Postexposure prophylaxis for victims of sexual assault: treatments and attitudes of emergency department physicians

Abstract Background Emergency departments (EDs) are the primary source of care for victims of sexual assault (SA). Provision of emergency contraception (EC) to these women has previously been noted to be sporadic. Completeness of care for victims of SA and the barriers to complete care are further i...

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Bibliographic Details
Published in:Contraception (Stoneham) 2010-08, Vol.82 (2), p.168-173
Main Authors: Bakhru, Arvind, Mallinger, Julie B, Fox, Michelle C
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Contraception, Postcoital
District of Columbia
Emergency contraception
Emergency departments
Emergency Service, Hospital
Female
Genital system. Reproduction
HIV prophylaxis
Humans
Male
Maryland
Medical sciences
Middle Aged
Obstetrics and Gynecology
Pharmacology. Drug treatments
Physician behavior
Physicians
Post-Exposure Prophylaxis - methods
Practice Patterns, Physicians
Prevention and actions
Public health. Hygiene
Public health. Hygiene-occupational medicine
Sex Offenses
Sexual assault
Sexually Transmitted Diseases - prevention & control
Specific populations (family, woman, child, elderly...)
Virginia
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Summary:Abstract Background Emergency departments (EDs) are the primary source of care for victims of sexual assault (SA). Provision of emergency contraception (EC) to these women has previously been noted to be sporadic. Completeness of care for victims of SA and the barriers to complete care are further investigated in this study. Study Design All ED attending physicians in Maryland, Virginia and the District of Columbia were identified and contacted for participation; 35% completed the survey. Practice patterns were analyzed for the 67% of physicians who do not refer SA victims to other hospitals. Results We found that 83% of physicians “always” or “usually” offer EC, but only half prescribe EC more than 48 h postassault. While most (89%) typically offer prophylaxis for STDs other than HIV, only 45% offer or counsel on HIV prophylaxis. Physician attitudes and hospital protocols were significant modifiers. Conclusion Sexual assault victims are often not offered comprehensive care including prophylaxis against pregnancy and all STDs including HIV. Additional research is warranted to determine why physicians do not routinely offer HIV prophylaxis after SA.
ISSN:0010-7824
1879-0518
DOI:10.1016/j.contraception.2010.01.005