Gender & Health Research Unit, Medical Research Council, Cape Town, South Africa.
Cult Health Sex. 2010 Jun;12(5):471-84. doi: 10.1080/13691050903556316.
Sexual violence and HIV are two serious public health problems in South Africa. Post exposure prophylaxis (PEP) to prevent HIV after rape was introduced into the South African public health services in 2002 but many questions on the completion of PEP medication remain. A qualitative study involving in-depth interviews was conducted with 29 women attending sexual assault services in an urban and a rural site to explore PEP use after rape. It showed how PEP adherence was a complex and challenging experience, with survivors experiencing disruptions in their lives and unable to adhere to the medication adequately. Only nine completed their prescribed drug regimes. Rape stigma and perceptions of rape impacted on adherence, which became a lesser priority if the rape was contested by important others. Being blamed and not receiving social support had profound psychological impact. Stigma of rape and fear of HIV played very powerful roles in debilitating women's ability to take medication to prevent HIV infection. Further research is needed to support the development of interventions that acknowledge the complex barriers to adherence of PEP after rape.
性暴力和艾滋病是南非的两个严重公共卫生问题。为了预防艾滋病，南非公共卫生服务部门于 2002 年推出了暴露后预防（PEP）措施，但关于完成 PEP 药物治疗仍有许多问题。本研究采用定性研究方法，对城市和农村地区性侵犯服务机构的 29 名妇女进行了深入访谈，以探讨强奸后使用 PEP 的情况。研究结果表明，PEP 依从性是一个复杂而具有挑战性的过程，幸存者的生活受到干扰，无法充分遵守药物治疗。只有九人完成了规定的药物治疗方案。强奸耻辱感和对强奸的看法影响了依从性，如果重要他人对强奸提出质疑，那么依从性就不再是优先考虑的问题。被指责和得不到社会支持对她们的心理健康产生了深远的影响。强奸耻辱感和对艾滋病的恐惧极大地削弱了妇女服用药物预防艾滋病感染的能力。需要进一步研究，以支持制定干预措施，承认强奸后 PEP 依从性的复杂障碍。
