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Current practice of HIV postexposure prophylaxis treatment for sexual assault patients in an emergency department.
Womens Health Issues 2014 Jul-Aug; 24(4):e407-12WH

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.

Authors+Show Affiliations

Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia. Electronic address: kathleen.h.krause@gmail.com.Women's CARE Clinic, Department of Nursing, Brigham and Women's Hospital, Boston, Massachusetts.Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts.Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24981399

Citation

Krause, Kathleen H., et al. "Current Practice of HIV Postexposure Prophylaxis Treatment for Sexual Assault Patients in an Emergency Department." Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, vol. 24, no. 4, 2014, pp. e407-12.
Krause KH, Lewis-O'Connor A, Berger A, et al. Current practice of HIV postexposure prophylaxis treatment for sexual assault patients in an emergency department. Womens Health Issues. 2014;24(4):e407-12.
Krause, K. H., Lewis-O'Connor, A., Berger, A., Votto, T., Yawetz, S., Pallin, D. J., & Baden, L. R. (2014). Current practice of HIV postexposure prophylaxis treatment for sexual assault patients in an emergency department. Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, 24(4), pp. e407-12. doi:10.1016/j.whi.2014.04.003.
Krause KH, et al. Current Practice of HIV Postexposure Prophylaxis Treatment for Sexual Assault Patients in an Emergency Department. Womens Health Issues. 2014;24(4):e407-12. PubMed PMID: 24981399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current practice of HIV postexposure prophylaxis treatment for sexual assault patients in an emergency department. AU - Krause,Kathleen H, AU - Lewis-O'Connor,Annie, AU - Berger,Amanda, AU - Votto,Teress, AU - Yawetz,Sigal, AU - Pallin,Daniel J, AU - Baden,Lindsey R, PY - 2013/05/13/received PY - 2014/03/28/revised PY - 2014/04/21/accepted PY - 2014/7/2/entrez PY - 2014/7/2/pubmed PY - 2015/4/14/medline SP - e407 EP - 12 JF - Women's health issues : official publication of the Jacobs Institute of Women's Health JO - Womens Health Issues VL - 24 IS - 4 N2 - 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. SN - 1878-4321 UR - https://www.unboundmedicine.com/medline/citation/24981399/Current_practice_of_HIV_postexposure_prophylaxis_treatment_for_sexual_assault_patients_in_an_emergency_department_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1049-3867(14)00051-6 DB - PRIME DP - Unbound Medicine ER -