Postexposure HIV/STI prophylaxis for victims of rape: an emergency attention program in Mexico City
U. Ramos1, P. Volkow2, C. Carlos3, A. González Rodríguez4, M.C. De Azcárraga Urteaga5
1Public Health Services Mexico City, Ginecology, City Mexico, Mexico, 2Institute of Cancerology, Mexico City, Mexico, 3Clinica Especializada Condesa, STIS, Mexico, Mexico, 4Mexico City HIV/AIDS Program, Direction, Mexico City, Mexico, 5Mexico City HIV/AIDS Program, Prevention, Mexico City, Mexico
Background: Non consent sexual intercourse increases the risk of HIV to victims, as mucosal lacerations and bleeding is greater in this conditions. In Mexico City, four rapes are denounced daily. In December 2008 postexposure program (PP) for victims of rape was established by the Mexico City HIV/AIDS Program Clínica Condesa (CC) in coordination with the Judicial System (Policies Station) in order to give medical attention, prevention of HIV, pregnancy and STI and psychological and legal counseling to victims of rape.
The PP was implemented through:
1. Training workshops for police stations stakeholders, to provide in situ PP (a special container with initial HAART and emergency contraception pills was provided to all polices stations), afterwards victims are referred to CC for clinical and laboratory follow-up.
2. Follow-up at CC: included HAART for 28 days and STIs prophylaxis, consent and confidential HIV, Hepatitis B, Hepatitis C and Syphilis tests were performed at first visit and repeated three and sixth months after rape. If needed reference for legal abortion
Results: During the first year of the program, 597 victims were attended of 42% of those denounced: 548 women (91.7 %) and 49 men (8.3 %).The age average for men was 14 (3-36) years and 17 (3-68) for women, 90% of them had not started sexual activity before the crime. 233 (40%) victims denounced within 72 hours (range 6-32 hours) of the rape and received HIV PP. After six months of follow-up no HIV, HBV, HCV and other STIs have been recorded. Five recurred to legal abortion.
Conclusions: A significant finding is that the majority of the victims were youth. The PP reduced the damage of sexual violence through prevention of HIV and STIs and unwanted pregnancies. We need to reinforce the program to increase the access to PP for victims of rape.
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