Rape survivors will be offered two anti-retroviral drugs, AZT and 3TC, by public health facilities in a bid to prevent HIV infection from the sexual assault. The drugs will also be available in syrup form for child rape

This is according to national protocols released this week by the Department of Health, following Cabinet’s decision on 17 April to offer free anti-AIDS drugs to those who have been raped.

“Anti-retrovirals are prescribed after rape on the basis that they have been shown to reduce infection among healthworkers who sustain needlestick injuries,” said Health Minister Dr Manto Tshabalala-Msimang.

“However, we lack research that shows conclusively the effectiveness of anti-retrovirals in preventing HIV transmission as a result of sexual assault,” she added.

“Because of this, we felt that our protocols for the prophylactic use of anti-retrovirals in the care of rape survivors should be modelled as closely as possible on the protocols that we follow for occupational needlestick injuries.”

A key component of the protocol is counselling of the survivors to ensure that they are aware that they may still contract HIV, and that the drugs have possible side-effects.

Government is also concerned that people who have unsafe sex may abuse the offer by claiming they have been sexually assaulted in order to get the drugs. However, such use of anti-retrovirals is dangerous as it could well lead to the person developing drug resistance.

Provinces will now have to decide how to insert the drugs into the services they offer to rape survivors. Each province will “begin to offer anti-retroviral prophylaxis as soon as it has done the necessary groundwork”, added the minister.

Dr Adrienne Wulfsohn of Netcare’s Sunninghill Hospital in Johannesburg has treated hundreds of women and children who have been raped with anti-AIDS drugs. None of those who received the drugs within 72 hours of being raped became HIV positive.