Rape survivors in South Africa: analysis of the baseline socio-demographic and health characteristics of a rape cohort

Abstract

Background Little is known about women who have experienced a recent rape, and how they differ from women without this exposure. Identifying factors linked to rape is important for preventing rape and developing effective responses in countries like South Africa with high levels of sexual violence. Objective To describe the socio-demographic and health profile of women recently exposed to rape and to compare them with a non-rape-exposed group. Methods The Rape Impact Cohort Evaluation Study (RICE) enrolled 852 women age 16–40 years exposed to rape from post-rape care centres in Durban (South Africa) and a control group of 853 women of the same age range who have never been exposed to rape recruited from public health services. Descriptive analyses include logistic regression modelling of socio-demographic characteristics associated with recent rape exposure. Results Women with recent rape reported poorer health and more intimate partner violence than those who were not raped. They had a lower likelihood of having completed school (Odds Ratio [OR] 0.46 95% Confidence Interval (CI): 0.24–0.87) and dependence on a government grant as a main source of income (OR 0.61: 95%CI 0.49–0.77). They were more likely to live in informal housing (OR 1.88 95%CI: 1.43–2.46) or rural areas (OR 2.24: 95%CI 1.61–3.07) than formal housing areas – however they were also more likely to report full-time employment (OR 4.24: 95%CI 2.73–6.57). Conclusion The study shows that structural factors, such as lower levels of education, poverty, and living in areas of poor infrastructure are associated with women’s vulnerability to rape. It also shows possible protection from rape afforded by the national financial safety net. It highlights the importance of safe transportation in commuting to work. Preventing rape is critical for enabling women’s full social and economic development, and structural interventions are key for reducing women’s vulnerability.

Gender and Context Matter: Behavioral and Structural Interventions for People Who Use Alcohol and Other Drugs in Africa

“…Multiple intersecting issues, including the syndemics of gender violence, HIV/STIs, and sexual risk as well as mental health comorbidities and psychological trauma arising from exposure to violence, are highly prevalent among many of the targeted study populations [ 34 , 108 , 109 , 110 ]. This review is important because it highlights the need to include HIV and target gender issues in interventions.…”

Multi-disciplinary Evaluation of Sexual Assault Referral Centres (SARCs) for better Health (MESARCH): protocol for a 1-year cohort study examining health, well-being and cost outcomes in adult survivors of sexual assault attending SARCs in England

“…To allow for four levels in a predictor variable (eg, four types of SARC service provider); up to 10 covariates; two time points; an expected small-to-moderate Cohen’s f, which corresponds to the MCID for our primary outcome variable29; and an α error probability of 0.05, 270 participants would be required at study end to achieve a power (1−β error probability) of 0.90. Based on previous studies,19 20 our pilot work, and recruitment and retention to date, we estimate attrition at 20% by 12-month follow-up, requiring a baseline target of 338 individuals (see estimated flow of participants in figure 1). Participants who do not complete a 6-month follow-up will still be eligible to complete 12-month follow-up measures.…”

“…We are aware from another similar study,19 20 our own pilot study and our early recruitment experiences of the challenges in recruitment. For the main study, we are providing clearer guidance to staff about the exceptional circumstances under which a person should be identified as ineligible.…”

“…In addition, although the substantial negative impacts of sexual violence are well-documented5 much less is known about the longer-term health and well-being outcomes for survivors. One exception is a recent study in South Africa which followed up female rape survivors over 3 years and, controlling for confounding variables, has shown they had a 60% increased risk of contracting HIV in that time compared with control group women who had not been raped 18–20. Data related to models of care survivors receive and health outcomes remain limited, however.…”

Associations of childhood maltreatment with hypertension in South African women: a cross-sectional study

“…Both groups of women were likely to be similar because they were recruited from the same geographical area and were of similar ages to ensure comparability. 18 19 The details of the study protocol have been published previously. 18 Eligible participants for both arms were women aged 18-40 years, while those who were more than 14 weeks pregnant, lactating, had cognitive disabilities or severely mentally distressed rape survivors were excluded.…”