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HIV Postexposure Prophylaxis Use Among Ontario Female Adolescent Sexual Assault Victims: A Prospective Analysis

Du Mont, Janice EdD*†; Myhr, Terri L. MSc*; Husson, Heather BA; Macdonald, Sheila MN§∥; Rachlis, Anita MD¶#; Loutfy, Mona R. MD, MPH*#

doi: 10.1097/OLQ.0b013e3181824f3c

Background: This study examined the use of HIV postexposure prophylaxis (PEP) among sexually assaulted adolescent females.

Methods: We analyzed data from the HIV PEP Project, an implementation and evaluation of a program of universal offering of PEP to sexual assault victims of all ages. Baseline and follow-up data were collected prospectively from consecutive clients seen at 18 hospital-based sexual assault treatment centers in Ontario, Canada from September 2003 to January 2005. Among 386 at-risk female adolescents, we examined the provision and uptake of and adherence to PEP, and factors related to antiretroviral acceptance and completion.

Results: Most adolescents were single (94.5%), living with family (68.0%), and attending school (67.4%). Slightly over two-fifths (42.7%) accepted and one-third (33.6%) completed the 28-day course of PEP. Factors associated with PEP acceptance were health care provider encouragement, being a student, and being moderately-to-highly anxious. PEP completion was associated with being white and an assailant known less than 24 hours.

Conclusions: Our findings highlight the importance of the health care provider's role in counseling sexually assaulted female adolescents about HIV PEP use. The results also suggest that at-risk adolescents not enrolled in school and those from culturally diverse backgrounds may require additional supports.

Among Canadian sexually assaulted adolescents at risk for HIV, PEP acceptance was related to health provider encouragement, being a student, and being moderately-to-highly anxious. Completion was associated with being white and an assailant known less than 24 hours.

From the *Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada; †Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada; ‡McMaster University, Hamilton, Ontario, Canada; §Ontario Network of Sexual Assault/Domestic Violence Treatment Centres, Toronto, Ontario, Canada; ∥Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada; ¶Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; and the #Department of Medicine, University of Toronto, Toronto, Ontario, Canada

The original HIV PEP Project was funded by a peer-reviewed grant from the Ontario Women's Health Council, Ministry of Health and Long-term Care, Ontario. The authors are indebted to the frontline sexual assault nurses and physicians, hospital pharmacists, local HIV experts, and SATC program coordinators for their dedication to the Project; to the members of the Project Advisory Committee for their expertise; to Terry Leeke for data management and statistical support; and to the participants who made the Project possible. J. Du Mont is the recipient of a New Investigator Award in Gender and Health from the Canadian Institutes of Health Research and is supported by the Atkinson Foundation. M.R. Loutfy is the recipient of a Scholarship Award from the Ontario HIV Treatment Network.

Correspondence: Dr. Janice Du Mont, EdD, Women's College Research Institute, 790 Bay Street, 7th Floor, Toronto, Ontario, Canada M5G 1N8. E-mail:

Received for publication February 20, 2008, and accepted June 4, 2008.

© Copyright 2008 American Sexually Transmitted Diseases Association