Research Highlights
Accessing and completing HIV preventative treatment for sexual assault patients
Sexual assault patients encounter barriers when accessing, accepting, and completing non-occupational post-exposure prophylaxis (nPEP). Little is known how sexual assault forensic examiners (SAFE) programs' protocols may influence patient completion of their nPEP. Interviews were conducted with SAFEs from an urban program to understand these barriers. The interviews found that patients encounter barriers related to stress and systems.
Systemic barriers include: Emergency department providers inconsistently offer prescriptions for the correct medication; patients have difficulty locating a local pharmacy that stocks the necessary treatment; and uninsured patients have to complete additional steps to access their treatment while they are also overwhelmed by their sexual assault. Distress barriers include: Patients' emotional distress and fear of acquiring HIV may impede their ability to comprehend information and access nPEP; patients may feel overwhelmed trying to access nPEP, while also managing emotional distress; the 28-day nPEP regimen might remind patients of the sexual assault on a daily basis.
To address systemic barriers, steps required to access nPEP can be reduced. Emergency Department providers also should be provided with written resources on the guidelines for communicating about HIV risk and nPEP as well as information on medications and dosages.
To address distress-related barriers, provides can wait to discuss HIV and nPEP until rapport has been established, and patients are less stressed. This may help patients comprehend and recall information and accept recommendations. Disucsssions should be had with a balance of realistic risk without exacerbating fear of potential exposure.
In partnership with Rutgers Center on Violence Against Women and Children and Wayne State University School of Social Work.
Djelaj, V., Patterson, D., Romero, C. M. (2017). A qualitative exploration of sexual assault patients' barriers to accessing and completing HIV prophylaxis. Journal of forensic nursing, 13(2), 45-51.
Sexual Assault Forensic Examiners (SAFEs) provide health care and medical forensic evidence collection in cases of sexual assault
There are two approaches to care that guide Sexual Assault Forensic Examiners (SAFEs):
- A patient-centered orientation = preferred approach that emphasizes attending to emotional needs, offering options, and respecting survivors' decisions
- A prosecutorial orientation = emphasizes evidence collection and has been associated with fewer comprehensive services
There is a need to better understand how training can bolster the use of patient-centered orientation.
Results from qualitative interviews with 64 health care professionals who participated in SAFE training revealed several elements of the training influenced participants to shift toward a patient-centered orientation.
In partnership with Rutgers Center on Violence Against Women and Children and Wayne State University School of Social Work.
Patterson, D., Pennefather, M., & Donoghue, K. (2017). Shifting sexual assault forensic examiners orientation from prosecutorial to patient-centered: the role of training. Journal of interpersonal violence. 0886260517717491.
Dead wrong: Capital punishment, wrongful convictions, and serious mental illness
This paper explores the relationship between serious mental illness (SMI), wrongful convictions, and capital punishment. An explanation of these vulnerabilities are discussed in detail by examining 26 case vignettes (derived from the National Registry of Exonerations and other sources) where such individuals were wrongfully convicted due to SMI. Data from the National Registry of Exonerations is further analyzed, leading to discussion of the disproportionate co-occurrence of wrongful convictions that are stimulated by SMI. This paper concludes with an analysis of reforms and a discussion of how to enact safeguards to protect individuals with SMI.
Carl, A. (2020). Dead Wrong: Capital Punishment, Wrongful Convictions, and Serious Mental Illness. The Wrongful Conviction Law Review, 1(3), 336-363.
Driving after cannabis use among young adults in Michigan
Driving after cannabis use is associated with a number of risks. Examination of driving after cannabis use among young adults is particularly important, as young adults have the highest rates of cannabis use and among the highest rates of traffic crashes. The current study examines rates and correlates of driving after cannabis use among young adults (aged 18–25) who reported past month cannabis use.
Methods: Participants were from Michigan and recruited through paid Facebook and Instagram advertisements between February and March 2018 (n=461).
Results: Nearly a third (31.9%) of the sample reported driving after cannabis use in the past month. Young adults who were employed (aOR=1.872, p=0.045), had medical cannabis cards (aOR=2.877, p<0.001), endorsed coping reasons for use (aOR=2.992, p=0.007), and endorsed social/recreational reasons for use (aOR=1.861, p=0.034) had greater odds of driving after cannabis use. Students had lower odds of driving after use (aOR=0.573, p=0.011).
Conclusions: Employment and having a medical cannabis card may be important risk markers for identifying individuals more likely to drive after use of cannabis. Prevention efforts could provide psychoeducation at dispensaries to individuals with medical cannabis cards about the risks of driving after use. Coping motives for cannabis use may also be useful in identifying young adults at the greatest risk of driving after use of cannabis.
Hicks, D. L., Resko, S. M., Ellis, J. D., Agius, E., & Early, T. J. (2020). Driving after cannabis use among young adults in Michigan. Cannabis and Cannabinoid Research, 1-7. DOI: 10.1089/can.2020.0096