What We Do
WHAT TO DO IN A RAPE SITUATION :
Scroll down for meds and correct dosages
DURING A RAPE try to remain calm.
Memorise what the rapist (not his clothes) looks like so that you will be able to make identification later. If there is a gang, try to remember at least one attacker. Do not make it obvious that you are doing this.
Fighting back may simply give the rapist sexual pleasure and increase your risk of being injured or killed. Remain calm unless you believe you can fight him off or deter them. You have a better chance of this in a public place than in an isolated setting or in your home which is where 65% of women get raped. In South Africa 85% of rapists are armed with a knife (most commonly) or a firearm – do not take chances with your life.
AFTER THE RAPE do not bath, change your clothes, go to the toilet or clean your teeth if you were forced to perform oral sex.
Phone the police, you will not be forced to lay a charge but they will help you. Laying a charge helps protect others at risk of rape too – by jailing a rapist, we protect others.
Ensure the police take you FIRST to the nearest clinic, hospital or district surgeon’s office, ideally do not go to your family doctor most have no rape or forensic training and the HIV knowledge of many is pitiful. It is imperative that you get antiretrovirals (Post Exposure Prophylaxis – PEP) within 72 hours of the first act of penetration or attempted penetration. Oral sex also puts you at risk of HIV. Anal sex increases your risk of HIV transmission 60 fold. The sooner you get PEP the better, the police can take statements much later.
You are entitled by law to a copy of your affidavit, even if the police do not give it to you on the night, ensure you know the name of the investigating officer and get the affidavit from him together with the case number. Make sure s/he informs you of the bail application – you have no right to testify at that application, but if you are told the name of the prosecutor and the which court it will be heard in, approach the Chief Prosecutor and/or the Prosecutor in Charge of Sexual Offences BEFORE the hearing and tell him or her of your fears if the alleged perpetrator/s is released.
Tell the district surgeon exactly what happened to you, to help him or her collect better evidence to help police find the rapist/s.
The doctor will test to see if you were HIV+ BEFORE the rape, if you already are, he or she will not give you PEP, if you are not HIV+ and it is less than 72 hours since the first act of penetration, you will be given HIV medication.
The doctor will also give medicines to prevent Sexually Transmitted Diseases, to prevent other infections such as hepatitis, and to prevent pregnancy (these are not always effective, so monitor your periods). In all you will probably swallow up to two dozen tablets at that first visit and be tested for HIV.
The doctor may remove your clothes if they carry blood, semen or any bodily fluid that could carry DNA and may help police catch the rapist. He will put them in a paper (never plastic) bag for evidence and will put all the evidence into a special police Crime Kit. You will not get these clothes back.
FREE COUNSELLING services are offered by many organizations including Lifeline, Childline, Rape Crisis, POWA, and others. Some religious groups also offer counseling.
If you are unhappy with the police investigation complain to the Independent Complaints Directorate, there are offices in major towns, look up their details in your local phone directory.
If you are unhappy with the treatment given to you by the Courts, telephone the office of the National Director of Public Prosecutions in Pretoria, 012-3175000 or 012-3175784 and ask for the Sexual Offences Unit.
Post Rape Medication
An HIV test must be taken of the survivor if he or she wishes to commence Post Exposure Prophylaxis (antiretroviral therapy) – we strongly recommend that you do. On average 22% of rape survivors are already HIV+ at the time of rape. Those infected cannot commence PEP. Those not infected may commence PEP if they present for treatment within 72 hours of the first act of penetration or attempted penetration. Research has shown that in SA at least 40% of rape survivors will become HIV+ after rape if they do not get PEP in time (Dr Adrienne Wulfsohn, Netcare, 2003).
Rape survivors return for HIV tests at 6 weeks, 3 months, 6 months and ideally at one year. A tiny percentage may seroconvert and become HIV+ at one year. The rape survivor should practise safe sex after sexual assault to prevent the transmission of HIV, other sexually transmitted illnesses or infections to his or her partner for at least six months . In addition to medication to prevent HIV, s/he needs to be protected against sexually transmitted diseases, pregnancy and secondary infections such as hepatitis.
Routine syndromic medication with doses to prevent sexually transmitted infections:
a.. Ciprofloxacin 250mg po stat
b.. Doxycycline 100mg po bd for 7 days (this is contraindicated for pregnancy)
c.. Metronidazole 400mg po tds for 7 days
Morning-after pill to prevent pregnancy
Ovral 2 tabs stat then 2 tabs after 12 hours or E-gen- c . Please note these have a 50% success rate so continue to monitor your periods.
Recommended dual-combination antiretroviral therapy over 28 days
AZT (Retrovir) 200mg po 8 hourly
3TC (Lamivudine) 150mg po 12 hourly
zidovudine (300mg) with lamivudine (150mg) in a combination pill Combivir, taken twice a day;
lamivudine plus stavudine (40mg stavudine twice a day for a person weighing more than 60kg; 20mg twice a day for a person weighing less than 60kg; and 150mg lamivudine for person more than 50kg and 2mg per kg twice a day for a person weighing less than 50kg
Recommended antiretroviral dosage for children from Johannesburg Hospital
The Centers for Disease Control say children must get PEP sooner than adults, literally within hours of the sexual assault. Johannesburg Hospital recommends that for a child under the age of 12, dependant on weight: AZT 2mg per kg dose, first 48 hours every six hours. For the following week the child must be given AZT every 8 hours, and for the remainder of the month take the doze every 12 hours.
In addition the child must be given 3TC – 4mg per kg per dose every 12 hours for 28 days.
Antiretroviral side-effects may include nausea, fatigue, headaches, thirst
(Sources: California Guidelines for PEP after sexual assault, 2001; Centers for Disease Control; Lifesense; Netcare)