Capacity assessment of mental health services for rape victims in acute health-care settings: A rapid appraisal of services in the Western Cape Province

Sexual violence and HIV are two serious public health problems in South Africa. Population-based prevalence studies with men found 28.37% disclose rape perpetration and 12.25% of women report victimisation (Machisa, Jewkes et al. 2011). In 2012, UNAIDS reported substantial decreases in new HIV infections, but HIV remains a critical health problem in South Africa, with 5.6 million people living with HIV in South Africa (UNAIDS, 2012; Shisana, 2005). In populations with high HIV prevalence such as South Africa, HIV transmission through rape is a serious issue. The South African government adopted a policy in 2002 to provide antiretroviral medication to prevent HIV transmission as part of a comprehensive service for people who have been sexually assaulted (Department of Health 2005). Studies have shown that post-exposure prophylaxis (PEP) to prevent HIV is highly effective if commenced as soon as possible, ideally within 72 hours of exposure and if taken for 28 successive days (Roland, Neilands et al. 2005). Other than the direct risk of HIV transmission during rape, there are also other indirect possible pathways for HIV risk post rape in the medium and long term. Evidence for these pathways stems from research on intimate partner violence (IPV) and HIV (Jewkes, Sikweyiya et al. 2011), and mental health has been hypothesised as one of the main mediators in the indirect pathways to HIV post rape. Unfortunately, managing and recognising these risks have not been adequately addressed in the treatment and care of rape survivors.

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Date: 
Sunday, February 8, 2015 - 13:45