HIV postexposure prophylaxis use among Ontario female adolescent sexual assault victims: a prospective analysis

This study examined the use of HIV postexposure prophylaxis (PEP) among sexually assaulted adolescent females.

We analyzed data from the HIV PEP Project, an implementation and evaluation of a program of universal offering of PEP to sexual assault victims of all ages. Baseline and follow-up data were collected prospectively from consecutive clients seen at 18 hospital-based sexual assault treatment centers in Ontario, Canada from September 2003 to January 2005. Among 386 at-risk female adolescents, we examined the provision and uptake of and adherence to PEP, and factors related to antiretroviral acceptance and completion.

Most adolescents were single (94.5%), living with family (68.0%), and attending school (67.4%). Slightly over two-fifths (42.7%) accepted and one-third (33.6%) completed the 28-day course of PEP. Factors associated with PEP acceptance were health care provider encouragement, being a student, and being moderately-to-highly anxious. PEP completion was associated with being white and an assailant known less than 24 hours.

Our findings highlight the importance of the health care provider's role in counseling sexually assaulted female adolescents about HIV PEP use. The results also suggest that at-risk adolescents not enrolled in school and those from culturally diverse backgrounds may require additional supports.