Sexual and gender-based violence and HIV in South Africa: An HIV facility-based study

Abstract

Background. South Africa (SA) is known to have high levels of sexual and gender-based violence (SGBV) and HIV. Studies that explore the intersections of the two phenomena tend to be done at sites that provide services for survivors of SGBV, but few have explored experiences of SGBV of individuals attending HIV testing and treatment health facilities. Although HIV voluntary counselling and testing (VCT) services are generally well practised at ensuring pre- and-post-test counselling, there is little evidence that SGBV is included in routine screening. There is therefore a gap in knowledge of the prevalence of SGBV among patient populations in HIV testing and treatment settings. Objectives. To assess levels of SGBV in a patient population of an HIV facility in SA. Methods. This cross-sectional study used a screening tool and a longer in-depth questionnaire on the prevalence of SGBV. A random sample of VCT clients were screened. Prevalence questionnaires were administered to a convenience sample of patients attending treatment literacy classes. Results. A total of 1 936 VCT clients completed the screening tool, of whom 2% reported forced sex without a condom or rape. Of the 436 patients who completed the in-depth prevalence questionnaire, 71% were women; 12% of women had been forced to have sex the last time that they had sexual intercourse. The lifetime prevalence of sexual violence was 14% and the lifetime prevalence of physical violence was 16%. Conclusions. Levels of SGBV are high among populations attending HIV testing and treatment facilities. Healthcare providers need to be able to identify SGBV and provide appropriate services to survivors of SGBV who are seen at HIV testing and treatment facilities.