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Nonoccupational Postexposure Human Immunodeficiency Virus Prophylaxis: Acceptance Following Sexual Assault

Draughon Moret, Jessica E.; Hauda, William E. II; Price, Bonnie; Sheridan, Daniel J.

doi: 10.1097/NNR.0000000000000122
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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 post-sexual 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 (adjusted odds ratio [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.

Jessica E. Draughon Moret, PhD, RN, SANE-A, is Assistant Professor of Clinical Nursing, Betty Irene Moore School of Nursing, University of California Davis.

William E. Hauda II, MD, is Medical Director, Forensic Assessment and Consultation Team, Inova Fairfax Hospital, Falls Church, Virginia.

Bonnie Price, RN, SANE-A, SANE-P, AFN-BC, is Director, Forensic Nurse Examiner Program, Bon Secours St. Mary's Hospital, Richmond, Virginia.

Daniel J. Sheridan, PhD, RN, FAAN, is Professor, Goldfarb School of Nursing, Barnes-Jewish College, St. Louis, Missouri.

Accepted for publication July 30, 2015.

The authors acknowledge that some data herein were presented in an altered format in the lead author's doctoral dissertation, “HIV Non-occupational Post-exposure Prophylaxis Following Sexual Assault: Program and Patient Characteristics and Protocol Adherence” (unpublished dissertation, Johns Hopkins University School of Nursing, 2013).

The authors thank the Biostatistics/Epidemiology Core of the Johns Hopkins University Center for AIDS Research (P30 AI094189) for their assistance.

This article was submitted and accepted for publication while J. E. D. was a postdoctoral scholar at the Department of Community Health Systems, University of California San Francisco School of Nursing.

This study was supported by the National Institutes of Health (NIMH F31 MH088850). J. E. D. was supported by NINR (T32 NR007081). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

The authors have no conflicts of interest to disclose.

Corresponding author: Jessica E. Draughon Moret, PhD, RN, SANE-A, 4610 X Street, #4202, Sacramento, CA 95817 (e-mail: jdmoret@ucdavis.edu).

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