The bevy of government ministers who lined up for the launch of this year’s Sixteen Days of Activism against Gender Violence campaign is a welcome sign that the gross violation of women’s rights has finally registered on the political agenda.
Unfortunately, the link between gender violence and the twin scourge of HIV/Aids has not. As politicians warming up for elections hit the campaign trail during this period that runs from International Day of No Violence against Women on November 25 to Human Rights Day on December 10, a critical clause is being quietly dropped from the Sexual Offences Bill being rushed through Parliament. Section 21 of the Sexual Offences Bill provides for post-exposure prophylaxis (PEP), a cocktail of drugs that can reduce the chances of contracting HIV/Aids after a sexual assault if taken within 72 hours.
Like the Domestic Violence Bill before the 1999 election, politicians have a lot to gain by getting the Sexual Offences Bill out before Christmas and electioneering next year. This long overdue complement to the Domestic Violence Act replaces anachronistic legislation by giving a gender neutral definition of sexual offences and spelling out stiff penalties.
The public reasons given for dropping Section 21 are that the clause has not been costed. In private, officials acknowledge that the government, which has not yet rolled out this provision, is concerned about litigation if it fails to provide PEP at all state health facilities.
So while the government is urging the nation to break out in white ribbons to show solidarity in the fight against gender violence, it has been left up to NGOs to urge that nation to break out in white and red HIV/ Aids ribbons, and to understand the link between the two. The Nisaa Institute for Women’s Development that first popularised the white ribbon will lead the white and red ribbon campaign.
Meanwhile, Gender Links and about 40 NGOs countrywide will drive a PEP Talk campaign to raise awareness on this vital provision that has been mired in the political morass surrounding HIV/Aids at a cost that will probably never ever be counted. The campaign will include door-to-door visits to hospitals and clinics to find out if the drugs are available and how they are administered.
Consider the facts we know, and the circumstances. In its latest report, the South African Police Service says that 45% of men arrested for rape are HIV-positive. Even if those statistics are not accurate, we know that the age bracket in which most rapists fall also has a high HIV/Aids prevalence rate. It is also a fact that the chances of contracting HIV increase in any situation where sex is coerced.
Now consider what a woman has to go through within 72 hours of what is probably the most traumatic experience in her life. She must report the rape to the police station, where she will be lucky to be treated with any kind of privacy, let alone decency. Then she must get a medical examination — vital proof for the rape case.
And now, to add to all this, she must ask the hospital about PEP. The first thing it will ask is for her, in the midst of her trauma, to take an HIV/Aids test. To put it bluntly, if the woman turns up HIV-positive, there is no point in administering the crash course of drugs. So, within 72 hours of being raped, a woman might have to deal with the double trauma of learning her HIV status — a counselling challenge that few health facilities are equipped to deal with.
And if the woman is HIV-negative, she has a 28-day course of treatment to take. So it is back and forth between the police, the court and the hospital, all of which deal with other emergencies, none of which are particularly sensitive to the emotional side of gender violence and the added stress of HIV/Aids.
In all the high-profile politics around whether to have nevirapine, PEP got lost.
Unlike nevirapine, whose safety and efficacy the minister of health questioned, PEP has not been a controversial issue. Indeed, most health facilities keep a supply of PEP on hand because it is the commonly used antidote by medical practitioners to needlestick injuries that might expose them to HIV/Aids.
However, the government’s general reluctance to rolling out anti-retroviral treatment for HIV/Aids has meant that PEP has been shoved on to the backburner. To put it differently, given that the government does not dispute that victims of sexual assault have a right to PEP or the pressures and time frames under which PEP needs to be taken, this issue requires a concerted public awareness campaign that simply has not been forthcoming.
Colleen Lowe Morna is director of Gender Links