207788 Developing capacity for clinical care of survivors of sexual assault in Kenya: Recommendations for an HIV care and treatment program

Sunday, November 8, 2009

Jody L. Myrum, MSW , International Center for AIDS Care and Treatment Programs, Columbia University, New York, NY
Emily Koech-Keter, MD , Mailman School of Public Health, International Center for AIDS Care and Treatment Program - Kenya, New York, NY
Despite the growing global awareness of the linkages between sexual assault and HIV transmission, few programs simultaneously address the determinants and consequences of sexual assault in an integrated and comprehensive manner. Research has found that the risk of HIV sero-conversion following sexual assault is likely to be higher than following consensual sex, given the increased physical trauma and lack of condom use during forced sex. This is especially true in the high HIV-prevalence settings of Sub-Saharan Africa. A comprehensive medical management package aims to reduce the physical and psychological consequences of sexual assault, including measures to reduce the risk of HIV transmission. Information gathered during an eight week HIV and Women's Health fellowship with the International Center for AIDS Care and Treatment Program (ICAP) in Kenya provided a base for how a low resource HIV care and treatment program can include comprehensive services in order to respond to survivors of sexual assault. Kenya-specific data from literature and key informant interviews with hospital staff in 10 ICAP supported health facilities throughout Eastern and Central Provinces in Kenya provide case examples. Findings suggest many health facilities in Kenya lack the capacity to adequately respond to survivors of sexual assault and that an HIV care and treatment program can play a critical role in strengthening response to sexual assault, especially in decreasing the risk of HIV transmission. Furthermore, recommendations to strengthen services in ICAP supported facilities are based on international and national guidelines for medical response to sexual assault.

Learning Objectives:
1. Evaluate response to sexual violence in hospitals in Eastern and Central Provinces in Kenya and provide recommendations on how services can be strengthened; 2. Demonstrate the need for HIV care and treatment programs to incorporate response to sexual violence into their programming; 3. Provide an example of how international guidelines on medical management of sexual violence can be adapted to a local context, including local guidelines on medical management of sexual violence.

Keywords: Women and HIV/AIDS, Sexual Assault

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Master of Social Work, Gender based violence assessment post-election violence in Kenya with UNICEF, Conducted extensive research on ending violence against women and girl with NoVo Foundation, Organized conference for Girls Internation Forum on gender based violence, reproductive health, access to education for girls, and human rights.
Any relevant financial relationships? No

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.

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