| dc.description.abstract | Background: Sexual assault centres (SACs) has been established all over the world, with the objective to provide physical and mental help to sexual assault victims, both in the acute phase and in follow-up. Different routines have been practiced in different countries regarding sexual transmitted infections (STI) testing and post exposure prophylactic (PEP) treatment. In the Trondheim SAC, Norway, 1g azithromycin was given orally prophylactically to all sexual assault patients until October 2014, when a study showed that STI prevalence was low and follow-up rates quite high. After 2014, routines were changed, so that only STI positive patients were given antimicrobial treatment and patients were offered follow-up testing after 2-3 weeks.
The aim of this study was to examine the STI-prevalence and rates of STI re-testing before and after changing the routines in October 2014. The overall aim was to explore whether or not such a practice can be justified.
Methods: We performed a retrospective, descriptive study based on data collected from medical records of women ≥12 years attending the Trondheim SAC, Norway, between 2012-2017. A total of 475 patients were included.
Results: Of the 475 patients included in this study, 442 (93%) and 435 (92%) were tested for Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) at the initial visit, respectively. Of these, 40 (9%) tested positive for CT and 19 (4.4%) tested positive for MG. Of the 428 patients (90%) tested for Neisseria gonorrhoea (NG), none tested positive. At follow-up, 190 (93%) and 231 (92%) were in any contact with a SAC nurse, before and after October 2014 respectively. The number of patients who were re-tested after the initial visit increased from 41 (20%) to 163 (63%) for CT, and from 39 (19%) to 158 (59%) for MG. The number of positive CT test-results at re-test within three months of the assault was 5/41 before October 2014 and 4/163 after this. For MG the number of positive tests were 4/39 before the change and 5/158 after the change. Of those positive for CT, four had changed from a negative to a positive test-result, while for MG three of the positive patients were new-diagnosed at follow up. Of one hundred women not complying to follow-up, 68 (68%) had ≥1 vulnerability factor.
Conclusion: This study has shown a lower prevalence of STIs in the SAC populations compared to national surveillance data. Almost all patients were in contact with the SAC after initial visit, and re-testing after the change in routines increased. This study finds no basis for antibacterial PEP treatment of all patients at the initial visit since we are able to reach out to and treat all CT positive patients. We anyway suggest that an assessment of the individual patients’ vulnerability might be done at the initial SAC visit to provide antibacterial PEP to those less likely to comply to follow-up. | en_US |
