National protocols in place for ARVs for rape survivors

On 17 April Cabinet concluded that anti-retroviral drugs should be offered as an option to survivors of sexual assault.

The Health Minmec has reviewed various drug combinations and procedures and has reached agreement on national protocols for ARVs in the context of care for rape survivors.

ARVs are prescribed after rape on the basis that they have been shown to reduce infection among health workers who sustain needlestick injuries. However, we lack research that shows conclusively the effectiveness of anti-retrovirals in preventing HIV-transmission as a result of sexual assault.

Because of this, we felt that our protocols for the prophylactic use of ARVs in the care of rape survivors should be modelled as closely as possible on the protocols that we follow for occupational needlestick accidents.

As a result, the public health service will offer a combination of the same two drugs we use in the occupational setting - that is, AZT and 3TC. We will also do the same preliminary tests and follow-up HIV-testing that we do in instances of needlestick injuries. And we will acquire the drugs in syrup form so that children, too, have access to this intervention.


In instances of sexual assault, special care must be taken to counsel the survivor to enable her or him to make an informed choice on the taking of ARVs. Counselling should include information on the risks of using anti-retrovirals as a preventive measure in this context.

Effectively, the option of ARVs will be "inserted" into existing services for survivors of sexual assault. In some areas these services are in the casualty sections of regional hospitals, while in other areas there are special clinics for survivors of rape and domestic assault. Each province will begin to offer ARV prophylaxis as soon as it has done the necessary groundwork.

Our aim in the public sector is to offer comprehensive care for rape survivors that includes counselling, treatment for physical trauma, prevention of pregnancy and sexually transmitted diseases and the careful gathering of forensic evidence.

I strongly encourage any person who suffers the experience of rape not to hesitate in seeking professional help. Prompt medical care - that is, within two or at most three days of the attack - can go a long way to limiting the damaging consequences of rape.

- Dr Manto Tshabalala-Msimang - Minister of Health