Abstract
Background
Comprehensive data that address current HIV nonoccupational postexposure prophylaxis
(nPEP) practices in the emergency care of sexual assault patients are limited. The
U.S. Centers for Disease Control and Prevention released HIV nPEP guidelines in 2005
and updated guidelines for Sexually Transmitted Disease Treatment in 2006 and 2010,
each of which support providing nPEP to sexual assault patients. This study examined
the offer, acceptance, and adherence rates of nPEP among sexual assault patients treated
at an emergency department (ED).
Methods
We conducted a retrospective review between January 1, 2008, and December 31, 2011,
of women, aged 16 years and older, treated for sexual assault in an academic ED that
participates in the sexual assault nurse examiner program.
Findings
One hundred seventy-one female patients were treated in the ED for 179 sexual assault
events. nPEP was not indicated in 19 cases and was offered to all 138 of patients
for whom nPEP was appropriate. Five patient cases that exceeded the 72-hour exposure
window were offered nPEP. Of the 143 patient cases offered nPEP, 124 (86.7%) initiated
nPEP. Of the 124 who accepted PEP, 34 (27.4%) had documented completion of the 28-day
course.
Conclusions
nPEP was offered in all 138 cases where patients were eligible for treatment. Of patients
who accepted nPEP, a minority are documented to have completed a course of treatment.
Systems to improve postassault follow-up care should be considered.
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References
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Biography
Kathleen H. Krause, MSc, served as a Clinical Research Project Manager at Brigham and Women's Hospital during this project and at the time of article submission. She is now a PhD student at the Rollins School of Public Health at Emory University.
Biography
Annie Lewis-O'Connor, PhD, NP-BC, MPH, is the Founder and Director of the Women's CARE (Coordinated Approach Recovery and Empowerment) program at Brigham and Women's Hospital. Her interests are in gender-based violence from a clinical, policy research, and academic education perspective.
Biography
Amanda Berger, RN, MSN, SANE-A, is the leader of the Quality Assurance Sexual Assault Team within the Emergency Department at Brigham and Women's Hospital. She provides education and support to staff caring for victims of sexual assault and serves as a patient advocate.
Biography
Teress Votto, BS, served as a Clinical Research Site Coordinator at Brigham and Women's Hospital during this project and at the time of article submission. She is now a Master's student at the Mailman School of Public Health at Columbia University.
Biography
Sigal Yawetz, MD, is the Director of the Program for HIV in Women and the Post-exposure Prophylaxis Program in the Division of Infectious Diseases at Brigham and Women's Hospital, and an Assistant Professor of Medicine at Harvard Medical School.
Biography
Daniel J. Pallin, MD, MPH, is the Chairman of the Clinical Investigation Committee of Brigham and Women's Hospital, the Director of Research for the Brigham and Women's Hospital Department of Emergency Medicine, and an Assistant Professor of Medicine (Emergency Medicine) and Pediatrics, Harvard Medical School.
Biography
Lindsey R. Baden, MD, is the Director of Clinical Research for the Division of Infectious Diseases at Brigham and Women's Hospital, and an Associate Professor of Medicine at Harvard Medical School.
Article info
Publication history
Accepted:
April 21,
2014
Received in revised form:
March 28,
2014
Received:
May 13,
2013
Identification
Copyright
© 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
