Date : July, 01 , 2010 Publication : SA Medical Journal Page Number: 362-363 SCIENTIFIC LETTERS Reported rapes at a hospital rape centre: Demographic and clinical profiles Kees I . i m H U T S I i i u l i M a r t i n , D onavan A n d r e w s , Soraya Seedat To the l-ditor: figures ior tin- period 2008/2009 indicate a 10% support tor the ongoing call for the provision o l effective and rise in Ilu* number of reported sexual offences compared w i t h integrated post-rape ser\ ices tor rape survivors. figures lor 2007/2008.' The increase may be partly attributable to the recent version of the acl regulating sexual offences: the t rimin.il I .iw (Sexual Offences and Related Matters) Amendment Act, Acl 32 of 2007 (Acl). In this Act, the definition of rape has been broadened to include the non-consensual vaginal, oral or anal penetration ol any person, regardless ol gender, w i l h a m object." South Africa has one of the highest incidences of rape in the w o r l d and the most v iolent types. o l rape in ihe w o r l d , w i l h gang rape and severe p i n sical injury to rape viclims commonly occurring. 11 Moreover, the consequences ol rape potent iaIK include m a i n medical and Methods We conducted a retrospective rev iew o l patient records for all male and teniale rape survivors, including children and adults, w h o presented to the Karl Bremer I lospital Rape v e n t r e from I August 2007 to " I | u l \ 2008. Standard procedures at this centre include a medical and forensic examination and treatment o l physical injuries and STIS. A 28-day course o l prophylactic anliretroviral medication is also provided to rape survivor*. presenting w i t h i n 72 hours ot the reported rape. psychological difficulties, such as unwanted pregnancy, risk Data from patient records included age ol rape survivors. Ol Sexually transmitted inleclions (SI Is), genital and physical day ot the week that the rape was reported, alcohol and d r u g injurs, and psychological disturbance e.g. post-traumatic stress use of the rap*' surviv or. number o l perpetrators involved, disorder, major depression, increased risk ol suicidal ideation, whether the perpetrator was k n o w n / u n k n o w n to the rape and alcohol and d r u g abuse problems.*' Rape s u n ivors have survivor, injuries sustained d u r i n g the rape, I I I V status o l spei ilu health needs, ideally met by p r o v i d i n g integrated the rape survivor, a m i the type ol rape committed (anal MK\ holistic pOSl-rape services, including the provision o l a n d / o r vaginal). D ata were analysed on SI*SS version 17. pregnancy testing and prevention, termination of pregnancy, Descriptive statistics (means and standard de\ iations (SI H)) testing and treatment of S I N ,ui\.i injuries, and ps\ chosocial were computed lor the variables ol interest, lo determine counselling. Rapt' survivors strongly value the ax ailabilit) whether any significant differences were evident between o l I IIV prophylaxis, an understanding health care provider, males and females in terms of the variables of interest, the chi- access to and r i v e n ing counselling, ,ii^\ thorough physical sijuare test or Fisher's exact test wen- used where appropriate. examination, emphasising the need tor a holistic appioai h I thical permission to conduct the study was obtained from the to post-rape c a r e . " The Act amis to provide certain s e n ices Stellenbosch University ethics committee. to survivors of sexual assault to minimise or present further traumatis.ition, yet the only medical sen ice conditional!) provided to rape survivors is the provision o l post-exposure prophylaxis (PI I V Results A total of I 1.12 confirmed rape cases were identified, comprising I 013 female (mean age 20.7 years, 5 D 11.2) and We aimed to replicate and build on a previous record review I I ' ' male < mean age 11.3 years, SD8.7) rape cases, respeclivelj o l female rape survivors 1 by p r o v i d i n g An overview o l the (Table h. The mean age for the total sample was 19.7 years demographic, clinical, and rape characteristics ol female and (SI) 11.4), w i t h the youngest survivor being a newborn and male children ami adult rape survivors presenting to a rape the eldest 7N years o l d ; 34.1% were < IS years old. Most patient centre in the Western Cape. We aimed to provide evidence and visits occurred o n a Sunday and Monday. I here was clinical evidence o l alcohol use i n 20.7".. of rape sur\ ivors, and ol d r u g use in \ 0 " . , . In 333".. o l gang rapes, survivors had consumed ■ ,'wii/," JW/M.',S;U U ninr*ilvrt K I J in HUTS, ll \ llinv* (IVvchuli>H)) luKTi-nftiNi IV Krtthtttuid* \IKi U nitimAiixh,t!/tutJ$lrr»DtHvJer*. U tiwtmtiH tif I'miiuttt)/, $tt1tfiitn**'h Ihihvi'itu Ti/gerbi '.■ '.'■ I 1 Mjrlin, MAllSychiitoRy] Stiith Alrtam Risotiyfrl IM/I fn ft*J tnmukHb Sins> i*t*nrklii Sonlti /Vfhun RrstwnH dun* tmtutin: Dffktrlntoil iff NHUM and fivftif itfiyv/WifMuwf Krsiwrli httinbthit timl MRC U iiitiwAnxkiittmttStres* D lMmfrrs Orjwltitfnlii l'-u • hutiiu >fi7/i'«NK,'< Uuttvrsllii SSccd»l,MB( hB. \1\led (ISvch) u ISvch. I'M) Hi■"!••' Ili^i'itiil K,i;ii'»"/mii:.l\i<- i WCup I) Aiidrcivs Ml) alcohol, and d r u g use was reported in 7S\> o l the gang rapes. I're\ ions rapes were reported hv (•."".. of alcohol users and h\ 6.3% oi d r u g users. In 10".. of »as(-s. there were ?2 perpetrators, ranging f r o m I lo S. In d/.H".. o l cases, the perpetrator was k n o w n lo the s u n ivor. and in survivors < I 5 years o l d , 84.S"» had been raped previously by someone known to them. A significant difference between males and females was found in terms of genital a n d / o r anal injuries; '2.4".. o l female sur\ ivors sustained genital injuries, whereas 4.V".. of male survivors had genital or anal injuries. A significant difference between genders i n terms ot moderate physical injuries, was observ ed. In 18.5% of all cases, physical injuries were documented. Moderate p i n sical injuries included abrasions and scratches (17.3",.); more severe physical injuries included stab w o u n d s < orrcspomliKgiiNthor. K Limiwr* Iklnitim2j>i. Page 1 /1 Size=a90K29Tmm Circulation: 14086 Readership: 14036