March 4, 2004

Deadly Delay:

South Africa's Efforts to Prevent HIV in

Survivors of Sexual Violence

I. Summary
II. Recommendations
To the Government of South Africa
Institutional and Programmatic Measures
Legal and Policy Measures
To Donors and Regional and International Organizations
III. Methods
IV. Background: HIV/AIDS and Sexual Violence in South Africa
HIV/AIDS in South Africa
Sexual Violence Against Women and Girls in South Africa
The Role of Gender-Specific Violence in HIV Transmission
Preventing HIV After Sexual Violence Through HIV Post-Exposure Prophylaxis
Antiretroviral Drug Therapy and HIV/AIDS
Health and Social Service Provision
V.PEP Implementation:Human Rights Watch Findings
Lack of Information about PEP
Provincial Efforts to Disseminate Information about PEP
Lack of Information about PEP among Service Providers
Lack of Information among Sexual Violence Survivors
Lack of Information about PEP in Rural Areas
Government Opposition to Antiretroviral Drugs as an Obstacle to PEP Services
Lack of Guidance Regarding PEP for Children Under Fourteen
Consent to HIV Testing and to Medical Treatment for Children Under Fourteen
Procedures to Bypass Consent
Parental/Guardian Refusal to Provide Consent
Unaccompanied Children
Recommendations to Facilitate Obtaining Consent
Police Interference with Access to PEP and Related Services
Arbitrary Denial of PEP Services
Sexual Violence Against Boys and Men
Stigma and Discrimination Interfering with PEP Services
Services for Low-Income Survivors and Rural Dwellers
Additional Challenges to PEP Implementation
Problems with Ensuring Completion of PEP Regimen
Problems with Coordination Among Service Providers
VI. Law and Policy Efforts to Improve Services for Rape Survivors
Prosecution of Sexual Offence Cases
Law Reform...
VII. South Africa's Obligations Under International and National Law..
International Law..
The Right to the Highest Attainable Standard of Health
The Right to Information
The Right to Life
The Right to Measures of Protection
National Law..
VIII. Conclusion
Acknowledgments