title: Demographics and care-seeking behaviors of sexual violence survivors in South Kivu province, Democratic Republic of Congo.
abstract: OBJECTIVE
  One of the most striking features of the ongoing conflict in the Democratic Republic of Congo (DRC) is the use of sexual violence. In spite of the brutality of these crimes, the experiences of women affected by sexual violence in Eastern DRC remain poorly characterized. This analysis aimed to (1) provide detailed demographics of sexual violence survivors presenting to Panzi Hospital; (2) examine how demographic factors might impact patterns of sexual violence; and (3) describe care-seeking behavior among sexual violence survivors.
  
  
  METHODS
  The demographics and care-seeking behavior of sexual violence survivors in South Kivu Province were described from a retrospective registry-based study of sexual violence survivors presenting to Panzi Hospital (2004-2008).
  
  
  RESULTS
  A total of 4311 records were reviewed. The mean age of survivors was 35 years. Most women (53%) were married, self-identified with the Bashi tribe (65%), and reported agriculture as their livelihood (74%). The mean time delay between sexual assault and seeking care was 10.4 months. Five reasons were identified to help explain the lengthy delays to seeking care: waiting for physical symptoms to develop or worsen before seeking medical attention, lack of means to access medical care, concerns that family would find out about the sexual assault, stigma surrounding sexual violence, and being abducted into sexual slavery for prolonged periods of time.
  
  
  CONCLUSIONS
  Many sexual assault survivors have very delayed presentations to medical attention. Promoting timely access of medical care may best be facilitated by reducing stigma and by educating women about the benefits of early medical care, even in the absence of injuries or symptoms.
authors.affiliation: Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. sbartels@bidmc.harvard.edu
authors.forename: Susan A
authors.initials: SA
authors.lastname: Bartels
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Scott
authors.forename: Jennifer
authors.initials: J
authors.lastname: Leaning
authors.forename: Jocelyn T
authors.initials: JT
authors.lastname: Kelly
authors.forename: Nina R
authors.initials: NR
authors.lastname: Joyce
authors.forename: Denis
authors.initials: D
authors.lastname: Mukwege
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Vanrooyen
mesh_terms: D000293:Adolescent; D000328:Adult; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004522:Educational Status; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D017533:Marital Status; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011902:Rape / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012742:Sex Offenses / Q000523:psychology* / Q000706:statistics & numerical data; D057545:Social Stigma; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D014857:Warfare; D055815:Young Adult