HIV prevention services miss rape survivors

South African rape survivors are not receiving vital anti-HIV treatment due to ignorance and a lack of basic treatment procedure at government health facilities and justice departments, new research shows.

The National Working Group on Sexual Offences, a consortium of 25 organisations that includes the Teddy Bear Clinic for sexually abused children and the Tshwaranang Legal Advocacy Centre (TLAC), which focuses on sexual abuse cases, submitted the findings of a recent survey to the South African Human Rights Commission (SAHRC).

According to the study, almost a third of government health practitioners at 31 national rape centres said they did not consider rape to be a serious medical condition.

Health staff at the centres also refused to provide medical treatment in the form of antiretroviral drugs, taken as post-exposure prophylaxis (PEP) to prevent HIV infection, if the rape had not been reported at a police station.

"And, given the 72-hour timeframe within which PEP has to be administered, this reluctance by healthcare workers usually has far-reaching consequences for survivors of sexual assault," TLAC senior research and policy manager Lisa Vetten told IRIN/PlusNews.

Many services to rape victims were also still located in the casualty section of hospitals. "These hospital wards are very noisy, busy, bloody and frightening ... precisely the departments most unsuited to dealing with rape patients." Vetten noted that this was hardly an ideal environment for someone in a state of shock.

Less than half (47.4 percent) of the facilities surveyed had a private room available for examining rape survivors, and these rooms were often kept locked after hours.

Another treatment hurdle was the "unsympathetic, judgemental and impatient attitudes" of health workers, which hampered access to treatment for marginalised individuals, such as gay, lesbian and commercial sex workers.

"For gay rape survivors this insensitivity by police and health workers usually means being labelled as promiscuous and deserving of the assault," commented Glenn de Swardt, acting director of the Triangle Project, a Cape Town-based gay rights group.

De Swardt said homophobia and ignorance regarding male-on-male rape not only often prevented homosexual men from obtaining PEP, but also heterosexual men and young boys who were rape victims.

"For straight men there is the fear of being 'effeminised' by their communities, but this also holds true for the families of young boys, who would rather keep the incident under wraps," he said.

Sharing De Swardt's concerns, Shaheda Omar, therapeutic manager of the Teddy Bear Clinic, said boy-child rapes were often not reported as a result. "Young boys have always been the victims of rape, but cases are only recently beginning to be reported."

The National Working Group on Sexual Offences estimated that 42.7 percent of some 50,000 rapes reported to police in 2005/06 represented children, but Omar suspected that the number was actually much higher.

Rape is defined in law as an act perpetrated by a man (or boy) against a woman (or girl), so police rape statistics do not include the rape of men and boys.

The working group's submission stated that, in some cases, doctors' reluctance to testify in court undermined the legal process.

"Parents are also hesitant to report cases, due to fear of being further victimised by the perpetrator, whom the police are often too slow, or altogether fail, to bring to book," Omar told IRIN/PlusNews.

She stressed the need for frank discussions between parents and children about sex-related issues, and "good and bad touching", as well as the dangers of HIV and how it was transmitted. One in nine South Africans are estimated to be living with the virus.

The SAHRC is convening public hearings next month on the "availability, accessibility, acceptability and quality" of health services.

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