167121 Implementing Post Rape Services in Public Health Settings: Challenges and Opportunities

Monday, November 5, 2007: 10:50 AM

Nduku Kilonzo , Director/ Policy, Research and Performance, Liverpool VCT, Care & Treatment, Nairobi, Kenya
Caroline Ajema , Liverpool VCT, Care & Treatment, Nairobi, Kenya
Miriam Taegtmeyer , Liverpool VCT, Care & Treatment, Nairobi, Kenya
Sassy Molyneux , Kenya Medical Research Institute/ Wellcome Trust Collaborative Research Centre, Nairobi, Kenya
Sally Theobald , Liverpool School of Tropical Medicine, Nairobi, Kenya

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.


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.


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

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.