title: Current practice of HIV postexposure prophylaxis treatment for sexual assault patients in an emergency department.
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.
  
  
  RESULTS
  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: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia. Electronic address: kathleen.h.krause@gmail.com.
authors: Kathleen H
authors: KH
authors: Krause
authors: Women's CARE Clinic, Department of Nursing, Brigham and Women's Hospital, Boston, Massachusetts.
authors: Annie
authors: A
authors: Lewis-O'Connor
authors: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors: Amanda
authors: A
authors: Berger
authors: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
authors: Teress
authors: T
authors: Votto
authors: Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors: Sigal
authors: S
authors: Yawetz
authors: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors: Daniel J
authors: DJ
authors: Pallin
authors: Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
authors: Lindsey R
authors: LR
authors: Baden
mesh_terms: D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital; D006678:HIV; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D056990:Post-Exposure Prophylaxis; D011902:Rape; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D055815:Young Adult