Kanagasabai Udhayashankar, Davis Stephanie M, Thorsen Viva, Rowlinson Emily, Laterra Anne, Hegle Jennifer, Angumua Carrine, Ekra Alexandre, Mpingulu Minlangu, Getahun Meklit, Sida Fikirte, Mndzebele Phumzile, Kambona Caroline, Ramphalla Puleng, Mtingwi Eunice, Msungama Wezi, Duffy Meghan, Adewumi Bukola, Olotu Ezeomu, Sebeza Jackson, Kitalile Jane, Apondi Rose, Muleya Carlos, Cain Meagan
HIV Prevention Branch, Division of Global HIV and Tuberculosis, CDC, Atlanta, Georgia, USA.
Division of Global HIV and Tuberculosis, CDC, Yaounde, Cameroon.
J Int AIDS Soc. 2025 Jun;28 Suppl 1(Suppl 1):e26469. doi: 10.1002/jia2.26469.
Sexual violence (SV) affects millions globally and has a well-documented bidirectional association with HIV. Post-exposure prophylaxis (PEP) is a critical, yet often underutilized, HIV prevention tool in post-SV care. Despite its potential impact to reduce HIV transmission, SV care remains an overlooked service delivery point for HIV prevention. The U.S. Centers for Disease Control and Prevention (CDC), as part of the President's Emergency Plan for AIDS Relief (PEPFAR), supports PEP provision within broader post-violence care (PVC) services. Understanding PEP utilization is crucial for optimizing service delivery and HIV prevention efforts.
Using Monitoring Evaluation and Reporting data from fiscal years 2018-2023, we conducted a descriptive analysis of clients who received PVC and SV services through CDC-supported programming in 14 sub-Saharan African countries.
From 2018 to 2023, the annual number of clients receiving any PVC, and specifically SV, services increased by 233% (in 2018, n = 206,764; in 2023, n = 689,349) and 163% (in 2018, n = 42,848; in 2023, n = 112,838), respectively. Fewer than half of SV clients completed PEP (38% in 2018, n = 16,103; 31% in 2023, n = 35,118). Across all years combined, most SV clients (female: 185,414; male: 59,618) were aged 15-19 years. The age band and sex with the lowest proportion of clients completing PEP were males aged 15-19 (4%, n = 2296).
The findings underscore a critical gap between the scaling of SV services and the completion of PEP within violence response programmes. Innovative implementation science approaches may help to identify and address barriers inhibiting effective PEP delivery and uptake within PVC service delivery programmes. Enhancing PEP uptake and completion can support mitigating the bidirectional relationship between violence and HIV acquisition, particularly among vulnerable populations like adolescents and young adults. Low PEP coverage also reflects missed opportunities, particularly among adolescent girls and young women, who experience disproportionate rates of HIV acquisition.
性暴力在全球范围内影响着数百万人，并且与艾滋病毒存在着有据可查的双向关联。暴露后预防（PEP）是性暴力后护理中一项关键但经常未得到充分利用的艾滋病毒预防工具。尽管其对减少艾滋病毒传播具有潜在影响，但性暴力护理仍然是艾滋病毒预防中一个被忽视的服务提供点。作为总统艾滋病紧急救援计划（PEPFAR）的一部分，美国疾病控制与预防中心（CDC）支持在更广泛的暴力后护理（PVC）服务中提供暴露后预防。了解暴露后预防的使用情况对于优化服务提供和艾滋病毒预防工作至关重要。
利用2018 - 2023财年的监测评估和报告数据，我们对通过疾病预防控制中心支持的项目在14个撒哈拉以南非洲国家接受暴力后护理和性暴力服务的客户进行了描述性分析。
从2018年到2023年，接受任何暴力后护理服务，特别是性暴力服务的客户年度数量分别增加了233%（2018年，n = 206,764；2023年，n = 689,349）和163%（2018年，n = 42,848；2023年，n = 112,838）。完成暴露后预防的性暴力客户不到一半（2018年为38%，n = 16,103；2023年为31%，n = 35,118）。在所有年份中，大多数性暴力客户（女性：185,414；男性：59,618）年龄在15 - 19岁之间。完成暴露后预防比例最低的年龄组和性别是15 - 19岁的男性（4%，n = 2296）。
研究结果强调了性暴力服务的扩大与暴力应对项目中暴露后预防的完成之间存在关键差距。创新的实施科学方法可能有助于识别和解决阻碍在暴力后护理服务提供项目中有效提供和接受暴露后预防的障碍。提高暴露后预防的接受度和完成率有助于减轻暴力与艾滋病毒感染之间的双向关系，特别是在青少年和年轻人等弱势群体中。暴露后预防覆盖率低也反映了错失的机会，特别是在艾滋病毒感染率不成比例的少女和年轻女性中。
