Preventing human immunodeficiency virus infection among sexual assault survivors in Cape Town, South Africa: an observational study
Roland, M.E.; Myer, L.; Martin, L.J.; Maw, A.; Batra, P.; Arend, E.; Coates, T.J.; Denny, L.A.
Aids and Behavior 16(4): 990-998
2012
ISSN/ISBN: 1090-7165 PMID: 21301949 DOI: 10.1007/s10461-011-9892-3Document Number: 563679
We describe 131 South African sexual assault survivors offered HIV post-exposure prophylaxis (PEP). While the median days completed was 27 (IQR 27, 28), 34% stopped PEP or missed doses. Controlling for baseline symptoms, PEP was not associated with symptoms (OR = 1.30, 95% CI = 0.66, 2.64). Factors associated with unprotected sex included prior unprotected sex (OR = 6.46, 95% CI = 3.04, 13.74), time since the assault (OR = 1.33, 95% CI = 1.12, 1.57) and age (OR = 1.30, 95% CI = 1.08, 1.57). Trauma counseling was protective (OR = 0.18, 95% CI = 0.05, 0.58). Four instances of seroconversion were observed by 6 months (risk = 3.7%, 95% CI = 1.0, 9.1). Proactive follow-up is necessary to increase the likelihood of PEP completion and address the mental health and HIV risk needs of survivors. Adherence interventions and targeted risk reduction counseling should be provided to minimize HIV acquisition.
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