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Citation
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Abrahams N, Mhlongo S, Dunkle K, Chirwa E, Lombard C, Seedat S, Kengne AP, Myers B, Peer N, Garcia-Moreno C, Jewkes R. AIDS 2020; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: To determine the incidence of HIV acquisition in women post-rape compared with t a cohort of women who had not been raped.
DESIGN: A prospective cohort study.
METHODS: The Rape Impact Cohort Evaluation (RICE) study based in Durban, South Africa, enrolled women aged 16-40 years from post-rape care services, and a control group of women from Primary Health Care services. Women who were HIV negative at baseline (441 in the rape-exposed group and 578 in the control group) were followed for 12 to 36 months with assessments every three months in the first year and every six months thereafter. Multivariable Cox regression models adjusted for baseline and time varying covariates were used to investigate the effect of rape exposure on HIV incidence over follow-up.
RESULTS: Eighty-six women acquired HIV during 1605.5 total person-years of follow-up, with an incident rate of 6.6 per 100 person-years (95% confidence interval (CI): 4.8 - 9.1) among the rape exposed group and 4.7 per 100 person-years (95% CI: 3.5 - 6.2) among control group. After controlling for confounders (age, previous trauma, social support, perceived stress, multiple partners and transactional sex with a casual partner), women exposed to rape had a 60% increased risk of acquiring HIV (adjusted hazard ratio: 1.59 (95% CI: 1.01 - 2.48) compared to those not exposed. Survival analysis showed difference in HIV incident occurred after month nine.
CONCLUSION: Rape is a long-term risk factor for HIV acquisition. Rape survivors need both immediate and long-term HIV prevention and care.
Language: en |