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• W1989272012 abstract "<b>Problem</b> Although international guidelines specify the central role of the health sector in providing comprehensive care, including HIV post-exposure prophylaxis (PEP), after sexual assault, in both industrialised and developing countries there are many challenges to providing timely and comprehensive services. <b>Design</b> A nurse driven model of post-rape care was integrated into existing hospital services; the before and after study design evaluated impacts on quality of care, reviewing 334 hospital charts and conducting interviews with 16 service providers and 109 patients. <b>Setting</b> 450 bed district hospital in rural South Africa. <b>Key measures for improvement</b> Quality of care after rape (forensic history and examination, provision of emergency contraception, prophylaxis for sexually transmitted infections, referrals); provision of HIV counselling and testing and provision and completion of full 28 day course of PEP; and service utilisation (number of service providers seen on first visit and number of rape cases presenting to hospital per month). <b>Strategies for change</b> After completing baseline research, we introduced a five part intervention model, consisting of a sexual violence advisory committee, hospital rape management policy, training workshop for service providers, designated examining room, and community awareness campaigns. <b>Effect of change</b> Existing services were fragmented and of poor quality. After the intervention, there were considerable improvements in clinical history and examination, pregnancy testing, emergency contraception, prophylaxis for sexually transmitted infections; HIV counselling and testing, PEP, trauma counselling, and referrals. Completion of the 28 day course of PEP drugs increased from 20% to 58%. <b>Lessons learnt</b> It is possible to improve the quality of care after sexual assault, including HIV prophylaxis, within a rural South African hospital at modest cost, using existing staff. With additional training, nurses can become the primary providers of this care." @default.
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• W1989272012 date "2009-03-13" @default.
• W1989272012 modified "2023-09-27" @default.
• W1989272012 title "Comprehensive care and HIV prophylaxis after sexual assault in rural South Africa: the Refentse intervention study" @default.
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• W1989272012 doi "https://doi.org/10.1136/bmj.b515" @default.
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