Factors Impacting HIV Postexposure Prophylaxis Among Sexually Assaulted Patients Presenting to Two Urban Emergency Departments

Abstract

ABSTRACT Introduction Sexually assaulted patients who seek care in emergency departments are often recommended for nonoccupational HIV postexposure prophylaxis treatment. HIV postexposure prophylaxis is an effective method in preventing HIV transmission if the treatment is administered promptly and if a full 28-day course is completed. However, research has shown that only a fraction of patients who start the treatment will complete a 28-day course. Research is needed to explore factors that may be associated with compliance to postexposure prophylaxis so that interventions can be designed to address the factors that put patients at risk for noncompletion. Methods A retrospective chart review was conducted examining 246 medical records of sexually assaulted female patients who presented to one of two urban hospitals. A number of patient and event-related factors were examined to determine whether they were associated with HIV postexposure prophylaxis adherence among patients presenting at an emergency room after a sexual assault. Results Results revealed that five factors showed significant associations with sexually assaulted female patients completing HIV postexposure prophylaxis treatment. These factors include educational level, employment, health insurance, vaginal injuries, and tongue–mouth assaults. Implications for Practice The results of this study represent a starting point from which to inform the development of targeted interventions such that those most at risk for nonadherence can receive additional support or services to improve HIV postexposure prophylaxis adherence.