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. 2025 Jul 10;54(7):410-418.
doi: 10.47102/annals-acadmedsg.202571.

Post-exposure prophylaxis and follow-up in children and young persons presenting with sexual assault

Sarah Hui Wen Yao  1 , Karen Nadua  2   3   4   5 , Chia Yin Chong  2   3   4   5 , Koh Cheng Thoon  2   3   4   5 , Chee Fu Yung  2   3   5 , Natalie Woon Hui Tan  2   3   4   5 , Kai-Qian Kam  2   3   4   5 , Peter Wong  6   3   4   5 , Juliet Tan  7   4   5 , Jiahui Li  2   3   4   5
Affiliations
Free article

Post-exposure prophylaxis and follow-up in children and young persons presenting with sexual assault

Sarah Hui Wen Yao et al. Ann Acad Med Singap. .
Free article

Abstract

Introduction: Paediatric sexual assault (SA) victims should be assessed for post-exposure prophylaxis (PEP) to mitigate the risk of sexually transmitted infections (STIs). We describe the clinical characteristics of children and young persons (CYPs) presenting with SA at KK Women's and Children's Hospital in Singapore, viral PEP (human immunodeficiency virus [HIV] and hepatitis B virus [HBV]) prescribing practices, and STI evaluation at follow-up.

Method: Medical records of CYPs ≤16 years who presented with SA between January 2022 and August 2023 were reviewed, including assault and assailant characteristics, baseline and follow-up STI screening, PEP prescription, adherence and follow-up attendance. CYPs with SA in the preceding 72 hours by HIV-positive or HIV-status unknown assailants with high-risk characteris-tics were eligible for HIV PEP.

Results: We analysed 278 CYPs who made 292 SA visits. There were 40 (13.7%) CYPs eligible for HIV PEP, of whom 29 (82.9%) received it. Among those tested at baseline, 9% and 34.9% of CYPs tested positive for Chlamydia trachomatis and Gardnerella vaginalis, respectively. None tested positive for Neisseria gonorrhoeae, Trichomonas vaginalis, HIV, HBV or hepatitis C. Majority of CYPs tested were HBV non-immune (n=167, 67.6%); only 77 (46.1%) received the vaccine. Out of 27 CYPs eligible for HBV PEP with immunoglobulin, only 21 (77.7%) received immunoglobulin. A total of 37 CYPs received HIV PEP, including 8 who were retrospectively deemed ineligible. Only 10 (27%) completed the course. Overall, 153 (57.7%) CYPs attended follow-up, and none seroconverted for HIV or HBV.

Conclusion: We report suboptimal rates of HBV post-exposure vaccination, and low compliance to HIV PEP and follow-up among paediatric SA victims. Factors contri-buting to poor compliance should be examined to optimise care for this vulnerable population.

Keywords: HIV; hepatitis B; infectious diseases; paediatrics; sexual assault.

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Conflict of interest statement

The authors declare there are no affiliations with or involvement in any organisation or entity with any financial interest in the subject matter or materials discussed in this manuscript.