Neu Natalie, Heffernan-Vacca Susan, Millery Mari, Stimell Mindy, Brown Jocelyn
Columbia University, New York, NY 10032, USA.
Sex Transm Dis. 2007 Feb;34(2):65-8. doi: 10.1097/01.olq.0000225329.07765.d8.
We sought to evaluate the tolerability and feasibility of establishing an HIV postexposure prophylaxis (PEP) program at our hospital using the guidelines for children and adolescents after sexual assault.
This study was a prospective, nonrandomized observational study conducted from March 1999 until September 2002. Subjects (age <19 years) who presented to a pediatric emergency room within 72 hours of a sexual assault were eligible for enrollment. A 28-day PEP regimen of zidovudine and lamivudine was given.
In all, 70 adolescents were evaluated and 33 (31 females and 2 males) were enrolled. The mean age of enrolled subjects was 15 years, 61% were Hispanic, 30% black, and 79% presented to the emergency room within 24 hours of assault. Vaginal exposure was the most common site of penetration (64% [21 of 33]), but 18% (6 of 33) reported anal penetration. Only 9 subjects (27%) took >or=90% of all the medications. All subjects who returned for follow up tested HIV-negative. Adverse events occurred in 48% (16 of 33) of subjects; the most common events were abdominal pain, nausea, or vomiting.
Poor adherence to medications and visits is a significant problem in PEP programs for sexually assaulted children and adolescents.
我们试图依据针对遭受性侵犯儿童和青少年的指南，评估在我院建立HIV暴露后预防（PEP）项目的耐受性和可行性。
本研究是一项前瞻性、非随机观察性研究，于1999年3月至2002年9月进行。在遭受性侵犯72小时内前往儿科急诊室就诊的受试者（年龄<19岁）符合入组条件。给予齐多夫定和拉米夫定28天的PEP治疗方案。
总共评估了70名青少年，33名（31名女性和2名男性）入组。入组受试者的平均年龄为15岁，61%为西班牙裔，30%为黑人，79%在遭受侵犯后24小时内前往急诊室。阴道暴露是最常见的插入部位（64%[33例中的21例]），但有18%（33例中的6例）报告有肛门插入。只有9名受试者（27%）服用了所有药物的≥90%。所有回来接受随访的受试者HIV检测均为阴性。48%（33例中的16例）的受试者出现不良事件；最常见的事件是腹痛、恶心或呕吐。
在针对遭受性侵犯儿童和青少年的PEP项目中，药物依从性差和随访不佳是一个重大问题。
