dissertation chair Dr. Barbara J. Guthrie, I appreciate all the support, advice and encouragement both academically and professionally you have given me. To my dissertation committee members Dr. Beth E. Molnar and Dr. Rachel Rodgers, I thank you for all guidance, advice, and encouragement you have given me through this process. To my wonderful mentor Dr. Deborah D'Avolio, I was truly blessed to be able to be your research assistant and colleague, of which we had some unforgettable moments. Special acknowledgement to the Harvard Catalyst for their biostatistical consultations at the Brigham and Women's Hospital, to the Emergency Nurses Association for awarding me the doctoral scholarship and to the Massachusetts Nurses Association for their generous scholarship. To the dearest and closest people, I have met along the way or who have been with me through this journey,

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The use of HIV post-exposure prophylaxis in forensic medicine following incidents of sexual violence in Hamburg, Germany: a retrospective study

Ebert

Sperhake

Degen

et al. 2018

Forensic Sci Med Pathol

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In Hamburg, Germany, the initiation of HIV post-exposure prophylaxis (HIV PEP) in cases of sexual violence is often carried out by forensic medical specialists (FMS) using the city's unique Hamburg Model. FMS-provided three-day HIV PEP starter packs include a combination of raltegravir and emtricitabine/tenofovir. This study aimed to investigate the practice of offering HIV PEP, reasons for discontinuing treatment, patient compliance, and whether or not potential perpetrators were tested for HIV. We conducted a retrospective study of forensic clinical examinations carried out by the Hamburg Department of Legal Medicine following incidents of sexual violence from 2009 to 2016. One thousand two hundred eighteen incidents of sexual violence were reviewed. In 18% of these cases, HIV PEP was initially prescribed by the FMS. HIV PEP indication depended on the examination occurring within 24 h after the incident, no/unknown condom use, the occurrence of ejaculation, the presence of any injury, and the perpetrator being from population at high risk for HIV. Half of the HIV PEP recipients returned for a reevaluation of the HIV PEP indication by an infectious disease specialist, and just 16% completed the full month of treatment. Only 131 potential perpetrators were tested for HIV, with one found to be HIV positive. No HIV seroconversion was registered among the study sample. Provision of HIV PEP by an FMS after sexual assault ensures appropriate and prompt care for victims. However, patient compliance and completion rates are low. HIV testing of perpetrators must be carried out much more rigorously.

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Factors Associated With Forensic Nurses Offering HIV nPEP Status Post Sexual Assault

Cited by 14 publications

References 31 publications

Nonoccupational Postexposure Human Immunodeficiency Virus Prophylaxis

Nonoccupational Postexposure Human Immunodeficiency Virus Prophylaxis

Exploring the issues of HIV post-exposure prophylaxis and sexually assaulted individuals

The use of HIV post-exposure prophylaxis in forensic medicine following incidents of sexual violence in Hamburg, Germany: a retrospective study

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