Adherence to HIV post-exposure prophylaxis in victims of sexual assault: a systematic review and meta-analysis

Sex Transm Infect. 2012 Aug;88(5):335-41. doi: 10.1136/sextrans-2011-050371. Epub 2012 Feb 13.

Abstract

Objective: To assess adherence to post-exposure prophylaxis (PEP) for the prevention of HIV infection in victims of sexual assault.

Methods: The authors carried out a systematic review, random effects meta-analysis and meta-regression of studies reporting adherence to PEP among victims of sexual violence. Seven electronic databases were searched. Our primary outcome was adherence; secondary outcomes included defaulting, refusal and side effects.

Results: 2159 titles were screened, and 24 studies matching the inclusion criteria were taken through to analysis. The overall proportion of patients adhering to PEP (23 cohort studies, 2166 patients) was 40.3% (95% CI 32.5% to 48.1%), and the overall proportion of patients defaulting from care (18 cohorts, 1972 patients) was 41.2% (95% CI 31.1% to 51.4%). Adherence appeared to be higher in developing countries compared with developed countries.

Conclusions: Adherence to PEP is poor in all settings. Interventions are needed to support adherence.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Chemoprevention / methods
  • HIV Infections / prevention & control*
  • Humans
  • Medication Adherence / statistics & numerical data*
  • Post-Exposure Prophylaxis / methods*
  • Rape*