Baseline Prescribing and Adherence Patterns of Human Immunodeficiency Virus Nonoccupational Postexposure Prophylaxis in Pediatric Sexual Assault Patients

Background Pediatric sexual assault patients may be eligible for human immunodeficiency virus nonoccupational postexposure prophylaxis (nPEP), yet adherence remains inconsistent. Aims To describe baseline prescribing and adherence patterns, and to inform quality improvement efforts. Methods A retrospective electronic health record review was conducted of patients presenting for sexual assault evidence collection at an urban children’s hospital between January 2024 and December 2024. Data were reviewed descriptively to characterize nPEP initiation, adherence, and documented barriers. Results Ninety-seven patients were identified; of those eligible, 11 (11.7%) were initiated on nPEP. One patient (9.1%) completed the full course, two (18.2%) completed at least one week of therapy, three (27.3%) discontinued nPEP before one week of therapy, and the remainder were lost to follow-up. Documented barriers included medication side effects, follow-up difficulties, and variability in counseling and risk stratification. Discussion Low initiation and adherence rates highlight a critical practice gap and informed development of a targeted program initiative.