Background: HIV transmission is one of the most significant concerns among survivors of sexual assault. In California, HIV PEP is offered routinely in some counties and not in others. To best provide HIV risk and trauma counseling and PEP medications after sexual assault, we collected data and developed policy for PEP after sexual assault in California. Methods: Between 11/99 and 1/00, key informants in all California counties were contacted by mail and phone to ascertain if PEP is provided after sexual assault. Chart review was conducted among all sexual assault survivors in San Francisco between 4/98 and 11/99. An expert panel was identified and will convene in April 2000 to develop guidelines for PEP after sexual assault. Results: 33 (59%) out of 56 counties responded. 12 (20%) reported presently offering PEP after sexual assault. In San Francisco, 376 individuals sought out treatment for sexual assault during the study period. 213 were offered PEP (90% female). 69 (32.4%) patients offered PEP chose to initiate medications, 26 (12%) returned after 10 days to complete the 28-day course of medications. In a multivariate logistic regression model, individuals penetrated anally were significantly more likely than others to initiate PEP medications. Conclusions: Statewide policy for PEP after sexual assault is needed. While the public health cost for 28 days of Combivir is $327, since most rape survivors chose not to initiate medications, the cost per person offered PEP is $55; similar to other prophylactic medications. The final policy developed from this process will be completed by August 2000.
Learning Objectives: Attendees will develop an understanding of the risks and benefits of HIV PEP after sexual assault and the data concerning sexual assault in California for development of policy in home states
Keywords: Sexual Assault, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.