vaccinated against Hepatitis B should receive the Hepatitis B vaccination, without Hepatitis B immunoglobulin (HBIG) If the assailant is known to be HBsAg-positive, victims should be given both Hepatitis B vaccine and HBIG with follow-up vaccine doses at to months and to months after the first dose Finally, consider Hepatitis C testing based on risk assessment of assault HPV vaccination is also recommended for male victims to 21 years of age and female victims aged to 21 who were unvaccinated prior to the acute sexual assault Follow-up HPV vaccination dosing is recommended at to months and months after the first dose HPV vaccination reduces risk of infection with human papillomavirus Remember, the HPV vaccination is contraindicated in pregnant women and in those with an allergy to yeast A negative HCG should be obtained prior to administering this vaccination HIV Prophylaxis HIV prophylaxis is not universally recommended because although HIV seroconversion has occurred in people whose only risk factor was sexual assault, the frequency of this occurrence is extremely low Several factors impact the medical recommendation for HIV postexposure prophylaxis (PEP) These include the likelihood of the assailant having HIV; any exposure characteristics that might increase the risk for HIV transmission based on type of sexual contact (e.g., single episode vs multiple/chronic), time elapsed after the event, and the potential benefits and risks associated with PEP Most often, an assailant’s HIV status at the time of the assault examination is unknown It is therefore important to consider any known HIV-risk behaviors of the perpetrator, local epidemiology of HIV/AIDS, and exposure characteristics of the assault Higher-risk exposures include vaginal or anal receptive intercourse, forceful intercourse, ejaculation on any mucous membrane, history of multiple assailants, and whether mucosal lesions are present in the assailant or patient