Prophylaxis Against Possible Human Immunodeficiency Virus Exposure After Nonoccupational Needlestick Injuries or Sexual Assaults in Children and Adolescents
Open Access
- 1 June 2001
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of Pediatrics & Adolescent Medicine
- Vol. 155 (6), 680-682
- https://doi.org/10.1001/archpedi.155.6.680
Abstract
BackgroundNonoccupational human immunodeficiency virus (HIV) postexposure prophylaxis (PEP) for adults has been described, although the Centers for Disease Control and Prevention, Atlanta, Ga, offer no specific recommendations. There is limited information about its use in children and adolescents.ObjectiveTo describe the current practices of physicians in pediatric infectious disease (PID) and pediatric emergency medicine (PEM) departments regarding nonoccupational HIV PEP for children and adolescents.DesignSurvey.ParticipantsDirectors of all PID and PEM departments with fellowship programs in the United States and Canada between July and November 1998.Main Outcome MeasuresGeneral questions regarding HIV PEP and questions concerning 2 scenarios (5-year-old with a needlestick injury and a 15-year-old after sexual assault).ResultsThe return rate was 67 (78%) of 86 for PID and 36 (75%) of 48 for PEM physicians. Fewer than 20% of physicians reported institutional policies for nonoccupational HIV PEP; 33% had ever initiated nonoccupational HIV PEP. In both scenarios, PID physicians were more likely than PEM physicians to recommend or offer HIV PEP in the first 24 hours after the incident (55 [83%] of 66 vs 20 [56%] of 36 for needlestick injuries [odds ratio, 4.0; 95% confidence interval, 1.6-10.1] and 47 [72%] of 65 vs 16 [50%] of 32 for sexual assault [odds ratio, 2.6; 95% confidence interval, 1.1-6.3]). Seven different antiretroviral agents in single, dual, or triple drug regimens administered for 2 to 12 weeks were suggested.ConclusionsAlthough few physicians reported institutional policies, and only one third had ever initiated HIV PEP, many would offer or recommend HIV PEP for children and adolescents within 24 hours after possible HIV exposure. A wide variation of regimens have been suggested. There is a need for a national consensus for nonoccupational HIV PEP.Keywords
This publication has 8 references indexed in Scilit:
- Red Book: 2009 Report of the Committee on Infectious DiseaseActa Paediatrica, 2010
- Intrapartum and Neonatal Single-Dose Nevirapine Compared With Zidovudine for Prevention of Mother-to-Child Transmission of HIV-1 in Kampala, Uganda: 18-Month Follow Up of the HIVNET 012 Randomized TrialObstetrical & Gynecological Survey, 2004
- HIV postexposure prophylaxis for children and adolescentsThe American Journal of Emergency Medicine, 2000
- The Care of Persons with Recent Sexual Exposure to HIVAnnals of Internal Medicine, 1998
- Prevention of simian immunodeficiency virus, SIVsm, or HIV-2 infection in cynomolgus monkeys by pre- and postexposure administration of BEA-005AIDS, 1997
- Probability of Heterosexual Transmission of HIV: Relationship to the Number of Unprotected Sexual ContactsJAIDS Journal of Acquired Immune Deficiency Syndromes, 1996
- "Reduction of Maternal-Infant Transmission of Human Immunodeficiency Virus Type I with Zidovudine Treatment."Studies in Family Planning, 1994
- Surveillance of HIV Infection and Zidovudine Use among Health Care Workers after Occupational Exposure to HIV-Infected BloodAnnals of Internal Medicine, 1993