Nonoccupational Postexposure HIV Prophylaxis in Sexual Assault Programs: A Survey of SANE and FNE Program Coordinators

Abstract

This cross-sectional study describes Sexual Assault Nurse Examiner (SANE)/Forensic Nurse Examiner (FNE) program practices related to HIV testing, non-occupational post-exposure prophylaxis (nPEP), and common barriers to offering HIV testing and nPEP. A convenience sample of 174 SANE/FNE programs in the United States and Canada was drawn from the International Association of Forensic Nurses database, and program coordinators completed web-based surveys. Three quarters of programs had nPEP policies, 31% provided HIV testing; and 63% offered nPEP routinely or upon request. Using Chi-square and Fishers' exact tests a greater proportion of Canadian programs had an nPEP protocol (p = .010), provided HIV testing (p = .004), and offered nPEP (p = .0001) than U.S.-based programs. Program coordinators rated providing pre-/post-counseling and follow-up as the most important barrier to HIV testing and medication costs as the most important barrier to providing nPEP. Our results indicate HIV-related services are offered inconsistently across SANE/FNE programs.

Improving Emergency Department Care to Sexual Assault Survivors Using a Risk Stratification Tool

“…Collectively, the evidentiary literature recommendations for practice include: 1) developing a clinical decision tool that rapidly, efficiently, and accurately assesses the risk of HIV transmission following sexual assault, 2) developing evidence-based, standardized HIV (N) PEP protocols tailored to meet community needs, and 3) consultation with multi-disciplinary experts to provide education and training on use of (N)PEP guidelines/protocols/tool. Additional studies indicated that since the publication of updated guidelines in 2010 HIV (N) PEP has been offered more frequently [16,17]; however, the rates remain remarkably low. Studies that provided site-specific guidelines and /or protocols were most successful at offering HIV (N) PEP appropriately [16].…”

“…Additional studies indicated that since the publication of updated guidelines in 2010 HIV (N) PEP has been offered more frequently [16,17]; however, the rates remain remarkably low. Studies that provided site-specific guidelines and /or protocols were most successful at offering HIV (N) PEP appropriately [16].…”

Prevention of Human Immunodeficiency Virus and AIDS

“…Perpetrators of sexual assault are considered to be a high-risk population for HIV infection and PEP should be offered for these cases. 39–41 …”

Nonoccupational Postexposure Human Immunodeficiency Virus Prophylaxis

“…Typically, prophylaxis is offered at the close of the exam. When patients accept the offer of nPEP, they are given the first dose immediately and often discharged with a three to five day starter pack of medications; however, the amount of medication, cost of the medication regimen, and who pays that cost varies from jurisdiction to jurisdiction, and forensic nursing program to program (Draughon, Anderson, Hansen, & Sheridan, 2014). …”