Engendering health sector responses to sexual violence and HIV in Kenya: Results of a qualitative study

Abstract

In Kenya many people who have been affected by sexual violence turn to the health sector for clinical treatment and preventive therapies. This interface provides a vital opportunity to impact on the dual epidemics of HIV and sexual violence. Despite this, the uptake of post-rape care services in health facilities as low and health care providers felt ill-prepared to deal with the consequences of sexual violence. A qualitative study was conducted to better understand the reasons for the low uptake of services and to establish perceptions of sexual violence in Kenya. Thirty-four key informants were interviewed and sixteen focus group discussions with women and men were held in three districts in Kenya. Blurred boundaries between forced and consensual sex emerged. Important implications for the delivery of HIV post exposure prophylaxis (PEP) after sexual violence include the need for gender-aware patient-centred training for health providers and for HIV PEP interventions to strengthen on-going HIV-prevention counselling efforts. Further research needs to determine the feasibility of on-going risk reduction measures in the context of PEP delivery.

Acknowledgements

The authors would like to thank all the participants of focus group discussions and the individual interviews. The HIV/AIDS Knowledge Programme, Liverpool School of Tropical Medicine is a collaborative programme funded by the Department for International Development, UK (DfID) to develop ‘knowledge for action’ in HIV/AIDS prevention and care and funded the situational analysis for six months. Liverpool VCT Kenya, through core funding and with support from TROCAIRE and DfID funded all other aspects of the study. The researchers were independent from funders.