1138. Statewide Survey of Emergency Department Practice for Prophylaxis of Sexually Trasmitted Infections in Rape Victims
Session: Oral Abstract Session: Sexually Transmitted Infections
Friday, October 4, 2013: 2:00 PM
Room: The Moscone Center: 250-262
Background:

In the United States (US), a woman is raped every 6 minutes. The rate of sexual assault in the US is the highest of any industrialized nation in the world. Post assault examination presents an important opportunity to identify and prevent sexually transmitted infections (STI). This study sought to examine how patients are evaluated and managed after presenting to emergency departments in the state of Georgia (GA) after being sexually assaulted. 

Methods:

This is a descriptive study where all acute care hospitals in the state of GA were contacted via telephone.  Data was obtained by interviewing either the emergency room charge nurse or medical director.  There were 4 main questions asked during each interview: 1. Does your hospital have a sexual assault policy/procedure in place? 2. Do you offer STI prophylaxis after a patient has been raped? 3. Do you test for HIV after a patient has been raped?  4. Do you offer HIV prophylaxis after a patient has been raped.

Results:

Of the 144 acute care hospitals contacted only 119 were interviewed successfully.  Ninety-seven hospitals (81.5%) reported having a sexual assault protocol/policy in place.  Twenty-two hospitals (18.5%) had no protocol.  A total of 64 hospitals (53.7%) reported offering STI prophylaxis after rape, 21 hospitals (17.6%) reported not offering STI prophylaxis, and 34 hospitals (28.5%) were inconsistent.  Sixteen hospitals (13.4%) reported always offering HIV testing to patients after sexual assault, 36 hospitals (30.2%) reported not offering HIV testing, 43 hospitals (36.1%) recommended the patient to follow up at an outside facility for testing, and 42 hospitals (35.2%) were inconsistent with offering HIV testing.  Only 11 hospitals (9.2%) reported routinely offering HIV post-exposure prophylaxis to patients that present after being raped.       

Conclusion:

Our study demonstrates that hospitals in the state of Georgia are not routinely following CDC guidelines on STI prophylaxis after rape.  Patients are not routinely being offered testing for HIV after rape in the state of GA as recommended by the CDC.  Only 9.2% of rape victims are routinely offered HIV post-exposure prophylaxis after rape. The sooner post exposure prophylaxis is initiated after an exposure, the higher the likelihood that it will prevent STI including HIV transmission if an exposure has occurred.

Adrienne Crow, MD1,2, Taalibah Ahmed, MD3,4, Ritu Kumar, MD5 and Harold Katner, MD6, (1)Ob/Gyn, Mercer University, macon, GA, (2)Obstetrics and Gynaecology, Mercer University, Macon GA, macon, GA, (3)Ob &gyn, Mercer University, Macon, GA, (4)Ob/Gyn, Mercer University, Macon, GA, (5)Internal Medicine, Mercer University School of Medicine, Macon, GA, (6)Mercer University School of Medicine, Macon, GA

Disclosures:

A. Crow, None

T. Ahmed, None

R. Kumar, None

H. Katner, None

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