Concentration Area: Women's Reproductive Health

Description:

• Authors: Carleyna Nunes BA, Lori Boardman MD, Donna Lafontaine MD, Chris Raker ScD
• Abstract: Objective: To determine the percentage of sexually assaulted female patients offered prophylaxis for sexually transmitted infections (STIs), HIV infection and pregnancy and to identify factors associated with the provision of prophylaxis. Methods: This is a cross-sectional study of 210 women presenting at a large, urban women’s hospital for evaluation following sexual assault between April 1, 2006 and April 20, 2008. Data extracted included demographic characteristics and selected quality of care measures, including prophylaxis for STIs and HIV infection as well as pregnancy prevention. Results: The patient population was young, racially and ethnically diverse, and less likely to be privately insured. Of the 210 women, 188 (90%) were offered prophylaxis for at least one of the following: Chlamydia (183/203 or 90%), syphilis (181/203 or 89%), gonorrhea (180/203 or 89%) and trichomoniasis (161/203 or 79%). The need for emergency contraception was assessed in 196 cases, with EC offered to 99% (147/148) of the population at risk for pregnancy. HIV prophylaxis was less frequently offered (66/210 or 31%). Factors associated with decreased likelihood of prophylaxis provision included insurance status (for HIV only: 47/169 (28%) of women with government assistance/self-pay were offered prophylaxis versus 18/39 (46%) of those privately insured, p=.05) and older age (for Chlamydia, 5/8 (63%) among women over 50 versus 178/195 (91%) among younger women (p=.03); for gonorrhea, 5/8 (63%) versus 174/195 (89%; p=.05) and for syphilis, 5/8 (63%) versus 176/195 (90%; p=.04). Conclusion: The majority of patients were offered appropriate prophylactic care, although age-related differences emerged with regards to provision.
• Journal: ACOG Annual Meeting 2009
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• Month:
• Year: 2009
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