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Healthcare Providers Alert

As of November 1, 2007, New York State Criminal Procedure Law §210.16 will require testing of criminal defendants, indicted for certain felony sex offenses, for human immunodeficiency virus (HIV), upon the request of the victim/survivor.

This law also amends New York State Public Health Law (subdivision 1 of section 2805-i) by adding a new paragraph that specifies that healthcare facilities providing treatment to victims/survivors of a sexual offense must:

  1. offer and make available "appropriate HIV post-exposure treatment therapies in cases where it has been determined, in accordance with guidelines issued by the commissioner, that a significant exposure to HIV has occurred," and
  2. inform the victim/survivor that "payment assistance for such therapies may be available from the New York State CrimeVictims Board (CVB) pursuant to the provisions of Article twenty-two of the Executive Law."

What is the effect of this law on the role of the Emergency Department healthcare provider?

  1. The medical treatment of the victim/survivor in the emergency department (ED) does not change. The victim/survivor should be evaluated in an ED as soon as possible for treatment and discussion of post exposure prophylaxis (PEP). If a significant exposure did occur and the decision is made to initiate PEP, it should be initiated ideally within 2 hours and generally no later than 36 hours from the time of the exposure. Studies have shown that the sooner PEP is initiated, the more likely it is to be effective.
  2. The law now requires healthcare facilities providing treatment to victims/survivors of a sexual offense to offer appropriate HIV post-exposure treatment when it has been determined, in accordance with NYS Department of Health guidelines, that a significant exposure to HIV has occurred. Refer to HIV Prophylaxis Following Non-Occupational Exposure Including Sexual Assault for guidance on determining whether a significant exposure has occurred.
  3. The ED must inform the victim/survivor that payment assistance for such therapies may be available from the CVB. To request brochuers or to find your local CVB refer to www.cvb.state.ny.us/vaps.htm

What is the effect of this law on the role of the healthcare provider providing follow-up care for the victim/survivor?

  1. If the defendant is tested for HIV within 30 days of the assault, the results may influence the decision to continue post-exposure prophylaxis. The NYSDOH AIDS Institute has issued guidance as to the type of HIV-related test that should be ordered, when follow-up testing is needed, and when discontinuing PEP may be possible. This guidance is entitled Medical and Psychological Benefit Guidance for Defendant Testing.
  2. It may be important to note that if the defendant tests positive for HIV before the victim's/survivor's own HIV test results are definitive, there may be an increased need for psychological counseling.

Visit these websites for information and assistance

Please contact Lyn Stevens, NP, MS, ACRN, Deputy Director, Office of the Medical Director, NYSDOH AIDS Institute, at (518) 473-8815 or lcs02@health.state.ny.us, for any qustions regarding medical guidance.