title: Preventing human immunodeficiency virus infection among sexual assault survivors in Cape Town, South Africa: an observational study.
abstract: We describe 131 South African sexual assault survivors offered HIV post-exposure prophylaxis (PEP). While the median days completed was 27 (IQR 27, 28), 34% stopped PEP or missed doses. Controlling for baseline symptoms, PEP was not associated with symptoms (OR = 1.30, 95% CI = 0.66, 2.64). Factors associated with unprotected sex included prior unprotected sex (OR = 6.46, 95% CI = 3.04, 13.74), time since the assault (OR = 1.33, 95% CI = 1.12, 1.57) and age (OR = 1.30, 95% CI = 1.08, 1.57). Trauma counseling was protective (OR = 0.18, 95% CI = 0.05, 0.58). Four instances of seroconversion were observed by 6 months (risk = 3.7%, 95% CI = 1.0, 9.1). Proactive follow-up is necessary to increase the likelihood of PEP completion and address the mental health and HIV risk needs of survivors. Adherence interventions and targeted risk reduction counseling should be provided to minimize HIV acquisition.
authors.affiliation: Positive Health Program at San Francisco General Hospital, University of California San Francisco, 94110, USA. Michelle.Roland@cdph.ca.gov
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Roland
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
authors.forename: Lorna J
authors.initials: LJ
authors.lastname: Martin
authors.forename: Anastasia
authors.initials: A
authors.lastname: Maw
authors.forename: Priya
authors.initials: P
authors.lastname: Batra
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Arend
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Coates
authors.forename: Lynette A
authors.initials: LA
authors.lastname: Denny
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D008297:Male; D056990:Post-Exposure Prophylaxis; D011902:Rape; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors; D047568:Unsafe Sex; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents