Mukwege Denis, M Mugisho Gilbert, Maroyi Raha
Panzi General Referral Hospital, Bukavu, The Democratic Republic of Congo.
School of Medicine, Université Evangélique en Afrique (UEA), Bukavu, The Democratic Republic of Congo.
PLoS One. 2025 Jan 28;20(1):e0317082. doi: 10.1371/journal.pone.0317082. eCollection 2025.
Despite the availability of a well-developed holistic care model for victims of conflict-related sexual violence, little is known about the factors that determine late presentation for care post-sexual violence care. Drawing from data from the Democratic Republic of the Congo, this study aimed to determine obstacles to accessing emergency medical care within 72-hours of sexual violence (SV).
We retrospectively analyzed data from 4048 victims of SV treated at Panzi Hospital (PH) in Bukavu city between 2015 and 2018. The factors of access to care within 72h were analyzed using logistic regression.
88% of the victims consulted after 72h post sexual violence. Several sociodemographic factors were found to limit access to the medical care post-sexual violence including the victim's age (p = 0,022), place of residence (p = 0,000) and education level (p = 0,039). Clinical discomfort from pain during urination (p = 0,002) and fear of pregnancy (p = 0,000) were also associated with late assessment of care.
Seeking medical care within 72 hours after sexual violence within the critical 72-hours timeframe is crucial to avoid several medical complications stemming from SV. Improvement will be achieved by integrating the post-exposure prophylaxis protocol into primary health care, as well as by increasing community awareness of the relevance of timely consultation after sexual abuse.
尽管已有完善的针对与冲突相关的性暴力受害者的整体护理模式，但对于决定性暴力后延迟就诊的因素却知之甚少。本研究利用刚果民主共和国的数据，旨在确定性暴力（SV）后72小时内获得紧急医疗护理的障碍。
我们回顾性分析了2015年至2018年期间在布卡武市潘齐医院（PH）接受治疗的4048名性暴力受害者的数据。使用逻辑回归分析了72小时内获得护理的因素。
88%的受害者在性暴力发生72小时后才就诊。发现几个社会人口学因素限制了性暴力后获得医疗护理的机会，包括受害者的年龄（p = 0.022）、居住地点（p = 0.000）和教育水平（p = 0.039）。排尿时的疼痛引起的临床不适（p = 0.002）和对怀孕的恐惧（p = 0.000）也与延迟护理评估有关。
在关键的72小时时间范围内，性暴力后72小时内寻求医疗护理对于避免性暴力引发的多种医疗并发症至关重要。通过将暴露后预防方案纳入初级卫生保健，以及提高社区对性虐待后及时咨询的重要性的认识，将实现改善。
