Factors associated with forensic clinical examiners offering HIV nPEP treatment to patients following rape or sexual assault

Hdl Handle:
http://hdl.handle.net/10147/620779
Title:
Factors associated with forensic clinical examiners offering HIV nPEP treatment to patients following rape or sexual assault
Authors:
Marshall, Deborah
Citation:
Marshall, D (2016) Factors associated with forensic clinical examiners offering HIV nPEP treatment to patients following rape or sexual assault Dissertation as part fulfilment of the requirement for Masters in Nursing Studies. University College Cork.
Publisher:
Marshall, Deborah
Issue Date:
Jul-2015
URI:
http://hdl.handle.net/10147/620779
Item Type:
Thesis
Language:
en
Description:
Background: Risk of HIV acquisition is higher for patients following rape or sexual assault with multiple factors identified. Patient assessment should be prompt and individualised, requiring knowledge of the factors associated with HIV transmission. Effective implementation of HIV nPEP (non occupational post exposure prophylaxis) treatment by forensic examiners is often protocol driven and may be dependent on the interpretation of risk assessment tools. However this treatment may be offered inconsistently to patients. Aim: To determine factors associated with forensic clinical examiners offering HIV nPEP Treatment to patients following a rape or sexual assault. Method:This study determined factors associated with the offer of HIV nPEP treatment to patients following a rape or sexual assault by forensic clinical examiners. A quantative, descriptive, correlation design was carried out. Retrospective chart review of a 3 year period yielded 276 charts. Statistical Package for Social Sciences (SPSS) was used for data analysis. Results:Two hundred patients attended <72hrs post rape/sexual assault and of these, 33 (16.5%) were commenced on HIV nPEP treatment . Seventy one risk factors were identified. Bivariate analysis demonstrated an association between the offer of HIV nPEP treatment and assailant number (p<0.001), assailant /patient relationship ( p=0.002), assailant race/ethnicity (p<0.001), assailant characteristics (p= 0.001), vaginal(p=0.019) anal penetration (p<0.001) and object penetration (p<0.012) . Twenty six per cent of charts had a risk assessment documented, associated with the offer of HIV nPEP treatment (p<0.001). Of the 25 patients who attended the HIV specialist service, 24 were continued on treatment. Six patients did not attend the HIV specialist service. Adherence to 28 days treatment was 56%. Reasons for not giving HIV nPEP treatment were noted in 24 charts. Conclusions:Findings highlighted that HIV nPEP treatment was appropriately prescribed to this cohort of patients and that some patients experienced multiple risk viii factors for HIV. Documented risk assessment is necessary for all patients, demonstrating decision making with each patient based on up to date risk assessment tools and protocols. Adding condom use to risk assessment tools is recommended. Treatment adherence was favourable when compared to other studies. Further research on the outcomes of patients not returning to the prescribing Sexual Assault Treatment Unit (SATU) for follow up is recommended.
Keywords:
RESEARCH; RAPE; SEXUAL ASSAULT
Local subject classification:
FORENSIC EXAMINATION

Full metadata record

DC FieldValue Language
dc.contributor.authorMarshall, Deborahen
dc.date.accessioned2016-09-30T11:09:28Z-
dc.date.available2016-09-30T11:09:28Z-
dc.date.issued2015-07-
dc.identifier.citationMarshall, D (2016) Factors associated with forensic clinical examiners offering HIV nPEP treatment to patients following rape or sexual assault Dissertation as part fulfilment of the requirement for Masters in Nursing Studies. University College Cork.en
dc.identifier.urihttp://hdl.handle.net/10147/620779-
dc.descriptionBackground: Risk of HIV acquisition is higher for patients following rape or sexual assault with multiple factors identified. Patient assessment should be prompt and individualised, requiring knowledge of the factors associated with HIV transmission. Effective implementation of HIV nPEP (non occupational post exposure prophylaxis) treatment by forensic examiners is often protocol driven and may be dependent on the interpretation of risk assessment tools. However this treatment may be offered inconsistently to patients. Aim: To determine factors associated with forensic clinical examiners offering HIV nPEP Treatment to patients following a rape or sexual assault. Method:This study determined factors associated with the offer of HIV nPEP treatment to patients following a rape or sexual assault by forensic clinical examiners. A quantative, descriptive, correlation design was carried out. Retrospective chart review of a 3 year period yielded 276 charts. Statistical Package for Social Sciences (SPSS) was used for data analysis. Results:Two hundred patients attended <72hrs post rape/sexual assault and of these, 33 (16.5%) were commenced on HIV nPEP treatment . Seventy one risk factors were identified. Bivariate analysis demonstrated an association between the offer of HIV nPEP treatment and assailant number (p<0.001), assailant /patient relationship ( p=0.002), assailant race/ethnicity (p<0.001), assailant characteristics (p= 0.001), vaginal(p=0.019) anal penetration (p<0.001) and object penetration (p<0.012) . Twenty six per cent of charts had a risk assessment documented, associated with the offer of HIV nPEP treatment (p<0.001). Of the 25 patients who attended the HIV specialist service, 24 were continued on treatment. Six patients did not attend the HIV specialist service. Adherence to 28 days treatment was 56%. Reasons for not giving HIV nPEP treatment were noted in 24 charts. Conclusions:Findings highlighted that HIV nPEP treatment was appropriately prescribed to this cohort of patients and that some patients experienced multiple risk viii factors for HIV. Documented risk assessment is necessary for all patients, demonstrating decision making with each patient based on up to date risk assessment tools and protocols. Adding condom use to risk assessment tools is recommended. Treatment adherence was favourable when compared to other studies. Further research on the outcomes of patients not returning to the prescribing Sexual Assault Treatment Unit (SATU) for follow up is recommended.en
dc.language.isoenen
dc.publisherMarshall, Deborahen
dc.subjectRESEARCHen
dc.subjectRAPEen
dc.subjectSEXUAL ASSAULTen
dc.subject.otherFORENSIC EXAMINATIONen
dc.titleFactors associated with forensic clinical examiners offering HIV nPEP treatment to patients following rape or sexual assaulten
dc.typeThesisen
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.