Postexposure Prophylaxis Compliance Low for Sexual Assault in South Africa

The current study sought to describe the demographic characteristics of victims of sexual assault in Transkei region, South Africa, and to assess the outcome of HIV transmission and evaluate the success of postexposure prophylaxis (PEP) after its implementation there. An earlier study found that more than 90 percent of sexual assault victims were HIV-seronegative at the time of the incident despite high HIV prevalence in the community.

PEP is recommended in sexual assault cases, specifically therapy with zidovudine (AZT) and lamivudine (3TC).

The present study examined 594 victims of sexual assault at Sinawe Center from 2000-2003. Of those, 346 (58.2 percent) were under age 15. "Seventeen children (2.9 percent) were found to be HIV positive at the first test," B.L. Meel and colleagues at the University of Transkei in Umtata reported. "Among the adults, 58 (9.8 percent) tested HIV positive. Of the 225 who attended after PEP was introduced, only two were found to be HIV seropositive at the time of the incident."

Investigators continued, "A second test was recommended after 4 weeks and a third after 12 weeks. The majority of the victims did not report for the second test, but all 35 who did come to be tested were seronegative. Seventeen of those were between 11-15 years of age."

The scientists reported that only seven victims came for the third test, and they were negative. Nausea and vomiting were the most common side effects of PEP in four patients and one developed a generalized rash. Only one victim seroconverted.

The study, "HIV/AIDS Postexposure Prophylaxis (PEP) for Victims of Sexual Assault in South Africa," appeared in Medicine, Science and the Law (2005;45(3):219-24).

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