Fewer than one-half of adolescent sexual assault survivors who are prescribed medications to prevent contraction of human immunodeficiency virus (HIV) may return for follow-up visits and only about 15 percent complete the therapy, according to a report in the July issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
As many as 10 percent of adolescent females experience sexual assault in their lifetimes, according to background information in the article. The risk of contracting HIV after a single exposure is low, but transmission has been reported after sexual assault. National guidelines published in 2005 recommend that physicians consider prescribing a 28-day course of antiviral medications after sexual assault to reduce the risk of contracting HIV, an extension of a practice first used by health care workers exposed to the virus by needle sticks.
Elyse Olshen, M.D., M.P.H., then at Boston University School of Medicine and now at Columbia University Medical Center, New York, and colleagues reviewed the charts of 145 adolescents ages 12 to 22 years who visited one of two pediatric emergency departments in Boston within 72 hours of a sexual assault. During the years of the study--2001 to 2003--both academic medical centers followed protocols directing that medications to prevent HIV be considered on a case-by-case basis following sexual assault and that adolescents prescribed these therapies visit their primary care providers or follow-up clinics for continuing treatment.
Of the 145 adolescents, 129 (89 percent) were offered prophylactic (preventive) therapy and 110 (76 percent) agreed to take it. Of the 86 of those 110 who were referred for follow-up treatment at one of the two hospitals in the study, only 37 (38 percent) returned for at least one follow-up visit and 13 (15 percent) completed the full 28 days of prophylactic therapy.
The results highlight the diffi
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