Evaluation of Adherence to HIV Postexposure Prophylaxis and Follow-up in Pediatric Sexual Assault Victims in Turkey: A Tertiary Center Experience

Background: Postexposure prophylaxis (PEP) is critical in preventing HIV acquisition after risky exposures, particularly in pediatric sexual assault victims. Despite its importance, adherence and follow-up remain significant challenges. Objectives: This study evaluates PEP and follow-up adherence and efficacy among pediatric sexual assault victims treated at a tertiary care hospital in Turkey. Methods: A retrospective analysis was conducted on 119 pediatric patients aged 1 month to 18 years, treated between September 2017 and September 2022. Data were collected on demographics, PEP initiation and completion, follow-up rates and serological testing for HIV. PEP compliance, follow-up adherence and outcomes were analyzed. Results: PEP was initiated in 97% of the eligible 119 patients, with 70% completing the regimen. Compliance showed no significant differences by sex or age. Follow-up adherence decreased progressively, from 55% at the first month to 30% by the sixth month. Nausea and vomiting occurred in one case, indicating a low incidence of side effects. None of the patients seroconverted to HIV. Conclusion: A structured care system involving multidisciplinary collaboration, pioneered by pediatric infectious diseases, can lead to high PEP initiation and completion rates in children. Single-pill PEP regimens may enhance adherence. However, the decline in follow-up rates underscores the need for improved follow-up mechanisms and future interventions.