暴露后预防和随访儿童和年轻人呈现性侵犯
Sarah Hui Wen Yao1, Karen Nadua2,3,4,5, Chia Yin Chong2,3,4,5
1Department of Paediatrics, KK Women's and Children's Hospital, Singapore.
儿童性侵犯受害者对乙型肝炎病毒 (HBV) 暴露后疫苗接种率较低,对人类免疫缺陷病毒 (HIV) 暴露后预防 (PEP) 和随访护理的遵守率较低. 优化对这一脆弱群体的护理需要检查导致遵守程度低的因素.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 儿科 儿科 儿科
背景情况:
- 儿童性侵犯 (SA) 需要立即评估暴露后预防 (PEP),以预防性传播感染 (STIs).
- 了解SA受害者的临床特征和管理对于优化护理至关重要.
- 病毒性PEP,包括人类免疫缺陷病毒 (HIV) 和乙型肝炎病毒 (HBV),在减轻感染风险方面发挥着至关重要的作用.
研究的目的:
- 描述在新加坡出现SA的儿童和青少年 (CYPs) 的临床特征.
- 评估病毒性PEP (HIV和HBV) 处方实践和随访时的性传播疾病查.
- 为了确定儿童SA受害者在护理和合规方面的差距.
主要方法:
- 对2022年1月至2023年8月期间出现SA的CYP (≤16岁) 的医疗记录的回顾性审查.
- 攻击和攻击者的特征分析,基线和后续性传播感染查,PEP处方,坚持和后续出席.
- 艾滋病毒PEP的资格标准包括艾滋病毒阳性或未知状态的高风险特征的攻击者在72小时内进行的SA.
主要成果:
- 278名CYPs接受了292次SA访问;40人 (13.7%) 符合HIV PEP的资格,其中29人 (82.9%) 接受了它. 只有10人 (27%) 完成了HIV PEP课程.
- 基线性传播疾病查显示,9%的患者感染了*Chlamydia trachomatis*和34.9%的患者感染了*Gardnerella vaginalis*;没有人感染了HIV,HBV或其他常见的性传播疾病.
- 只有46.1%的符合条件的CYP接种了乙型肝炎疫苗,77.7%接受了HBV PEP与免疫球蛋白. 总体而言,57.7%的人参加了随访,没有艾滋病毒或HBV血清转化.
结论:
- 在儿童SA受害者中观察到HBV暴露后疫苗接种率低于最佳水平,以及对HIV PEP和随访的遵守率低.
- 在完成PEP方案和出席后续预约时存在重大差距.
- 对影响不良合规因素的进一步调查对于加强对这一脆弱人群的护理至关重要.
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