Postexposure prophylaxis after sexual assaults: a prospective cohort study

Area of Science:

• Medical Science
• Infectious Diseases
• Public Health

Background:

• Rape victims are at risk of HIV infection.
• Postexposure prophylaxis (PEP) is crucial for preventing HIV transmission after exposure.
• Evaluating the efficacy and safety of PEP protocols in this vulnerable population is essential.

Purpose of the Study:

• To assess the effectiveness of an HIV postexposure prophylaxis (PEP) protocol in victims of sexual assault.
• To determine the safety and tolerability of different PEP regimens.
• To identify factors associated with compliance to PEP treatment.

Main Methods:

• Victims were categorized into low, moderate, or high exposure risk groups.
• Moderate risk group received Zidovudine (ZDV) + Lamivudine (3TC).
• High risk group received Zidovudine (ZDV) + Lamivudine (3TC) + Protease Inhibitor (PI) for up to 72 hours, with a 6-month follow-up.

Main Results:

• Out of 347 victims attended, 278 were offered PEP.
• No HIV seroconversions were observed in 180 victims completing the follow-up.
• Higher incidence of side effects was noted in the triple therapy group (ZDV + 3TC + PI).
• Schooling level, knowledge of aggressor's HIV status, and PEP use were linked to compliance.

Conclusions:

• The evaluated HIV PEP protocol demonstrated effectiveness in preventing seroconversion in rape victims.
• Triple therapy regimens were associated with increased side effects, suggesting a need for protocol review.
• Factors influencing HIV transmission risk also impacted patient compliance with PEP.