A procedure for the administering of a regimen of drugs that is known to prevent HIV if taken within 72 hours of exposure will be created at Sparrow Hospital in the wake of an incident in which a sexual assault victim was allegedly delayed in getting the medication.

According to a letter written to Sparrow Hospital by Todd Heywood, a local reporter and HIV/AIDS activist, he accompanied a 22-year-old male to the Sparrow Hospital emergency room on Nov. 21 for treatment after an alleged sexual assault. As part of the treatment, the man wanted to receive non-occupational post-exposure prophylaxis — or NPEP — which is a regimen of retroviral drugs taken over 28 days that have be known to possibly prevent HIV from taking hold in the body. The drugs work up to 72 hours after a possible transmission of HIV, but are also known to be debilitating. NPEP, according to the CDC, has not proven to be effective in preventing HIV in 100 percent of cases, and can cause fatigue, nausea, allergic reactions and swelling of the liver.

Heywood wrote that upon requesting the NPEP treatment, the victim was initially refused it by a doctor who cited guidelines for its use set by the World Health Organization. According to Heywood’s account, he protested and told the doctor that the federal Centers for Disease Control has set forth guidelines for NPEP use. Heywood wrote that he eventually called a doctor at the CDC to get an opinion on whether the sexual assault victim should receive the NPEP treatment. Heywood said the victim received the NPEP treatment after four hours of discussion between the Sparrow doctor and the victim.

The victim, through Heywood, declined to be interviewed for this story.

John Berg, executive director for strategic marketing management at Sparrow Hospital, could not talk about specifics of the incident. But Berg, speaking in general, said the hospital has realized that there is a “gap in treatment that’s not in the best interest of the patient” in relation to providing NPEP. The “gap,” Berg said, was there because the hospital had traditionally deferred HIV treatment and testing to a patient’s primary care physician or the Ingham County Health Department.

“Currently, what we’re doing now is taking care of protocol around NPEP,” Berg said.

Speaking in general about instances of sexual assault, Berg said, “Let’s say in a sexual assault situation, or another type of encounter, a patient will want to have prophylactic care as quickly as possible. Now, as the standard of care is evolving, we’re recognizing we have a role to help facilitate that.”

Berg said that the protocol is in development, and a period of education for hospital employees will have to be undertaken. He could not immediately say how long it would be before Sparrow has the protocol in place. Berg said that the hospital’s policy would be based around “best practices.”

A request to Ingham Regional Medical Center for its NPEP policy was not returned.

According to CDC guidelines, NPEP is to be used in sexual assault cases, but not 100 percent of the time. The CDC recommends that victims of sexual assault who want to undergo NPEP should be decided on a case-by-case basis, and as much information on the perpetrator — whether they may be an HIV carrier — should be found out.

The CDC does not recommend NPEP for people whose risk of exposure to HIV is believed to be “negligible,” or those who constantly practice unsafe sex or share needles.

The incident at Sparrow seems to underscore a little known HIV treatment.

Marcus Cheatham, the Ingham County Health Department public information officer, said that the availability of NPEP is probably not widely known. The health department, he said, does administer NPEP and follows CDC guidelines on using it. Cheatham recalled an incident in which a worker handling medical waste thought that he had been stuck with a needle. The worker brought the needle into the health department, but it was determined that the worker’s skin was not punctured, and that the needle probably had not been used on another human.

Cheatham said that the fact that someone has been the victim of sexual assault might not always require NPEP. Cheatham said that a physician would generally talk with the victim and try to corroborate his story and find out as much about the perpetrator as possible before deciding whether to use NPEP.

“It’s the do no harm thing. You don’t want to wind up making someone really sick if there’s no medical benefit,” Cheatham said. “It’s like any medical procedure — you don’t want to go willy nilly cutting people open.”

When asked if a victim of sexual assault came to Sparrow today looking for a NPEP treatment whether they would receive it, Berg said that there is still an issue of educating hospital staff on NPEP.

“I would say that we’re starting the (protocol) process, but we have not completed it,” Berg said. “Every staff member is not educated today. We’re targeting to have it in place within the next month.”