Use of Human Immunodeficiency Virus Postexposure Prophylaxis in Adolescent Sexual Assault Victims

Olshen, Elyse; Hsu, Katherine; Woods, Elizabeth R.; Harper, Marvin B.; Harnisch, Brooke; Samples, Cathryn L.

doi:10.1001/archpedi.160.7.674

Cited by 36 publications

(29 citation statements)

References 29 publications

(26 reference statements)

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“…85 A retrospective study found that uncertainties regarding exposure, high rates of psychiatric comorbidity, and low rates of return for follow-up care were all factors in the low rates of adherence to postexposure prophylaxis. 86 Centers that specialize in treatment of sexual assault victims often provide care without cost to their clients and can advise about local resources when payment, confidentiality, and safety are concerns. No large studies examining different combinations of treatment have been performed with sexual assault victims, but on the basis of current occupational-exposure guidelines, 2 nucleoside reverse-transcriptase inhibitors and 1 of either a nonnucleoside reverse-transcriptase inhibitor or protease inhibitor for 4 weeks is recommended.…”

Section: Acute Carementioning

confidence: 99%

Care of the Adolescent Sexual Assault Victim

Kaufman¹

2008

Pediatrics

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Sexual assault is a broad-based term that encompasses a wide range of sexual victimizations including rape. Since the American Academy of Pediatrics published its last policy statement on sexual assault in 2001, additional information and data have emerged about sexual assault and rape in adolescents and the treatment and management of the adolescent who has been a victim of sexual assault. This report provides new information to update physicians and focuses on assessment and care of sexual assault victims in the adolescent population.

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Section: Acute Carementioning

confidence: 99%

Care of the Adolescent Sexual Assault Victim

Kaufman¹

2008

Pediatrics

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“…[2][3][4][5][6][7] However, U.S. ED clinicians report giving HIV PEP much more often to health care workers (HCWs) than non-HCWs, even when the risks of infection are similar. 2 Studies also indicate that HIV PEP, occupational and nonoccupational, has been prescribed in U.S. EDs when it should not have been and was not offered when it could have been.…”

Section: Introductionmentioning

confidence: 99%

Predictors of the Initiation of HIV Postexposure Prophylaxis in Rhode Island Emergency Departments

Merchant

Mayer

Becker

et al. 2008

AIDS Patient Care and STDs

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The objective of this study was to elucidate factors that predicted the initiation of HIV postexposure prophylaxis (PEP) for blood or body fluid exposures evaluated at Rhode Island emergency departments (EDs). The study involved a retrospective review of patient visits to all civilian Rhode Island EDs for these exposures from 1995 to mid-2001. Multivariate logistic regression models were created to evaluate predictors of the offering and the acceptance and receipt of HIV PEP from 1996 to 2001. The search identified 3622 patients who sustained a blood or body fluid exposure. Of these, 43.8% were health care workers (HCWs) and 57.2% were not HCWs. Most (52.0%) of the exposures were nonsexual. HIV PEP was offered to 21.0% and accepted and received by 9.4% of all patients. HIV PEP was offered more often after significant exposures, exposures to known HIV-infected sources, when time elapsed after the exposure was shorter, if the patients were HCWs, adults, presented to a teaching hospital, presented during the latter years of the study, or sustained nonsexual exposures. Once offered HIV PEP, patients who were male, adult, sustained a significant exposure, knew the source was HIV infected, sustained a nonsexual exposure, or were HCWs had a greater odds of accepting and receiving HIV PEP. Even when controlling for exposure significance, HIV status, and time elapsed since the exposure, several factors such as gender and type of hospital that are unrelated to the exposure appeared to influence the initiation of HIV PEP. ED providers should ensure that these factors do not inappropriately restrict its initiation.

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“…Factors associated with patient nPEP acceptance were similar to those associated with provider offering of nPEP (see Table 8). Again, the factor most frequently found was a positive association with high-risk exposure and/or a HIV-positive assailant Loutfy et al, 2008;Myles et al, 2000;Olshen et al, 2006;Wiebe et al, 2000). Lack of insurance or financial hardship was negatively associated with acceptance (Myles et al, 2000;Wiebe et al, 2000).…”

Section: Npep Acceptancementioning

confidence: 99%

Nonoccupational postexposure prophylaxis following sexual assault in industrialized low-HIV-prevalence countries: A review

Draughon

Sheridan

2012

Psychology, Health & Medicine

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Although available for over a decade, use of nonoccupational postexposure prophylaxis (nPEP) remains controversial in the United States. There are concerns over sexual assault survivors' adherence, or lack thereof, leading to increased costs without an appreciable decrease in human immunodeficiency virus (HIV) transmission. This review examines and synthesizes the available literature from the past 10 years to determine the true rates of provision and adherence to nPEP regimens in sexual assault survivors in low HIV prevalence, industrialized nations. Findings suggest that further prospective research is necessary to better understand the process of post-assault nPEP evaluation and subsequent follow-up and adherence.

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Use of Human Immunodeficiency Virus Postexposure Prophylaxis in Adolescent Sexual Assault Victims

Abstract: We observed low rates of PEP completion among adolescent sexual assault survivors. Potential difficulties of using PEP in this population include uncertainties regarding exposure, high rates of psychiatric comorbidity, and low rates of return for follow-up care.

Cited by 36 publications

References 29 publications

Care of the Adolescent Sexual Assault Victim

Care of the Adolescent Sexual Assault Victim

Predictors of the Initiation of HIV Postexposure Prophylaxis in Rhode Island Emergency Departments

Nonoccupational postexposure prophylaxis following sexual assault in industrialized low-HIV-prevalence countries: A review

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