Fast Five Quiz: Addressing Sexual Assault

Richard H. Sinert, DO

Disclosures

May 08, 2019

According to the CDC, HPV vaccination is recommended for girls and women aged 9-26 years and boys and men aged 9-21 years. Men who have sex with men and have not received the HPV vaccine or who have been incompletely vaccinated can receive vaccination through age 26 years. The vaccine should be administered at the time of the initial examination, with follow-up doses administered at 1-2 months and 6 months after the first dose.

An empiric antimicrobial regimen for chlamydia, gonorrhea, and trichomonas is recommended by the CDC. The CDC also recommends postexposure hepatitis B vaccination (without HBIG) if the hepatitis status of the assailant is unknown and the survivor has not been vaccinated previously. If the assailant is known to be HBsAg positive, unvaccinated survivors should receive both hepatitis B vaccine and HBIG. The vaccine and HBIG should be administered to sexual assault survivors at the time of the initial examination, if indicated, and follow-up doses of vaccine should be administered 1-2 and 4-6 months after the first dose. Survivors who were vaccinated previously but did not receive postvaccination testing should receive a single vaccine booster dose.

HIV PEP is individualized according to risk and must be started as soon as possible, and within 72 hours of exposure for HIV-uninfected persons. A 28-day course of PEP is recommended, as follows: Tenofovir disoproxil fumarate (TDF) 300 mg orally (PO) daily and emtricitabine 200 mg PO daily plus raltegravir 400 mg PO twice daily or dolutegravir 50 mg PO daily.

Patients should be referred to a sexual assault center for aftercare and community resources. Given the long-term emotional and psychosocial impact of sexual assault on the victim, aftercare is vital. A few of the many resources available include:

Read more on the treatment of patients who have experienced sexual assault.

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