Department of Biostatistics and Division of Policy, Translation and Leadership Development, Harvard School of Public Health, Boston, MA, USA.
Am J Reprod Immunol. 2013 Feb;69 Suppl 1(0 1):132-41. doi: 10.1111/aji.12053. Epub 2012 Dec 28.
Sexual violence is a public health problem in Haiti, potentially augmenting HIV transmission. Reports from L'Hôpital de l'Université d'État d'Haiti (HUEH) suggest severe underutilization of antiretroviral post-exposure prophylaxis (ARV-PEP) among rape survivors. Cross-sectional design using mixed methods. Informational interviews were conducted with HUEH personnel to learn about post-rape service offerings. HUEH surveillance data were used to estimate the sexual assault reporting rate/100,000 and to examine the proportion of survivors receiving ARV-PEP within 72 hr, stratified by age (<18 years, ≥18 years). Informational interviews revealed that survivors were navigated through two hospital algorithms to receive post-rape care; however, <5% of victims sought mental health services. Surveillance data show that 2193 sexual assault survivors (adult and pediatric) reported a rape to HUEH personnel between 2004 through first quarter of 2010. Annual estimates suggest a twofold increase comparing cases in 2004 versus 2009. Between 2008 and 2009, uptake to ARV-PEP within 72 hr was lower for pediatric (38.4%; N = 131/341) compared with adult survivors (60.1%; N = 83/138) (χ(2) = 18.8, P < 0.001). The prioritization of funding and comprehensive interventions that align sexual violence, HIV, and mental health is crucial to support the timely uptake to ARV-PEP.
性暴力是海地的一个公共卫生问题，可能会增加 HIV 的传播。来自海地国立大学医院（HUEH）的报告表明，强奸幸存者严重未充分利用抗逆转录病毒暴露后预防（ARV-PEP）。采用混合方法的横断面设计。对 HUEH 人员进行信息访谈，以了解强奸后服务的提供情况。使用 HUEH 监测数据来估计性侵犯报告率/每 10 万人，并按年龄（<18 岁，≥18 岁）分层，检查在 72 小时内接受 ARV-PEP 的幸存者比例。信息访谈显示，幸存者通过两种医院算法接受强奸后护理；然而，<5%的受害者寻求心理健康服务。监测数据显示，2004 年至 2010 年第一季度，2193 名（成人和儿科）性侵犯幸存者向 HUEH 人员报告了强奸事件。年度估计表明，2004 年与 2009 年相比，病例增加了一倍。2008 年至 2009 年，在 72 小时内接受 ARV-PEP 的儿童（38.4%；N=131/341）与成年幸存者（60.1%；N=83/138）相比，接受率较低（χ²=18.8，P<0.001）。优先考虑资金和综合干预措施，将性暴力、艾滋病毒和心理健康联系起来，对于支持及时接受 ARV-PEP 至关重要。
