4th International AIDS Society Conference on HIV Pathogenesis and Treatment


Sydney, Australia - July 22 - 25, 2007

HIV PEP UPTAKE AMONG SEXUAL ASSAULT SURVIVORS: RESULTS OF AN OBSERVATIONAL STUDY

IAS Conf HIV Pathog Treat 2007 Jul 22-25;4th: Abstract No. MOPDC04

Kilonzo N.1, Ajema C.1, Theobald S.2, Taegtmeyer M.2
1Liverpool VCT, Care & Treatment, Policy & Research, Nairobi, Kenya, 2Liverpool School of Tropical Medicine, Liverpool, United Kingdom

OBJECTIVES: Sexual assault survivors in Kenya access hospitals for treatment, preventive therapies, and psychological support. An observationsal study aimed at evaluating the uptake and delivery of post rape services including HIV PEP was undertaken in 3 district hospitals in Kenya between November 2003 and June 2005.

METHODS: Sexual assault survivors presenting at casualty were provided with the standard of care according to the Kenya national guidelines inlcuidng delivery of STI and HIV PEP, and counselling for HIV tesing and PEP adherence. Data on demographic, sexual assault, HIV test and PEP delivery characteristics were abstracted from routine clinical data collected at casualty and the HIV care clinic. Primary outcomes measured included quality of HIV PEP delivery and counselling. Multi-variate analysis using Epi-Info described associations between survivor characteristics and outcomes of interest.

RESULTS: 295 survivors recieved the standard of care. 89% were female. Median age was 16.5, IQR 9,25. 99% of 250 survivors presenting <72hours initiated PEP. 43 (14%) were lost to follow up prior to or post HIV testing. 13 (6%) of 207 who accepted HIV testing were positive at baseline. 180 (72%) continued PEP. 132 (73%) followed up at 2 weeks. 99 (51%) completed PEP. 67 (32%) recieved 6-weeks HIV testing with 1 documented sero-conversion (female, 7 years). 50% survivors intiated counselling, of whom 40% recieved at least 3 consecutive counselling sessions. First counselling session was associated with PEP completion (0R 2.7P P=0.004).

CONCLUSIONS: Baseline test data demonstrates other contextual HIV risk among survivors. 1 seroconversion could be probable PEP failure of poor adherence. Adherence was not measured. HIV PEP counselling for assault survivors is essential and should address other HIV risk. PEP utilization needs to be optimized through enhanced adherence counselling, strengthening follow up and retention of surivors for HIV testing.

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2007-07-22
MOPDC04
The Treatment-Prevention Nexus

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