Improving HIV Nonoccupational Postexposure Prophylaxis Completion in Survivors of Sexual Assault

PURPOSE This project aimed to increase adherence to HIV nonoccupational postexposure prophylaxis (nPEP) among adult survivors of sexual assault using a 24-hour nurse-led callback intervention to reinforce patient education and support treatment completion. BACKGROUND This project was implemented within a public healthcare system’s forensic nursing program. Sexual assault survivors face an elevated risk of HIV transmission, yet completion of the 28-day nPEP regimen often remains below 40%. Barriers to completion include limited understanding, gaps in follow-up, as well as psychosocial and socioeconomic challenges. METHODOLOGY The FADE QI framework was utilized for this project. The population included adult, non-incarcerated patients who received SANE exams and accepted nPEP. The pre-intervention group (n = 14) received standard discharge care without callback. The intervention group (n = 9) received identical care plus a structured 24-hour callback by trained forensic nurses using an education checklist. Both cohorts were surveyed 4–7 weeks post-exam to assess nPEP completion. Data were summarized with descriptive statistics. RESULTS Overall nPEP completion rose from 28.6% (4/14) pre-intervention to 55.6% (5/9) post-intervention (p = 0.383), demonstrating feasibility and clinical value. IMPLICATIONS This low-cost, trauma-informed intervention is sustainable and can be embedded in discharge protocols to improve HIV prevention outcomes. Future efforts should integrate case management to address barriers to adherence and enhance continuity of care for vulnerable populations.