Draughon Jessica E, Hauda William E, Price Bonnie, Rotolo Sue, Austin Kim Wieczorek, Sheridan Daniel J
Johns Hopkins University School of Nursing, Baltimore, MD, USA
Virginia Commonwealth University, Richmond, USA.
West J Nurs Res. 2015 Sep;37(9):1194-213. doi: 10.1177/0193945914530192. Epub 2014 Apr 14.
Nonoccupational, postexposure prophylaxis (nPEP) for human immunodeficiency virus (HIV) is offered inconsistently to patients who have been sexually assaulted. This may be due to Forensic Nurse Examiner (FNE) programs utilizing diverse nPEP protocols and HIV risk assessment algorithms. This study examines factors associated with FNEs offering nPEP to patients following sexual assault at two FNE programs in urban settings. Offering nPEP is mostly driven by site-specific protocol. At Site 1, in addition to open anal or open genital wounds, the presence of injury to the head or face was associated with FNEs offering nPEP (adjusted odds ratio [AOR] 64.15, 95% confidence interval [CI] = [2.12, 1942.37]). At Site 2, patients assaulted by someone of Other race/ethnicity (non-White, non-African American) were 86% less likely to be offered nPEP (AOR 0.14, 95% CI = [.03, .72]) than patients assaulted by Whites. In addition to following site-specific protocols, future research should further explore the mechanisms influencing clinician decision making.
对于遭受性侵犯的患者，人类免疫缺陷病毒（HIV）的非职业性暴露后预防（nPEP）服务提供情况并不一致。这可能是由于法医护士检查官（FNE）项目采用了不同的nPEP方案和HIV风险评估算法。本研究调查了在城市环境中的两个FNE项目中，与FNE在性侵犯后为患者提供nPEP相关的因素。提供nPEP主要由特定场所的方案驱动。在地点1，除了开放性肛门或开放性生殖器伤口外，头部或面部受伤与FNE提供nPEP相关（调整后的优势比[AOR]为64.15，95%置信区间[CI]=[2.12,1942.37]）。在地点2，与被白人侵犯的患者相比，被其他种族/族裔（非白人、非非裔美国人）侵犯的患者获得nPEP的可能性低86%（AOR为0.14，95%CI=[.03,.72]）。除了遵循特定场所的方案外，未来的研究应进一步探索影响临床医生决策的机制。
