HIV continues to be pandemic with an estimated 56,000 new HIV infections in the United States (US) in 2006. The number of new HIV infections due to sexual assault is unknown, but young women, especially of color, are among the fastest growing groups contracting HIV. Sexual assault affects both men and women. Sexual assault presents several factors making transmission of HIV more likely such as: lack of condom use;infliction of genital and/or anal trauma;concurrent sexually transmitted infections (STIs);and multiple and/or unknown assailants. Non-occupational post-exposure prophylaxis (nPEP) for sexual assault remains controversial in the US. However, nPEP is recommended as standard practice internationally, especially in areas of high sexual assault with greater rates of HIV such as in South Africa. The proposed mixed methods study will address the following specific aims, hypotheses and research questions:
Aim 1 : To compare the frequency and factors related to offering nPEP to sexual assault patients by Sexual Assault Nurse Examiners (SANE) in urban settings.
Aim 2 : To identify predictors of acceptance and adherence to nPEP post- sexual assault. Hypothesis 2.1: Survivors with depression and/or trauma symptoms will be less likely to complete nPEP than those with lower levels of these symptoms. Research Question: Does intention mediate the relationship between cognitive/personal factors and the behavior - completion of nPEP? Hypothesis 2.2: Survivors who have higher perceptions of HIV risk will be more likely to accept and complete nPEP than those with lower perceptions of HIV risk. Hypothesis 2.3: Survivors with higher levels of social support will be more likely to complete nPEP than those with low levels of social support.
Aim 3 : To explore the perceptions of a sub-sample of sexual assault survivors of the experience in SANE clinics after assault care, including: reactions to discussion of nPEP;attitudes and understanding related to HIV and nPEP as well as barriers and facilitators to nPEP acceptance and adherence.

Public Health Relevance

The intersection of HIV and gender based violence requires greater understanding and scrutiny as young men and women of color are among the fastest growing groups infected by HIV;these same groups are also at highest risk for sexual assault, which may increase HIV transmission. This study aims to determine factors and predictors of sexual assault survivor acceptance and adherence to HIV nPEP in an effort to determine the current utility of nPEP as a public health intervention through surveys and in-depth interviews. A greater understanding of sexual assault survivor's perceptions of nPEP will influence development of future interventions to decrease HIV.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Predoctoral Individual National Research Service Award (F31)
Project #
5F31MH088850-03
Application #
8399644
Study Section
Special Emphasis Panel (ZRG1-AARR-H (22))
Program Officer
Stoff, David M
Project Start
2011-01-01
Project End
2013-08-31
Budget Start
2013-01-01
Budget End
2013-08-31
Support Year
3
Fiscal Year
2013
Total Cost
$30,119
Indirect Cost
Name
Johns Hopkins University
Department
Type
Schools of Nursing
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Draughon Moret, Jessica E; Hauda 2nd, William E; Price, Bonnie et al. (2016) Nonoccupational Postexposure Human Immunodeficiency Virus Prophylaxis: Acceptance Following Sexual Assault. Nurs Res 65:47-54
Draughon, Jessica E; Hauda 2nd, William E; Price, Bonnie et al. (2015) Factors Associated With Forensic Nurses Offering HIV nPEP Status Post Sexual Assault. West J Nurs Res 37:1194-213
Draughon, Jessica E; Lucea, Marguerite B; Campbell, Jacquelyn C et al. (2015) Impact of Intimate Partner Forced Sex on HIV Risk Factors in Physically Abused African American and African Caribbean Women. J Immigr Minor Health 17:1313-21
Clough, Amber; Draughon, Jessica E; Njie-Carr, Veronica et al. (2014) ""Having Housing Made Everything Else Possible"": Affordable, Safe and Stable Housing for Women Survivors of Violence. Qual Soc Work 13:671-688
Draughon, Jessica E; Anderson, Jocelyn C; Hansen, Bryan R et al. (2014) Nonoccupational postexposure HIV prophylaxis in sexual assault programs: a survey of SANE and FNE program coordinators. J Assoc Nurses AIDS Care 25:S90-S100
Campbell, Jacquelyn C; Lucea, Marguerite B; Stockman, Jamila K et al. (2013) Forced sex and HIV risk in violent relationships. Am J Reprod Immunol 69 Suppl 1:41-4
Stockman, Jamila K; Lucea, Marguerite B; Draughon, Jessica E et al. (2013) Intimate partner violence and HIV risk factors among African-American and African-Caribbean women in clinic-based settings. AIDS Care 25:472-80
Draughon, Jessica E (2012) Sexual assault injuries and increased risk of HIV transmission. Adv Emerg Nurs J 34:82-7