n Child Abuse Research in South Africa - An assessment of the efficacy of HIV Post-Exposure Prophylaxis (PEP) following childhood sexual assault

Volume 14, Issue 2
  • ISSN : 1562-1383



South Africa is well known for both its high prevalence of Human Immunodeficiency Virus (HIV) infections and high crime rates. The crimes against children include childhood sexual assault. In a setting where both conditions are common, childhood sexual assault becomes a risk factor for acquiring HIV infection. The objectives of this study were to define the proportion of children eligible for Post Exposure Prophylaxis (PEP) following childhood sexual assault, to determine their compliance with the PEP regimen, to determine the rate of HIV seroconversion in children receiving PEP and to identify factors associated with HIV seroconversion. A retrospective chart review of 150 children presenting to Edendale and Greys hospitals in Pietermaritzburg following childhood sexual assault between 1 January and 30 June 2009 was undertaken. Children were considered eligible for PEP if they had a negative HIV baseline test at presentation, if they presented within 72 hours of sexual assault and the caregiver or child consented to PEP. Of the files 74 were complete, of those 4 children were excluded from the study as 3 had a positive HIV baseline test and 1 presented more than 72 hours post sexual assault. All 70 children had a workup for STI and were prescribed PEP for 4 weeks duration. Only 29 (41.4%) of the children attended the 1 week follow up visit and 22 (31.4%) the 3 months follow up visit at which all 22 had a negative HIV test. Although this was a small sample study, the results are in keeping with prior studies where PEP was found to be effective when given within 72 hours of sexual assault and also overall poor PEP compliance. In conclusion, in a setting where HIV prevalence is high PEP administration should be acceptable, feasible and cost effective.

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