Ortega Briana, Thayer Jennifer, Chen Liwei, Steblin Sandy, Mhaskar Rahul S, Straub Diane M
Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Crisis Center of Tampa Bay, Tampa, FL, USA.
AIDS Care. 2022 Oct;34(10):1268-1275. doi: 10.1080/09540121.2021.1957079. Epub 2021 Jul 31.
Non-occupational Post-Exposure Prophylaxis for HIV (nPEP) is recommended by the CDC for isolated exposures that pose "substantial risk" for HIV transmission. To combat multiple barriers to nPEP utilization, a comprehensive program was developed through the local community sexual assault provider. The purpose of this study was to evaluate nPEP protocol implementation. A retrospective chart review was conducted of all sexual assault victims seen during a six-month period, and all patients who accepted nPEP were selected for follow-up phone interviews. 157 patients presented during the study period. Mean time to care was 32.4hrs, with 126/157 (80%) presenting ≤72hrs. 114/157 (73%) patients were offered nPEP by providers. 67/114 (59%) patients accepted, with the most common reason for declining being needing more time to decide. 10/13 (77%) patients able to be contacted reported completing nPEP, with side-effects cited as the most common noncompletion reason. 9 reported side effects and 4 received recommended follow-up HIV testing. 83/99 (84%) patients clearly eligible by chart review were offered nPEP, suggesting good adherence to CDC guidelines. Most patients contacted completed nPEP despite side-effects, suggesting good adherence. Our findings demonstrated multiple points status post-sexual assault to potentially improve the nPEP process.
美国疾病控制与预防中心（CDC）建议，对于存在HIV传播“重大风险”的孤立暴露情况，应进行非职业性暴露后预防（nPEP）。为应对nPEP使用过程中的多重障碍，通过当地社区性侵犯服务机构制定了一项综合计划。本研究的目的是评估nPEP方案的实施情况。对六个月内就诊的所有性侵犯受害者进行了回顾性病历审查，并选择所有接受nPEP的患者进行随访电话访谈。在研究期间有157名患者就诊。平均就诊时间为32.4小时，其中126/157（80%）的患者在≤72小时内就诊。114/157（73%）的患者被医护人员提供了nPEP。67/114（59%）的患者接受了nPEP，拒绝的最常见原因是需要更多时间来做决定。10/13（77%）能够联系上的患者报告完成了nPEP，报告最多的未完成原因是出现了副作用。9名患者报告有副作用，4名患者接受了推荐的后续HIV检测。通过病历审查明确符合条件的83/99（84%）患者被提供了nPEP，这表明医护人员很好地遵循了CDC指南。尽管有副作用，但大多数接受联系的患者完成了nPEP，这表明患者很好地遵循了医嘱。我们的研究结果表明，性侵犯后有多个环节可潜在地改进nPEP流程。
