- The US-based group Human Rights Watch accuses the South African ANC government of "inaction and misinformation," thus undermining its own programme to help rape victims avoid HIV infection by providing antiretroviral drugs. The government is "putting lives at risk amid a dual epidemic of sexual violence and HIV/AIDS," the group says.
A 73-page report released in New York today had revealed a massive increase in mortality rates among young adults since 1998 that is apparently related to AIDS, the group said. The report also had documented "how government inaction and misinformation from high-level officials have undermined the effectiveness" of South Africa's AIDS programme.
The ANC government in April 2002 had launched a programme to provide rape survivors with post-exposure prophylaxis (PEP) - antiretroviral drugs that can reduce the risk of contracting HIV from an HIV-positive attacker. This was the first South African programme that involved providing antiretrovirals and it only came after heavy pressure from civil society groups.
- The South African government has taken a crucial step in recognizing the importance of HIV prevention for rape survivors, comments Rebecca Schleifer of Human Rights Watch. "But there is a deadly disconnect between the government's stated intention to provide drugs that can prevent HIV and the reality for rape survivors who can't get them," she added.
According toe the US group, the South African government had launched its PEP programme "in near silence." This alleged government failure to provide adequate information or training on PEP had "left both service providers and rape survivors in the dark," Human Rights Watch concluded in its study.
- Police and nurses who should have been helping rape survivors get anti-HIV drugs didn't do so, sometimes because they had no idea that the programme even existed, Ms Schleifer said. "And some service providers may not have offered these drugs even when they knew about them, because they thought that doing so was against government policy."
After years of government opposition to providing antiretrovirals in the public health system, including statements by President Thabo Mbeki questioning whether these drugs were too toxic to use, the government announced in August 2003 a nationwide treatment programme for people with AIDS.
- South Africa's broader plan to provide antiretroviral treatment will encounter many of the same challenges as providing anti-HIV drugs to rape survivors, Ms Schleifer predicts. These problems included effective public education, clear political support, and guaranteed access for children.
The study had found that South African police often responded inadequately to rape complaints," neglecting to help rape survivors get medical treatment, or in some cases, even turning them away." Coupled with health professionals' insistence that rape survivors file a police report to get medical services, which is a requirement at odds with Department of Health policy, these factors had further impeded access to PEP.
One counsellor told had Human Rights Watch that "almost all the time police refuse to open a case" for rape survivors. In turn, doctors had refused to examine rape survivors who had not reported their cases to police.
Children, an estimated 40 percent of rape and attempted rape survivors in South Africa, were especially harmed by this, the study found. By law, children under 14 cannot consent on their own to PEP services or the prerequisite HIV testing. This was posing problems for children seeking services unaccompanied by a parent or legal guardian.
Moreover, national PEP guidelines do not include information on how to give PEP to children under 14, "leaving many health professionals without basic guidance for younger children," Human Rights Watch found.
Few African countries provide PEP for rape survivors, although this is a standard service in many other countries. "South Africa's PEP program could become a model as other states in the region begin to develop PEP services and broader antiretroviral treatment programmes," the group said.
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