EPISODE 20 - Post-exposure prophylaxis

In April 2002 the South African government announced the roll-out of post-exposure prophylaxis (PEP) for rape survivors and medical practitioners with needle stick injuries. The importance of PEP in South Africa shouldn't be underestimated due to the high rates of gender based violence and rape. In 2002 alone over 50 000 rapes were reported to the South African Police Service and it is estimated that only 1 in 9 rape survivors actually report to the police. PEP is administered to victims of sexual crimes who report to a health facility within 72 hours of the crime. As a prevention measure PEP is only administered to survivors who are known not to be HIV positive. Consequently survivors who decline to be tested for HIV cannot be given PEP.

Despite the acute need for post-exposure prophylaxis, this service isn't as widely available as it should be with rape survivors in poorer rural communities often not receiving this service and the necessary support. Even if they manage to receive an initial dose of PEP they are often economically unable to travel to access the follow up dose.

This week Siyayinqoba Beat It! looks in-depth at this problem and finds out the facts about what can be done to ensure a higher uptake of PEP.  Joining the support group in the studio is Ntutu Ntwana from Simelela - an organisation that runs clinics for rape survivors. Our first segment comes from Kwazula Natal where the Siyayinqoba Outreach Team teach people about PEP.  Busi Mgabi talks to people from the area about the risk of HIV infection after being raped. Various discussion points are raised and dealt with including questions around same-sex rape and the stigma attached to it.  We find out that PEP by law should be administered to both men and women who have been sexually assaulted and raped.

Back in the studio we find out that Simelela alone sees about 70 "clients" a month.  What's even more frightening is that some of the survivors are only children and this has led to Simelela now having to speak to crèches about rape. Other issues are also discussed involving the trauma and uncertainty a victim experiences.

The next segment shares the experiences of Nomsenbenzi Ngxasana, a rape survivor, from Lusikisiki in the Eastern Cape. We hear about her harrowing ordeal but also her courage. We hear how she reported the crime, agreed to be tested for HIV and received post exposure prophylaxis.

In our final story we speak to Thembelihle in KwaZulu Natal. During sex with her HIV positive partner, Thembelihle recounts how, the condom they were using broke. Fortunately Thembelihle and her partner knew about post exposure prophylaxis and set about to access it. Unfortunately, despite being given the morning after pill and pills to prevent sexually transmitted infections, the clinic could not give them PEP because government policy only allows for the administration of PEP to Rape survivors. Thembelihle however wisely decided, despite the cost, to get a prescription from the doctor and to buy the PEP drugs from a pharmacy.

Post-exposure prophylaxis is an important intervention in our fight against HIV. If we are to halve our country's infection rate by 2011 we all need to ensure that this intervention becomes more widely available. PEP ensures that rape survivors don't serve out a life sentence because of another's crime.

IT'S A FACT