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Uptake to HIV Post‐Exposure Prophylaxis in Haiti: Opportunities to Align Sexual Violence, HIV PEP and Mental Health
Author(s) -
Marc Linda,
Honoré JeanGuy,
Néjuste Patrick,
Setaruddin Monica,
Lamothe NikaNola,
Thimothé Gabriel,
Cornely JeanRonald
Publication year - 2013
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12053
Subject(s) - medicine , psychological intervention , mental health , human immunodeficiency virus (hiv) , sexual violence , sexual assault , reproductive health , public health , sexual transmission , population , psychiatry , suicide prevention , poison control , family medicine , environmental health , nursing , microbicide
Sexual violence is a public health problem in Haiti, potentially augmenting HIV transmission. Reports from L ' H ôpital de l' U niversité d' É tat d' H aiti ( HUEH ) suggest severe underutilization of antiretroviral post‐exposure prophylaxis ( ARV ‐ PEP ) among rape survivors. Cross‐sectional design using mixed methods. Informational interviews were conducted with HUEH personnel to learn about post‐rape service offerings. HUEH surveillance data were used to estimate the sexual assault reporting rate/100,000 and to examine the proportion of survivors receiving ARV ‐ PEP within 72 hr, stratified by age (<18 years, ≥18 years). Informational interviews revealed that survivors were navigated through two hospital algorithms to receive post‐rape care; however, <5% of victims sought mental health services. Surveillance data show that 2193 sexual assault survivors (adult and pediatric) reported a rape to HUEH personnel between 2004 through first quarter of 2010. Annual estimates suggest a twofold increase comparing cases in 2004 versus 2009. Between 2008 and 2009, uptake to ARV ‐ PEP within 72 hr was lower for pediatric (38.4%; N = 131/341) compared with adult survivors (60.1%; N = 83/138) (χ 2 = 18.8, P < 0.001). The prioritization of funding and comprehensive interventions that align sexual violence, HIV , and mental health is crucial to support the timely uptake to ARV ‐ PEP .