4CPS-137 Evaluation of post-exposure prophylaxis effectiveness in preventing sexually transmitted diseases and unwanted pregnancies in sexual assault victims in a tertiary university hospital

<h3>Background and Importance</h3> Women who suffer a sexual assault(SA) are exposed to pathogens that cause sexually transmitted infections(STIs) and unwanted pregnancies. Bacterial,viral and fungal post-exposure prophylaxis(PEP), in addition to emergency contraception, can be effective prevention. <h3>Aim and Objectives</h3> To evaluate PEP and emergency contraception effectiveness, using a medication kit prepared and dispensed by Pharmacy Service(PS) for the prevention of STIs and unwanted pregnancy in female victims of SA. <h3>Material and Methods</h3> Retrospective observational study in women with SA diagnosis between 04/2022–08/2024. Data were obtained from Orion Clinic: age, kit prescription, prescribing service, SA timepoint, adverse events (AE), mental health care need and drug urinalysis. PEP kit contained: Metronidazole, Tinidazole, Ceftriaxone and Azithromycin for STIs prophylaxis; Emtricitabine/Tenofovir and Raltegravir for human immunodeficiency virus (HIV) prevention and Levonorgestrel for emergency contraception. Kit’s effectiveness was assessed at 7,10,21,42 days and 3–6 months by detecting STIs causative agents: microbiology tests(<i>Chlamydia trachomatis</i>, <i>Neisseria gonorrhoeae</i>, <i>Mycoplasma genitalium</i>, <i>Trichomonas vaginalis), s</i>erological tests(HIV, hepatitis viruses). Additional pathogens in endocervical exudate samples were examined. Contraception effectiveness was assessed by pregnancy test. <h3>Results</h3> Thirty-one patients were included with a median of 23(16) years old, being 9(29%) under 18. PEP kit was exclusively prescribed by Gyneacology Service. Metronidazole, Azithromycin and Ceftriaxone were administered to all patients and Tinidazole to 23(74.2%). Emtricitabine/Tenofovir and Raltegravir to 29(93.6%).Vomiting was the only AE occurred in 3(9.7%) patients. Tests were positive at 7–10 days after kit dispensation for <i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> in 2(6.5%) patients; <i>Trichomonas vaginalis</i> in 1(3.2%) at 7–10 days and 6 months. Any <i>Mycoplasma genitalium</i> infection was developed. No positive serological tests were detected, except for 6(19.4%) who received hepatitis vaccination after SA. Other endocervical infections observed included: Human papillomavirus(HPV)(9.7%), <i>Gardnerella vaginalis</i>(9.7%) and <i>Candida albicans</i>, <i>Haemophilus parainfluenzae, Streptococcus agalactiae</i> and <i>Gardnerella leopoldi/swidsinkii</i>(6.5%) each one. 10(32.3%) patients were suspected of chemical submission; urinalysis detected cannabis(6.5%), benzodiazepines(6.5%), cocaine(6.5%) and opiates(3.2%). 15(48.4%) required mental health assistance. Levonorgestrel was administered to 21(67.7%). Reasons for not administration were: previous sterilising surgery(6.5%), sexual intercourse occurred 5 days before(6.5%),non-fertile age(6.5%),absent penetration(3.2%),contraception use(3.2%), taking it previously(3.2%), unknown reason(3.2%) (being the only patient who became pregnant after SA). <h3>Conclusion and Relevance</h3> In the studied population, PEP kit prepared by PS for STIs appears to have been effective in the most of SA victims,mainly in preventing HIV infection. Pregnancy contraception was highly effective using levonorgestrel. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest