Treatment
Rainbow Clinic for Abused Children, April 2020
Treatment of Child Sexual Abuse
Follow Up of Child Sexual Abuse Cases
Treatment of Child Sexual Abuse
Post-Exposure HIV Prophylaxis (PEP) in Children
HIV prophylaxis is given in acute cases (<72 hours) as soon as possible after the incident, and for a period of 28 days, where the child’s rapid HIV test is negative..
Refer to the flow diagram and table below for the dosing guide.
Flow Diagram for HIV PEP
Click on image to enlarge
Zidovudine: AZT
Lamivudine: 3TC
Lopinavir/Ritonavir: Aluvia
Dolutegravir: DTG
Tenofovir/Lamivudine/Dolutegravir: TLD
DT: Dispersible tablet (dissolve in 5ml water)
FC: Film coated tablet
All Patients:
Evaluation for symptoms of acute HIV infection
Baseline Bloods
- HIV test
- < 18 months: PCR
- 18-24 months: rapid confirm with PCR/VL
- >24 months: rapid confirm with ELISA
- HepBsAg
- Creatinine if a candidate for TDF
- FBC and diff if a candidate for AZT
- Pregnancy test
- RPR
Dosing Guidelines for PEP
Click here to view the above table
Pregnancy Prophylaxis
- Ovral, 2 tablets prescribed immediately and 2 after 12 hours (can be prescribed up to 7 days after the incident). Ovral may cause nausea – Metoclopramide may be given as 10mg tds.
Sexually Transmitted Infection Treatment/ Prophylaxis
- Ceftriaxone 125mg IMI stat (< 6 years) or 250mg IMI stat (> 6 years).
- Metronidazole 15mg/kg/dose tds for 7 days if there is chronic abuse or symptoms of an STI, otherwise metronidazole 2g stat (adolescents) or 15mg/kg tds for one day.
- Azithromycin 20mg/kg stat po (max 1g).
Follow Up of Child Sexual Abuse Cases
- All acute cases should be followed up at one week to assess healing of injuries, check for complications, and ensure adherence to prophylactic medications.
- Bloods for syphilis, hepatitis B and HIV must be repeated at 6 weeks, 3 months and 6 months.
- All cases, including the caregivers involved, must be assessed for emotional trauma and referred for counselling if necessary.
Step by Step Guide to the Management of Child Abuse; Rainbow Clinic, RMMCH; Version: July 2023; Treatment of Child Sexual Abuse and Follow Up of Child Sexual Abuse Cases