The first 72 hours are a crucial time in the care cycle for victims of sexual assault.
Deemed a time of “emotional and mental overload” by Johns Hopkins University School of Nursing (JHUSON) PhD student Jessica Draughon, MSN, RN, FNE-A, those first three days are when a victim must both begin to process the attack and face health choices that should, or in many cases must be made when HIV infection is possible.
For victims of violence already infected with HIV, and kept by necessity or fear in violent situations, maintaining care can be just as difficult.
PhD student Jocelyn Anderson, MSN, RN, CNRN is in the process of crafting a dissertation that evaluates the connections between domestic violence, adherence to HIV care and subsequent treatment outcomes, in hopes of developing interventions to help women in abusive relationships better stay safe and manage their HIV.
Draughon is conducting foundational research to find ways to ease and simplify the process of providing patients a four-week course of antiretroviral medications known as post-exposure prophylaxis (HIV PEP) shortly after experiencing a sexual assault.
Patients have a 72-hour window to decide whether to take HIV PEP before the medications are no longer effective in reducing the likelihood of HIV infection, she said.
Victims handle assaults in their own way, so there is no predictor as to whether they will initially follow medical guidelines or not. Some quickly agree to take the medications while others decline initially and then ultimately decide to begin receiving the medicine, Draughon said.
For Draughon, the mental effect of the assault puts an emphasis on clinicians to guide the patients through the process of post-assault care in relation to HIV prevention as clearly as possible.
“My overall goal is making sure that all patients who have experienced a sexual assault are getting adequate and appropriate evidence-based care,” Draughon said.
Anderson is working with partners at the JHUSON, assistant professor Jason Farley, PhD, MPH, CRNP, and the Moore Clinic to complete her dissertation. “I am going to look at the affect of intimate partner violence on women’s engagement in HIV care and subsequently their treatment outcomes,” she said.
Prior to beginning her studies at the JHUSON, she spent some time in South Africa and received a first-hand look at violence and HIV. She hopes to eventually return and gather more information pertinent to the prevalence of both issues there.