229   HIV Seroprevalence in Male Sexual Offenders in Rhode Island: Implications for Post- Exposure Prophylaxis.

A. Spaulding*^1,2, C. Salas², D. Cleaver², M. Grundy², G. Macalino², P. Marcussen¹, and J. Rich².
¹The Rhode Island Dept. of Corrections, Cranston and²The Miriam Hosp. and Brown Univ., Providence, RI.

Background:Barriers to administering post-exposure prophylaxis (PEP) to sexual assault survivors include cost, unsure efficacy, side effects, unknown transmission rates following a single violent sexual exposure, and lack of knowledge regarding the assailant's serostatus. This study examined the serostatus of male sexual offenders charged or convicted of a sexual assault in Rhode Island from 1995—1999.

Methods:A blinded retrospective IRB-approved chart review of all men arrested or convicted of a sexual offense between 1994 and 1999 was conducted. Data collected included charge, conviction status, age, race, and HIV status at time of incarceration.

Results:Between 1994 and 1999, 1,524 men in Rhode Island had been arrested and charged with a sexual offense. Of the 1,524 men charged, 65.5% were charged with explicitly sexually penetrative offenses. The ages of the offenders ranged between 18 and 90 years, with the majority (83%) falling between 20 and 50 years. Of the 1,524 men charged with a sexual offense, 992 were classified as white, 222 Latino, 282 black, and 28 other. Data regarding HIV status upon intake was available for 93.3% (n = 1,422) of the total sample population. Among arrested men, 0.8% (11 of 1,422) tested positive at intake. The prevalence among convicted sexual offenders was 1% (5 of 504). Rates of HIV infection were higher among sexual offenders than among the general population of males in Rhode Island (0.3%). Overall HIV prevalence at the prison is estimated to be 3%. Factors associated with higher prevalence of HIV include black race and age over 40.

Conclusions:This study found a 1% prevalence of HIV among men charged or convicted of a sexual offense. This information may be useful when a decision needs to be made regarding the use of post-exposure HIV prophylaxis in the setting of sexual assault.