title: Barriers to post exposure prophylaxis (PEP) completion after rape: a South African qualitative study.
abstract: Sexual violence and HIV are two serious public health problems in South Africa. Post exposure prophylaxis (PEP) to prevent HIV after rape was introduced into the South African public health services in 2002 but many questions on the completion of PEP medication remain. A qualitative study involving in-depth interviews was conducted with 29 women attending sexual assault services in an urban and a rural site to explore PEP use after rape. It showed how PEP adherence was a complex and challenging experience, with survivors experiencing disruptions in their lives and unable to adhere to the medication adequately. Only nine completed their prescribed drug regimes. Rape stigma and perceptions of rape impacted on adherence, which became a lesser priority if the rape was contested by important others. Being blamed and not receiving social support had profound psychological impact. Stigma of rape and fear of HIV played very powerful roles in debilitating women's ability to take medication to prevent HIV infection. Further research is needed to support the development of interventions that acknowledge the complex barriers to adherence of PEP after rape.
authors.affiliation: Gender & Health Research Unit, Medical Research Council, Cape Town, South Africa. nabraham@mrc.ac.za
authors.forename: Naeemah
authors.initials: N
authors.lastname: Abrahams
authors.forename: Rachel
authors.initials: R
authors.lastname: Jewkes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011902:Rape / Q000706:statistics & numerical data*; D012107:Research Design; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents