Background Victims of sexual assault (VSA) frequently do not receive emergency contraception (EC) or STD treatment in the emergency department (ED) as recommended by the Centers for Disease Control (CDC) and American College of Obstetrics and Gynecology (ACOG). At times, sexual assault nurse examiners (SANE) assist in evaluating VSA. However, their impact on compliance with CDC/ACOG guidelines is unknown.
Objective To determine the effect of ED team SANE presence on rates of CDC/ACOG guideline-compliant EC and STD treatment among adolescent VSA.
Methods This was a retrospective study of female VSA, 12-17 yrs, seen at a pediatric ED<72 hrs following an alleged assault. Patients were grouped by provider type: specialized team (SANE/MD) or MD only (MD). STD and EC treatment data were compared between groups using chi-square analyses.
Results 130 charts were reviewed for inclusion, 80 met study criteria: 40 in the SANE/MD group, 40 in the MD group. Patients were 14.8 ± 1.5 yrs (no difference between groups). SANE/MD patients were prescribed STD prophylaxis for gonorrhea and chlamydia more often than MD patients, 100% vs. 88%, (rate ratio = 1.14 [95% CI: 1.01, 1.17]) but the frequency of EC prescription did not differ significantly, 97.5% vs. 88% (RR = 1.11 [0.98, 1.26]). STD prophylaxis prescribed was infrequently CDC-compliant with no statistical difference between groups. For gonorrhea: 70% of SANE/MD patients vs. 54% of MD patients (RR = 1.3 [0.9-1.8]). For chlamydia: 97.5% vs. 91% (RR = 1.07 [0.96, 1.2]). Similarly, EC prescribed was infrequently ACOG-compliant with no difference between groups, 66% vs. 55% (RR 1.2 [0.8-1.7]).
Conclusions SANE/MD patients were more often prescribed STD prophylaxis. These preliminary data also suggest a trend towards more frequent overall EC prescription and guideline-compliant STD and EC treatments but without statistical significance. Further data are needed to clarify the effect of SANE specialists on STD prophylaxis and EC use among adolescent VSA.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.