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Sunday, October 08, 2006

Sexual Assault & HIV Prevention

Rape, (n) the act of forcing penetrative sexual acts, against another's will through violence, force, threat of injury, or other duress, or where the victim is unable to decline, due to the effects of drugs or alcohol.
It is a scary fact that many people will know someone who has been sexually assaulted, and further that they may not ever know that the person was ever raped. Further, I make the careful distinction of using gender-neutral "person" because rape is not a male-on-female crime.

It is likely, especially if the victim is male, the attack has not been violent per se, or the assailant is known to the victim, that they will be unwilling to report the incident. Consequently, they will deny themselves of access to extremely important medical and other support services.

One of the more dire things about rape, apart from physical and mental trauma, is the possible contraction of sexually transmitted disease. Fortunately, most diseases are treatable with prescribed antibiotics. Further, if dealt with very early, the possibility of HIV infection is also significantly reduced or it can be completely preventable. However, administration of treatment inside of a seventy-two hour window is key and critical to treatment success.

I've been advised by a friend, a doctor involved in HIV research here in Trinidad, that it is extremely important for women and men alike to know that treatment and support are available to them locally, particularly with respect to HIV prevention. This is even if they do not want to make a formal report of the incident to the Police. Medical support and confidential counselling can be provided regardless.

The victim can visit any of the public health institutions in the country to seek initial assistance, where one of the first things on the agenda will be testing for HIV and other STDs. Immediately following this, treatment can begin which can include medication for pregnancy prevention, as well as antibiotics to prevent contraction of sexually transmitted disease.

Where the victim has tested HIV negative, medical treatment then includes HIV Post-Exposure Prophylaxis, or PEP. HIV PEP can take many forms, but is usually delivered as a cocktail of antiretroviral medication taken over the course of four to six weeks. Again, given any possibility that the assailant was HIV positive, treatment needs to begin within seventy-two hours of the incident to be most effective.

Once PEP is administered, follow-up over the course of treatment is done at Ward 2 of the San Fernando General Hospital and at the Medical Research Centre in Port of Spain. Additional HIV testing is done after six weeks, three months and six months, this to ensure that infection has not taken place. All the while, the victim has access to counsellers at both centres, and at the Rape Crisis Centre.

There is though the occasion where the victim will test positive for HIV at the outset, will have already known themselves to be HIV positive, or will still contract the virus despite administration of HIV PEP. As my friend indicates, the public health care system does still take care of the victim, with on-going counselling and regular antiretroviral and antiretrofungal medication. This too is administered by Ward 2 at the San Fernando General Hospital and the Medical Research Centre in Post of Spain.

It is of extreme importance that a victim of sexual assault get help as soon as possible after the incident. The health of the victim is paramount, even if there is no desire to have the Police involved. Despite this, it is still highly recommended that the assault be reported so that steps can be taken to ensure that the perpetrator never has opportunity to rape again.

Rape Crisis Society of Trinidad & Tobago
40 Woodford St., Newtown, Port of Spain, Trinidad
Phone: (868) 622-7273 (Port of Spain), (868) 657-5355 (San Fernando)
Fax: (868) 622-1079
Email: rapetnt@tstt.net.tt

Medical Research Centre
7 Queen's Park East, Port of Spain, Trinidad
Phone: (868) 623-5834

San Fernando General Hospital
Independence Avenue, San Fernando, Trinidad
Phone: (868) 652-3581 to 86
Ask for Ward 2, then ask for the Counsellor

Types of Rape
A discussion of the different kinds of sexual assault, including child abuse, and acquaintance rape.

Effects of Rape & Aftermath
A discussion on the immediate and ongoing impact of sexual assault, and the societal victimization that can take place.

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