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THE streets are becoming less safe over the years in most urban areas.
It is not only in the brightly lit cities alone that scores of people, women in particular, have to constantly look over their shoulders once the sun sets.
In rural areas too, women are brutally raped by assailants who potentially infect them with HIV.
Even worse, it is not strangers alone that sexually violate women and girls, they are unsafe from their grandfathers, uncles, brothers and fathers too.
Recently, a Bulawayo woman broke down in court as she narrated how three men gang-raped her at knife point.
Two of the men, who allegedly cut off her clothes with a knife before taking turns to rape her, appeared in court facing rape and robbery charges.
The woman sustained serious injuries after one of the suspects allegedly savagely kicked her in her private parts after she said she was on HIV medication. Her little lie saved her from the third suspect raping her.
It was double tragedy for this woman. Not only was she hurt physically but she suffered emotional scars which will be stuck with her for the rest of her life.
But the real question is after the rape – were her health concerns addressed? Did she receive HIV post exposure prophylaxis (PEP) in time?
As the HIV status of an attacker is never known, PEP cannot be emphasised enough.
Sadly, a significant number of people do not know about PEP and miss out on the chance of taking these lifesaving drugs.
Some do not have the courage to speak out about their rape ordeal in time and wait until it is too late for the drug to be administered.
Others suffer in silence as family members conceal the rape in order to protect the family name and the perpetrator.
In some communities, families choose to settle the rape case among themselves as the offended family may demand compensation from the perpetrator in the form of cattle for example, without considering the health risks the victim would have been exposed to.
As a result, other rape cases have culminated in unwanted pregnancies and the contraction of HIV.
Some rape victims have had to give birth to children who are a constant reminder of their violation.
Zimbabwe Young Women’s Network for Peace Building director, Grace Chirenje, feels that most women and girls who have been sexually abused do not get timely help.
She says authorities often overlook victims’ health concerns.
“The police and health system in the majority of cases don’t offer rape victims effective and timely help. There’re still no women and girl friendly health centers with deposited efforts being made by those who are advocates in this field such as Adult Rape Centre,” said Chirenje.
She says sexuality is still shrouded in secrecy and not openly talked about, hence failure by many women and girls to access morning after pills and PEP.
“The Zimbabwe National Family Planning Council and the Ministry of Health and Child Care have done their part in ensuring the availability of contraceptives and HIV medication but information dissemination is still rather low. Most women and girls engaging in sex are also not open to exploration of their sexuality, hence the low uptake of PEP and also low knowledge levels around PEP,” said Chirenje.
Zimbabwe Young Women’s Network for Peace Building want more to be done in order to disseminate information about PEP publicly so that women and girls are aware.
“I admire the publicity of the voluntary male circumcision programme. Imagine if the same was employed for PEP, how many women and girls would benefit? However, patriarchy still has a strong influence on women and girls’ bodily interfaith and this is a challenge even in information generation and sharing,” said Chirenje.
Post-exposure prophylaxis, or PEP, is a way for a person who may have recently been exposed to HIV to prevent HIV infection.
It involves taking antiretroviral medications right after a potential exposure to HIV. Anyone who thinks they may have been exposed to HIV should contact their doctor immediately to access the drugs.
PEP consists of a combination of two to three antiretroviral drugs that an HIV-negative person who may have been exposed to HIV takes to reduce the HIV infection risk.
Victims should take PEP as soon as possible, within 72 hours of being exposed to HIV. These prescription drugs need to be taken daily, as directed, for four full weeks.
It is of paramount importance that the patient does not default on the medication for whatever period it has been prescribed in order for it to work effectively.
“Public health institutions and even private medical facilities do give PEP to patients who need it without necessarily asking for a police report,” said Nomsa Mabunda, a local nurse.
In previous years, victims of rape could not access PEP without a police report proving that they were indeed raped and reported to the police.
The process was lengthy and in some instances lapsed beyond 72 hours — the deadline for which PEP and morning after pills should have been administered.
“Health practitioners all over are now equipped with both knowledge and resources. They’re trained in dealing with such sensitive issues.
Now, as soon as you make contact with a health care practitioner and tell them of your possible exposure to HIV — either sexually or from contact with bodily fluids through an injection prick — a rapid HIV test is done,” said Mabunda.
The patient, she says, is given the drugs if she is HIV negative and advised to test again after the window period has lapsed.
PEP cannot be prescribed on patients who already HIV positive. Instead, the patient is put on an antiretroviral regimen that the attending doctor deems necessary.
“Unfortunately, a lot of people don’t know about the availability of PEP. Before one actually goes to report to the police, they need to visit a health care facility within 72 hours of the rape. This time frame is very critical,” said Mabunda.
Although PEP is not a 100 percent guarantee that HIV infection will be prevented, it improves the chances of HIV infection prevention.
In other countries, there have been reservations around PEP as some people engage in risky behaviour knowing they can always access PEP.
“When a person walks into the charge office and mentions to the police at the front desk that they’ve come to report an incident of rape, that person is immediately taken to our Victim Friendly Unit where they can speak in private,” said Bulawayo police spokesperson, Inspector Precious Simango.
As soon as the report is made, she said, the victim has to visit a doctor where they are examined.
“For us, it’s enough for a victim to mention that they’ve been raped. We take down the report and take it from there. The victim has to see a doctor who will examine them. They will check for any physical harm, penetration and probably bodily fluids like semen. This is why the need to report incidents of rape as soon as possible cannot be emphasised enough,” she said.
PEP is safe but may cause side effects like nausea in some people. These side effects can be treated and aren’t life-threatening.
Online Reporter