FRONTIERS PROJECT
Post-rape Care and HIV Post-exposure Prophylaxis in Rural South Africa

This study, implemented in collaboration with the Rural AIDS and Development Action Research Programme (RADAR), University of the Witwatersrand, and the Tshwaranang Legal Advocacy Centre (TLAC), tested an integrated delivery model for post-rape care, and will subsequently examine ways to integrate medical and legal services for rape survivors. The purpose of the study is to define an operational model for introducing post-exposure prophylaxis (PEP) as part of a strengthened, multisectoral response to post-rape care and to examine the costs and benefits of such a model.

Interventions to strengthen post-rape services will include:

• analysis of existing training materials and national guidelines for post-rape care management and PEP;
• development of training workshops for health care workers on treatment of physical injuries, forensic examination, treatment of sexually transmitted infections, provision of emergency contraception, and PEP counseling and support needs;
• initiation of a rape care network to support survivors through community outreach workers and support groups; and
• monitoring client load, quality of care provided, initiation of PEP, referrals, and case management through a rape care register, client questionnaires, and a case management logbook.

Findings from Phase I showed that implementation of the model improved the quality of care provided for all indicators, especially in provision of VCT and PEP. The consolidation of treatment into one designated room increased service efficiency. Nurses were able to conduct high-quality medical management of the post-rape cases, but were reluctant to conduct the forensic examination, citing a lack of clarity regarding their legal ability to give court evidence if needed. Additionally, findings revealed significant abuse of children (with 25 percent of survivors under age 14) and also sexual violence against males, showing that protocols must be developed to address the needs of many groups of survivors.

Phase II of the project, which began in April 2007, involves an expansion of the original scope of work, specifically to incorporate legal services along with existing health services. Phase II began in April 2007 and is being implemented by TLAC. For continuity in implementation, several key RADAR staff involved in the Phase I effort will now continue in their roles as staff of TLAC.

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Location

Rural South Africa

Duration

Phase I: May 2004–March 2007

Phase II: April 2007–March 2008

Population Council researcher

Ian Askew

Non-Council collaborators

Phase I: Rural AIDS and Development Action Research Programme, University of the Witwatersrand

Phase II: Tshwaranang Legal Advocacy Centre

Donor

US Agency for International Development

Publications/Resources
Council researchers' names appear in boldface type. 

2008
"South Africa: Integrated approach improves quality of post-rape care," FRONTIERS OR Summary no. 69. Washington, DC: Population Council. (full text)

2007
Kim, Julia, Lufuno Mokwena, Ennica Ntlemo, Ntabozuko Dwane, Amanda Noholoza, Tanya Abramsky, Edmore Marinda, Ian Askew, Jane Chege, Saiqa Mullick, Liesl Gerntholtz, Lisa Vetten, and Anneke Meerkotter. "Developing an integrated model for post-rape care and HIV post-exposure prophylaxis in rural South Africa," FRONTIERS Final Report. Washington, DC: Population Council. (PDF, 1.13 MB)

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See Also

• South Africa
• Gender-based Violence
• HIV and AIDS/Prevention
• FRONTIERS South Africa
• FRONTIERS FP/HIV Integration
• FRONTIERS HIV Prevention 
• FRONTIERS Violence Against Women
• Horizons Program

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