Postexposure prophylaxis for sexual assault
Posted by dkwinter

Chlamydia

  • Azithromycin

 

Gonorrhea

  • Ceftriaxone

 

Hepatitis B

     If victim was vaccinated previously:

  • no Hepatitis B prophylaxis is required (some references recommend always give Hep B vaccine)

     If victim has not been vaccinated:

  • Hepatitis B vaccine (and repeated at 1 and 6 months)

     If victim has not been vaccinated and assailant is known to be hepatitis B positive (or high-risk, e.g. IV drug user or multiple assailants):

  • Hepatitis B vaccine (and repeated at 1 and 6 months)
  • AND
  • Hepatitis B immune globulin
    • Given up to 14 days after assault

 

HIV (some references suggest only treat on a case-by-case basis, others suggest always treating)

  • 3-drug regimen (e.g. tenofovir-emtricitabine with raltegravir)
    • Given up to 72 hours after the assault

 

Trichomonas vaginalis

  • Metronidazole (may be omitted if microscopic examination shows an absence of flagellated motile organisms)

 

HPV vaccination

  • for female victims aged 9-26 and male victims aged 9-21 (males up to 26 if MSM and no prior complete HPV vaccination)
  • first dose at time of initial examination
  • second and third doses at 1-2 months and 6 months, respectively

 

Syphillis

  • no post-assault prophylaxis recommended

 

Diagnostic tests

  • Pregnancy test (baseline)
  • Drug/ethanol testing if unable to recall events
  • Urine for Chlamydia and Gonorrhea
  • Syphilis screening serology (and repeat in 3 months)
  • HBV and HCV screening serology (and repeat in 3 months)
  • HIV screening serology (and repeat in 3 and 6 months)

 

Reference:

     2015 Sexually Transmitted Diseases Treatment Guidelines (CDC)

 

See also:

     Emergency contraception