Existing tests are too slow in an emergency, say scientists, who are asking doctors to try out their alternative.

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“There is a fear of judgement that happens around rape, and silence is the way to protect you from that fear. But the only person that is to blame for rape is the rapist,” Larissa Klazinga said today at the 11th annual Silent Protest, which was hosted at the University of Cape Town (UCT) by the Aids Healthcare Foundation (AHF) – in line with Women’s Month.

Klazinga is the Regional Policy and Advocacy Manager at AHF.

The event was attended by hundreds of students and members of the public in solidarity with rape victims and survivors. They also advocated victims’ rights for Post Exposure Prophylaxis (PEP).

“The first Silent Protest was founded in 2007 at Rhodes University in the Eastern Cape, and this year marks the 11th year the Silent Protest is taking place in South Africa”, said Klazinga.

“The reason an HIV organisation is involved in a gender-violence prevention event is because there’s a clear connection between the epidemic of rape and the epidemic of HIV and if we don’t address rape we are never going to stop new infections.

“AHF is the largest HIV/Aids organisation in the world, treating around 750 000 people a month”, said Klazinga.

South Africa has one of the highest reported rape rates in the world. 

“This is the fourth year that the AHF has organised the Silent Protest to highlight the serious issues surrounding rape and sexual violence,” said Klazinga.

Why a silent protest?

The Silent Protest aims to draw awareness to the importance of receiving PEP within 72 hours after somebody has been raped, helping the body fight off HIV infection, said Klazinga.

“There is enormous stigma against gender-based violence. People are assigning blame to the victim and not the perpetrator, and excuses are made on behalf of the perpetrator.”

Rape is rife in South Africa – one in every three girls will be victims of sexual assault before the age of 16 years, and one in every five boys will be victims before the age of 16 years.

PEP after rape

“PEP is free for all who need it and readily available in clinics,” said Klazinga. “But there is a lack of information on PEP. Our aim is to educate the public on the critical importance of PEP and urge the government to improve the education on the importance of PEP.”

Victims can simply report to a medical facility, state that they have been raped and ask for PEP, said Klazinga.

“Once the victim reports a rape, there would need to be a pregnancy test, and HIV test, a blood draw for sexually transmitted infections (STIs), and would be given a broad-spectrum antibiotic for the STIs. They would be given the morning after pill, and a short course of antibiotics if the victim is HIV negative at the time of the test.”

But healthcare workers are under the assumption that rape victims need to come with a police report to gain access to PEP, added Klazinga.

According to the Criminal Law (Sexual Offences and Related Matters) Amendment Act of 2007, it mandates that victims of rape must receive PEP for HIV infection at public hospitals and clinics. It further mentions that PEP should be free of charge.

South African legislation therefore guarantees all survivors of rape and sexual violence the right to access to PEP.

The Silent Protest included a morning briefing; symbolic silencing whereby participants had their mouths taped shut in front of the hall; a march to highlight the silence in communities and the larger South Africa; the “die-in” (where participants lie on the floor in silence); followed by removing the tape and breaking the silence.

The event ended off with an open mic session, which allowed participants to share their stories and views, breaking the silence against gender-based violence.  

^{Image credits: Naseema Barday}

Naseema Barday

Samkelo Mabaso* was raped by a stranger in Nelspruit, but when he told his friends they laughed at him so he decided not to report the rape.

“I still remember that horrible night like it was just yesterday,” said Mabaso, 26, who was walking home at around 7pm. “In front of me, there were two ladies and behind me, a man. Those ladies took a turn and I continued on the same road and the man followed me.

Needed support and advice

“As I was about to take a left turn, the man hit the back of my head.  I woke up in an abandoned house. He was on top of me and he took his penis and put it between my thighs. Then he turned me over and with force, he raped me,” said Mabaso.

The following morning, Mabaso opened up to a group of his friends because he needed their support and advice

“But instead of comforting me, they laughed at me,” said Mabaso. “One of my friends said: ‘What, are you gay now?’ I just said ‘I’m not gay, I was raped’. But at that moment I knew that disclosing the event and opening a case would be a waste of time because, if my friends thought it was a joke, other people would probably also make fun of me.”

Without support, understanding and advice from friends, Mabaso decided to keep quiet and deal with the trauma by himself because of the fear of being judged. But he soon realised that he was in needed of help and spoke to Andrew Langa, a lay preacher at his church.   

“Rape is a sensitive issue and traumatic event to someone. Mabaso tried opening up but after being laughed at, he stopped disclosing the rape and he never got post-exposure prophylaxis that may have protected him from HIV,” said Langa.

Wrong response

If an HIV negative person has been raped, they can take a course of antiretroviral medicine within 72 hours of the rape and this – known as post exposure prophylaxis (PEP) – protects them against HIV infection.

Mabaso has not reported the rape yet, but Langa hope that, “with time and counselling he will do so”.

Meanwhile, one of Mabaso’s friends has since realised that their response was wrong: “When Samkelo first told us, we honestly thought it was a joke because he always jokes but we soon realised it wasn’t when he stopped socialising with us,” said the friend who cannot be named to protect Samkelo’s real identity.

“On behalf of my friends I would like to apologise to him because, by laughing at him and not trusting him, it feels like we have let him down.”

The South African Male Survivors of Sexual Abuse (www.samsosa.org) was set up to offer support to male victims of rape. Rees Mann, founder of SAMSOSA, says that 19.4% of all victims of sexual abuse in 2012 were male victims.

No support systems in SA

“One in five adult males are the victims in sexual offences and this figure could be much higher as a male is 10 times less likely to report a sexual violation than a woman. This could mean that South Africa could have the highest number of adult male victims in the world,” said Mann, himself a survivor of rape and sexual abuse.

“It is because of this that SAMSOSA, launched in September, serves as a resource and referral centre, providing information, support and training for victims, affected individuals and organisations in a safe, non-judgemental environment.

Mann says he realised, after his own experiences of abuse, that there were no support systems in South Africa for males: “Disclosing your sexual abuse encounter can be an extremely difficult thing to do. Choosing the right person to share your story about what happened to you can really make things easier, allowing you to feel a lot better about yourself and your situation,” he explains.

He adds that victims need to understand that what has happened to them is not their fault and that people from all walks of life can be affected by sexual abuse, including men. “There needs to be a dialogue and a safe space for men to confront these experiences and come to terms with the fact that they are not to blame.” – Health-e News.

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^{*Not his real name}

An optometrist put “highly vulnerable patients at risk of harm”, a disciplinary panel decides.

Methamphetamine (known as “tik” in South Africa) is notorious for its harmful side effects. Tik is highly addictive and affects the central nervous system and heart.

And not only are the physical effects severe, but methamphetamine use tends to be associated with aggression/violence, high-risk sexual risk behaviour which can cause HIV/Aids, and sexually transmitted diseases and crime. 

Now a new study suggested that there are even more negative effects. Younger adults who use methamphetamine may be at greater risk for stroke.

This is particularly relevant in South Africa, where more than a quarter of tik patients in the Western Cape are younger than 20.

More meth-related diseases

With use of this stimulant increasing, particularly in more potent forms, doctors in many countries are seeing more meth-related disease and harms, the Australian study authors said. This is especially true for younger people, who are the major users of the drug.

Statistics compiled by the Medical Research Council (MRC) have found that the number of people seeking help at Cape Town rehabilitation centres has increased drastically, with 37% of those cases being tik-related.

“It is likely that methamphetamine abuse is making a disproportionate contribution to the increased incidence of stroke among young people observed over recent years,” said researchers led by Julia Lappin. She’s with the National Drug and Alcohol Research Centre at the University of New South Wales in Sydney.

These strokes can lead to disabilities or death, she and her colleagues pointed out.

Bleeding strokes

For the review, Lappin’s team analysed 77 studies that investigated the link between methamphetamine use and stroke risk in adults younger than 45. They identified reports of 98 strokes – 81 caused by bleeding into the brain (haemorrhagic) and 17 caused by a blood clot (ischaemic). Men were twice as likely as women to suffer one of these strokes.

The study was published online in the Journal of Neurology Neurosurgery & Psychiatry.

Ischaemic strokes are more common in the general population.

But eight out of 10 of the strokes associated with methamphetamine abuse were bleeding strokes, the researchers said. This is a dramatically higher rate than typically reported among people in this age group and older adults.

The brain bleeds also increased the risk of death among younger methamphetamine users: One-third of them died, the study found.

Bleeding strokes were associated with the drug regardless of whether it was swallowed or injected. In about one-third of all cases, the strokes were linked to inflamed blood vessels and high blood pressure, the researchers said.

They added that methamphetamine abuse could cause high blood pressure in otherwise healthy people.

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