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Abstract #167121
Audio (mp3) recordingNduku Kilonzo1, Caroline Ajema1, Miriam Taegtmeyer1, Sassy Molyneux2, and Sally Theobald3. (1) Director/ Policy, Research and Performance, Liverpool VCT, Care & Treatment, PO Box 19835-00202 KNH, Nairobi, Kenya, 011-254-020-271-4590, nduku@liverpoolvct.org, (2) Kenya Medical Research Institute/ Wellcome Trust Collaborative Research Centre, c/o LVCT PO Box 19835-00202 KNH, Nairobi, Kenya, (3) Liverpool School of Tropical Medicine, c/o LVCT PO Box 19835-00202 KNH, Nairobi, Kenya
Background
Survivors in Kenya access health sector services for physiological and psychological support. Liverpool VCT, Care & Treatment, a Kenyan NGO carried out a situation analysis of post rape care services in Kenya in 2002. It established blurred boundaries between forced, coerced and consensual sex. It revealed lack of standards, policy, and care delivery mechanisms in the health sector.
Methods
An intervention study to describe and evaluate a standard of care (clinical evaluation, documentation; clinical management; counselling; referral) was undertaken in 3 district hospitals. A counselling protocol was developed. Health provider targeted training was knowledge, skill and value based. Between 2003 and 2005, data were collected from routine clinical records and in-depth interviews were done with 37 purposively sampled health providers.
Findings
Of 295 survivors, 89% were female, 56% children. 9% adult women were HIV positive at baseline, indicating prior HIV risk. 72% (250) survivors continued PEP, of whom 51% completed. 16% were lost to client flow system. Training improved provider skill, confidence and was described as ‘important'.
Lessons learnt
The standard of care must be based on local health systems, and have guidelines. Training must be value-based and explore health provider gendered constructions of sexual violence and their impact on service delivery. PEP delivery should be utilised to leverage on-going HIV risk reduction with active follow up systems. Counselling is central and requires acknowledging other HIV risk given the blurred boundaries between forced and consensual sex.
Learning Objectives:
- Attendees will be able to identify 2 problems with post-rape service delivery identified in LVCT's Kenya assessment
- Attendees will be able to list 2 recommended elements for standard care for rape victims
Keywords: HIV Interventions, Sexual Assault
Related Web page: www.liverpoolvct.org
Presenting author's disclosure statement:
Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA