Date of Conferral

2020

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Srikanta Banerjee

Abstract

Use of HIV screening/testing and prophylaxis has been found to be low in the general emergency department (ED) population. Less is known about the use of HIV/sexually transmitted infection (STI) screening, testing, and prophylaxis among sexual assault survivors who present to EDs. The main research questions asked whether there was a relationship between race, socioeconomic status (SES), geographic region, or age, HIV/STI, treatment, and prophylaxis among sexual assault survivors that present to U.S. EDs. This study was a secondary analysis of data collected in the NHAMCS years 2010 to 2016 and included 112 geographic primary sampling units, about 480 hospitals. The findings of this quantitative, cross-sectional study, informed using the socioecological framework, found that White sexual assault patients had a 3 times greater likelihood of receiving an HIV test than Black sexual assault patients. Sexual assault patients in the West have an 8.7 times higher lower likelihood of receiving an HIV test than do patients in the Northeast, despite having a lower number of sexual assaults. Sexual assault patients aged 0 to 10 have an 8 times lower likelihood of receiving appropriate HIV/STI medications for treatment or prophylaxis than the reference group. This new knowledge can contribute to positive social change through improved care of sexual assault patients, a potential decrease in the rate of HIV transmission, and a decrease in social cost and stigma. Findings from this research may promote protocols and specialized staff and influence policy, research, law, and support of evidence-based interventions to address the disparities outlined above.

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