Audit on management of sexual assault victims attending an integrated sexual health service in Coventry

2019 ◽  
Vol 30 (9) ◽  
pp. 911-914
Author(s):  
Billakanti Swarna Kumari ◽  
Shyamalie Bopitiya ◽  
Anne Bassinder ◽  
Satyajit Das

The management of victims of sexual assault need a holistic approach. The British Association of Sexual Health and HIV (BASHH) has set up standards for the management of sexual assault victims attending Sexual Health Clinics. We audited the management of victims of sexual assault attending an integrated sexual health service against recommendations from the latest BASHH guidelines. We included the recommendations and implementations already in place following an earlier audit in 2013 using the same guideline. Sixty-seven individuals identified themselves as victims of sexual assault. Most were of white ethnic origin (78%), female (96%) and the commonest age group was 18–25 years (39%). We achieved the 100% target in recording the date of assault, offering baseline sexually transmitted infection (STI) screening, HIV risk assessment, offer of post-exposure prophylaxis (PEP) for HIV where applicable and offer of emergency contraception. We were below the 100% target for other categories but improved compared to the previous audit except in recording the time when the first dose of PEP for HIV was given. The BASHH guideline has 14 auditable standards, all with a target of 100%. Our audit cycle completed in three years showed considerable improvement in achieving the standards in the management of Sexual Assault Victims. We hope this will encourage other centres audit their practice against the standards set by BASHH.

2016 ◽  
Vol 92 (Suppl 1) ◽  
pp. A73.4-A74
Author(s):  
Joanne Hamilton ◽  
Tatyana Sahabandu ◽  
Justine Orme ◽  
Suneeta Soni ◽  
Daniel Richardson

Author(s):  
Eric P F Chow ◽  
Jane S Hocking ◽  
Jason J Ong ◽  
Tiffany R Phillips ◽  
Christopher K Fairey

Abstract Background We aimed to examine the impact of lockdown on sexually transmitted infection (STI) diagnoses and access to a public sexual health service in the COVID-19 pandemic in Melbourne, Australia. Methods The operating hours of Melbourne Sexual Health Centre (MSHC) remained the same during the lockdown. We examined the number of consultations and STI at MSHC between January and June 2020 and stratified the data into pre-lockdown (3-February to 22-March), lockdown (23-March to 10-May) and post-lockdown (11-May to 28-June) with seven weeks in each period. Incidence rate ratio (IRR) and its 95% confidence intervals (CI) were estimated using Poisson regression models. Results The total number of consultations dropped from 7,818 in pre-lockdown to 4,652 during lockdown (IRR=0.60;95%CI:0.57-0.62) but increased to 5,347 in the post-lockdown period (IRR=1.15;95%CI:1.11-1.20). There was a 68% reduction in asymptomatic screening during lockdown (IRR=0.32; 95%CI:0.30-0.35) but it gradually increased in the post-lockdown period (IRR=1.59;95%CI:1.46-1.74). STI with milder symptoms showed a marked reduction, including non-gonococcal urethritis (IRR=0.60;95%CI:0.51-0.72), and candidiasis (IRR=0.61;95%CI:0.49-0.76) during lockdown compared with pre-lockdown. STI with more marked symptoms did not change significantly, including pelvic inflammatory disease (IRR=0.95;95%CI:0.61-1.47) and infectious syphilis (IRR=1.14;95%CI:0.73-1.77). There was no significant change in STI diagnoses in post-lockdown compared to lockdown. Conclusions The public appeared to be prioritising their attendance for sexual health services based on the urgency of their clinical conditions. This suggests that the effectiveness of clinical services in detecting, treating and preventing onward transmission of important symptomatic conditions is being mainly preserved despite large falls in absolute numbers of attendees.


2015 ◽  
Vol 91 (Suppl 1) ◽  
pp. A59.1-A59 ◽  
Author(s):  
Nicola Wallis ◽  
Sue Ralph ◽  
Alison Wardropper ◽  
Conrad White ◽  
Sarah Duncan

2014 ◽  
Vol 26 (3) ◽  
pp. 181-186 ◽  
Author(s):  
Alex Collister ◽  
Manroop Bains ◽  
Rachel Jackson ◽  
Emily Clarke ◽  
Raj Patel

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Jennifer R Silva-Nash ◽  
Stacie Bordelon ◽  
Ryan K Dare ◽  
Sherrie Searcy

Abstract Background Nonoccupational post exposure prophylaxis (nPEP) following sexual assault can prevent HIV transmission. A standardized Emergency Department (ED) protocol for evaluation, treatment, and follow up for post assault victims was implemented to improve compliance with CDC nPEP guidelines. Methods A single-center observational study of post sexual assault patients before/after implementation of an ED nPEP protocol was conducted by comparing the appropriateness of prescriptions, labs, and necessary follow up. A standardized order-set based on CDC nPEP guidelines, with involvement of an HIV pharmacist and ID clinic, was implemented during the 2018-2019 academic year. Clinical data from pre-intervention period (07/2016-06/2017) was compared to post-intervention period (07/2018-08/2019) following a 1-year washout period. Results During the study, 147 post-sexual assault patients (59 Pre, 88 Post) were included. One hundred thirty-three (90.4%) were female, 68 (46.6%) were African American and 133 (90.4%) were candidates for nPEP. Median time to presentation following assault was 12.6 hours. nPEP was offered to 40 (67.8%) and 84 (95.5%) patients (P< 0.001) and ultimately prescribed to 29 (49.2%) and 71 (80.7%) patients (P< 0.001) in pre and post periods respectively. Renal function (37.3% vs 88.6%; P< 0.001), pregnancy (39.0% vs 79.6%; P< 0.001), syphilis (3.4% vs 89.8%; P< 0.001), hepatitis B (15.3% vs 95.5%; P< 0.001) and hepatitis C (27.1% vs 94.3%) screening occurred more frequently during the post period. Labratory, nPEP Prescription and Follow up Details for Patients Prescribed nPEP Conclusion The standardization of an nPEP ED protocol for sexual assault victims resulted in increased nPEP administration, appropriateness of prescription, screening for other sexually transmitted infectious and scheduling follow up care. While guideline compliance dramatically improved, further interventions are likely warranted in this vulnerable population. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support)


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