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Master Thesis

Expositions sexuelles aux risques viraux prises en charge au CH de Cayenne : étude rétrospective 2015-2016

Abstract : Introduction: French practical guidelines on non-occupational post-exposure prophylaxis (nPEP) against viral risks were updated in 2017. In French Guiana, the region of France most affected by HIV pandemic and intermediate endemicity zone for HBV, prophylactic management is particular. This place also has the biggest number of rapes, particularly child rapes. Objectives: To make an evaluation of local management of non-occupational exposures in Cayenne, where there is the main hospital of the region. To describe population characteristics, to make a focus on sexual assault and pediatric managements. Method: monocentric retrospective study (2015-2016) on medical files of concerned departments : emergencies, adult and pediatric ambulatory consultations, and forensic unit. Results: between 2015 and 2016, 323 sexual exposures of less than 72 hrs were managed ; 30 % rapes (48,5% among underage patients). 38,39 % without condom use. 88,85 % unknown sexual partner serologic status. 44,45 % emergency contraception. 86,07 % anti-HIV nPEP provided (70,7 % tritherapy with protease inhibitor). 5,88 % HBV vaccination initiated, no specific immunoglobulines provided. 6,19 % follow-up completion. A heterogeneous consulting population, mainly heterosexual (93,75%), marked by important racial and gender inequalities. Discussion: it is the first study of this magnitude evaluating nPEP practices in French Guiana, revealing an insufficient management, focused on HIV risk, a low patient-retention, and major inequalities in consulting population.
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Master Thesis
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David Perat. Expositions sexuelles aux risques viraux prises en charge au CH de Cayenne : étude rétrospective 2015-2016. Médecine humaine et pathologie. 2018. ⟨dumas-01921538⟩



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