The critical role gender and gender-based inequalities play in creating vulnerability to HIV/AIDS, in the African context and many others, has been well demonstrated. RADAR has been working to better understand these relationships and develop a profile of research activities with a specific focus on gender.
1. Developing an Integrated model for post-rape care in rural South africa:
Internationally, and in South Africa , there has been increasing recognition of the unmet needs of a particularly vulnerable group: survivors of rape and sexual assault. Within the complex array of immediate and long-term responses required, the role and responsibility of the health sector in meeting these needs is becoming clearer. Emerging best practice guidelines suggest that existing reproductive health (RH) interventions may be well positioned to play a critical role in meeting some of these needs, including the treatment of immediate injuries and trauma, prevention of STIs, and unwanted pregnancy, HIV post-exposure prophylaxis (PEP), forensic examination, and provision of adequate counselling and support. Moreover, such interventions need to be located within a broader, multi-sectoral response, drawing on key stakeholders such as social workers, police, the judiciary, and the broader community. However the implementation and co-ordination of these services, particularly in under-resourced areas, remains a significant challenge.
Starting in 2004, the Refentse Sexual Violence Initiative, a collaborative programme between RADAR and the Population Council (Frontiers in Reproductive Health), will be attempting to answer the following questions: What are the various programme components that need to be strengthened as part of a holistic, co-ordinated post-rape service? Given the current reliance on a doctor-driven response, how effectively can the service be delivered by nurses? Can such a programme be integrated into existing RH/HIV services within a rural, public sector setting?
Using a pre/post-intervention study design and a combination of qualitative and quantitative methods, a nurse-driven rape care programme is being developed and evaluated at a rural public sector hospital in LImpopo Province , South Africa . The evaluation will gauge the impact of these interventions on a range of indicators including uptake of sexual violence services at the hospital, quality of care delivered (from patient and provider perspectives), uptake and adherence to PEP, and use of referrals to other sectors. An economic evaluation will assess the costs and benefits of this model, and results of the study used to better understand and guide appropriate policy and implementation at local and national levels. The study thus responds to the South African Department of Health?s recent national policy in support of comprehensive post-rape care - and aims to address questions of operational importance to the effective implementation of that policy.
Contact details : For further information, please contact
Dr. Julia C. Kim
RADAR (Rural AIDS and Development Action Research Programme)
School of Public Health, University of the Witwatersrand
P.O. Box 2, Acornhoek, 1360
South Africa
email : jkim@soft.co.za
Tel: 27 13 795 5076
Fax: 27 13 795 5082
The follwoing papers explore the issue of rape and PEP from the perspective of South Africa
