Contraception
Volume 82, Issue 2 , Pages 168-173, August 2010

Postexposure prophylaxis for victims of sexual assault: treatments and attitudes of emergency department physicians

  • Arvind Bakhru

      Affiliations

    • Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland Medical Center, Baltimore, MD 21201, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 410 328 5959; fax: +1 410 328 0279.
    • Currently at: University of Michigan Medical Center, Department of Obstetrics and Gynecology, L4510WH, 1500 East Medical Center Drive, Ann Arbor, MI 48109. Tel.: +1 734 232 3797; fax: +1 734 764 7261.
    • ,
  • Julie B. Mallinger

      Affiliations

    • Georgetown University Law Center, Washington, DC 20001, USA
    • ,
  • Michelle C. Fox

      Affiliations

    • Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD 21224, USA

Received 18 May 2009; received in revised form 7 December 2009; accepted 7 January 2010. published online 11 February 2010.

Abstract 

Background

Emergency departments (EDs) are the primary source of care for victims of sexual assault (SA). Provision of emergency contraception (EC) to these women has previously been noted to be sporadic. Completeness of care for victims of SA and the barriers to complete care are further investigated in this study.

Study Design

All ED attending physicians in Maryland, Virginia and the District of Columbia were identified and contacted for participation; 35% completed the survey. Practice patterns were analyzed for the 67% of physicians who do not refer SA victims to other hospitals.

Results

We found that 83% of physicians “always” or “usually” offer EC, but only half prescribe EC more than 48 h postassault. While most (89%) typically offer prophylaxis for STDs other than HIV, only 45% offer or counsel on HIV prophylaxis. Physician attitudes and hospital protocols were significant modifiers.

Conclusion

Sexual assault victims are often not offered comprehensive care including prophylaxis against pregnancy and all STDs including HIV. Additional research is warranted to determine why physicians do not routinely offer HIV prophylaxis after SA.

Keywords: Emergency contraception, HIV prophylaxis, Sexual assault, Physician behavior, Emergency departments

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PII: S0010-7824(10)00006-5

doi:10.1016/j.contraception.2010.01.005

Contraception
Volume 82, Issue 2 , Pages 168-173, August 2010

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