title: Piloting post-exposure prophylaxis in Kenya raises specific concerns for the management of childhood rape.
abstract: Thika District, Kenya, is the site of an operational research study on the provision of comprehensive post-rape care, including the free provision of HIV post-exposure prophylaxis (PEP). It is a typical rural Kenyan district in terms of resources and patient throughput. The high rate of children attending for post-rape services was unexpected and had significant programming implications. An age-disaggregated analysis of existing quantitative data from the first 8 months of service provision was conducted. Ninety-four case records were reviewed, of whom 48 (51%) were in the age range 1.5-17 years inclusive. All three cases of male rape were in children. Children were more likely to know their assailant than adults and were more likely to be HIV-negative at baseline. The majority (86%) of children presented in time for PEP, with adherence and completion rates similar to adults but lower rates of 6-week follow-up. The use of weight bands to determine drug dosages greatly simplified the appropriate and early administration of paediatric PEP. The high rates of childhood rape and demand for post-rape services were an enormous challenge for service providers and policy-makers.
authors.affiliation: Liverpool VCT & Care, P.O. Box 43640, Nairobi, Kenya.
authors.forename: C G
authors.initials: CG
authors.lastname: Speight
authors.forename: A
authors.initials: A
authors.lastname: Klufio
authors.forename: S N
authors.initials: SN
authors.lastname: Kilonzo
authors.forename: C
authors.initials: C
authors.lastname: Mbugua
authors.forename: E
authors.initials: E
authors.lastname: Kuria
authors.forename: J E
authors.initials: JE
authors.lastname: Bunn
authors.forename: M
authors.initials: M
authors.lastname: Taegtmeyer
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D001835:Body Weight; D002648:Child; D002650:Child Abuse, Sexual; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007630:Kenya; D019259:Lamivudine / Q000008:administration & dosage*; D008297:Male; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D011902:Rape; D012307:Risk Factors; D012423:Rural Health; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D015215:Zidovudine / Q000008:administration & dosage*
chemical_list: D019380:Anti-HIV Agents; D019259:Lamivudine; D015215:Zidovudine