Implementing the right to post-exposure prophylaxis for HIV prevention in a broken system: lessons from a community-based organisation in South Africa

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The Thohoyandou Victim Empowerment Programme (TVEP) is a non-governmental organisation that was established in 1997. The organisation facilitates the provision of urgent medico-legal and psychosocial support to survivors of sexual and gender-based violence at two trauma centres at public hospitals in rural Thohoyandou, Limpopo. South Africa’s sexual offences legislation confers the right to post-exposure prophylaxis (PEP), within 72 hours, to prevent HIV infection among rape survivors. However, various institutional and practical challenges obstruct access and/or adherence to this treatment within the crucial time limit. Although these challenges include lack of awareness about PEP among both survivors and professionals, the main problem is the inability of individual provider institutions to meet patients’ needs, especially in rural areas.

This paper describes the framework within which PEP is provided in South Africa, rape survivors’ experiences of accessing PEP, and the response of TVEP. The latter has continuously adapted its services to overcome these obstacles and adopted strategies aimed at holding providers accountable to their mandates. TVEP’s Zero Tolerance Village Alliance Programme (ZTVA) is aimed at the education and capacitation of community members with regard to their rights and responsibilities as they pertain to sexual assault, domestic violence, child abuse and HIV/AIDS. TVEP promotes a multi-sectoral approach involving the departments of justice, social services, health and non-governmental organisations (NGOs) to ensure the provision of holistic treatment, care and support to rape survivors.

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