NCJ Number
215872
Journal
Child Abuse & Neglect Volume: 30 Issue: 8 Dated: August 2006 Pages: 919-927
Date Published
August 2006
Length
9 pages
Annotation
This study sought to describe the utilization of antiretroviral post-exposure prophylaxis (ARV-PEP), which can decrease the risk of HIV infection, by physicians for child and adolescent patients being evaluated for sexual abuse/assault at an inner-city hospital pediatric emergency department in a city with high HIV prevalence.
Abstract
Overall, the results indicated that child and adolescent victims were rarely provided ARV-PEP, even in cases in which there were physical findings upon medical evaluation. Most child victims of sexual abuse/assault were actually ineligible for ARV-PEP because they presented to the hospital beyond the 72-hour window required for ARV-PEP use. Specifically, of the 227 victims, only 87 presented within the 72-hour window for ARV-PEP use. Of these 87 victims, 23 exhibited trauma or bleeding but only 5 were provided ARV-PEP. Further analysis revealed that the most significant predictor of ARV-PEP receipt was stranger assault. Other findings indicated that 69 percent of victims who presented within 72-hours were given some type of antibiotic treatment and 90 percent of the post-menarchal girls were provided with emergency contraception. The findings suggest that pediatric emergency department staff should familiarize themselves with the risks and benefits of ARV-PEP and should utilize community HIV data as well as victim data to evaluate the appropriateness of giving ARV-PEP in cases of sexual abuse/assault. The study was retrospective and involved a review of the medical records of children and adolescents who were examined for possible sexual abuse in the pediatric emergency department of a pubic healthcare facility located in inner-city Atlanta, GA from January 1 through December 30, 2002. The analysis focused on identifying perpetrator and victim characteristics, assault characteristics, and physical examination findings associated with ARV-PEP receipt or increased risk of HIV transmission to the victim. Additionally, an informal telephone survey was conducted regarding the policies of Atlanta healthcare facilities that provided emergency management of child sexual abuse/assault and a convenience sample of pediatric emergency department physicians were interviewed regarding the use of ARV-PEP for child victims of sexual abuse. Data analysis techniques included Fisher exact testing. References