Nonoccupational Postexposure Human Immunodeficiency Virus Prophylaxis

Abstract

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.

“Reclaiming Control” Patient Acceptance and Adherence to HIV Post-Exposure Prophylaxis Following Sexual Assault

“…Interpretive description-guided qualitative data collection and analysis in a two-part multi methods study in which data was triangulated from quantitative sources and qualitative interviews collected continuously throughout the study to garner a more complete picture of post-sexual assault patients’ experience of HIV PEP (Draughon et al, 2015; Draughon Moret et al, 2016). The multi methods study was guided by the theory of reasoned action and planned behavior (TRA/TPB) as a framework for understanding patient perceptions of experiences influencing HIV PEP adherence post-sexual assault.…”

“…Approximately half of post-sexual assault patients offered HIV PEP initiate the medication regimen (Scannell et al, 2018). Factors positively associated with patients' starting HIV PEP post-sexual assault in the US (Draughon Moret et al, 2016), and Canada (Loutfy et al, 2008) include having a known high-risk exposure (per CDC or program-specific guidelines) or an assailant known to have HIV. One's mental state has been reported to impact South African post-sexual assault patients' understanding of HIV PEP (Vetten & Haffejee, 2005).…”

Psychosocial Health Factors Among Men Reporting Recent Sexual Assault

“…The parent-study survey included several measures to assess factors known in the literature to be associated with HIV PEP acceptance and adherence or HIV medication adherence more broadly (Draughon, 2013;Draughon et al, 2014Draughon et al, , 2015Draughon & Sheridan, 2012;Draughon Moret et al, 2016, 2021. These were organized in domains adapted from the theory of reasoned action/theory of planned behavior: personal factors, cognitive factors, mental health, barriers, and facilitators-all of which contribute to behavioral intentions (decision to initiate HIV PEP) and downstream to ultimate behaviors (completion of HIV PEP; Draughon, 2013;Montaño & Kasprzyk, 2008).…”

SANE Knowledge of HIV nPEP

“…Upon further inquiry, a significant gap in the literature concerning SANE knowledge of HIV infection and HIV nPEP evidence-based practice guidelines was identified. Current literature on the topic of HIV nPEP for victims of sexual assault surrounds risk of exposure, patient adherence, access and barriers, current practices in various states and countries, and standardized order sets (Chacko et al, 2012; Djelaj et al, 2017; Draughon et al, 2014; Draughon et al, 2015; Draughon & Sheridan, 2012; Draughon-Moret et al, 2016; DuMont et al, 2011; Krause et al, 2014; Ortega et al, 2022; Saadatzadeh et al, 2021; Segovia et al, 2023; Shipeolu et al, 2020; Silva-Nash et al, 2022). Although SANE education topics are clearly outlined and include the topic of HIV transmission and prophylaxis (IAFN, 2018; USDOJ, 2018), the assessment and retention of knowledge after nurses complete SANE training may be lacking.…”