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. 2021 Mar 15;35(4):633-642.
doi: 10.1097/QAD.0000000000002779.

Increase in HIV incidence in women exposed to rape

Naeemah Abrahams  1   2 , Shibe Mhlongo  1 , Kristin Dunkle  1 , Esnat Chirwa  1 , Carl Lombard  3 , Soraya Seedat  4 , Andre P Kengne  5 , Bronwyn Myers  6   7 , Nasheeta Peer  5 , Claudia Garcia-Moreno  8 , Rachel Jewkes  1   9   10
Affiliations

Increase in HIV incidence in women exposed to rape

Naeemah Abrahams et al. AIDS. .

Abstract

Objective: To determine the incidence of HIV acquisition in women postrape compared with a cohort of women who had not been raped.

Design: A prospective cohort study.

Methods: The Rape Impact Cohort Evaluation study based in Durban, South Africa, enrolled women aged 16-40 years from postrape care services, and a control group of women from Primary Healthcare services. Women who were HIV negative at baseline (441 in the rape-exposed group and 578 in the control group) were followed for 12-36 months with assessments every 3 months in the first year and every 6 months thereafter. Multivariable Cox regression models adjusted for baseline and time varying covariates were used to investigate the effect of rape exposure on HIV incidence over follow-up.

Results: Eighty-six women acquired HIV during 1605.5 total person-years of follow-up, with an incident rate of 6.6 per 100 person-years [95% confidence interval (CI): 4.8-9.1] among the rape exposed group and 4.7 per 100 person-years (95% CI: 3.5-6.2) among control group. After controlling for confounders (age, previous trauma, social support, perceived stress, multiple partners and transactional sex with a casual partner), women exposed to rape had a 60% increased risk of acquiring HIV [adjusted hazard ratio: 1.59 (95% CI: 1.01-2.48)] compared with those not exposed. Survival analysis showed difference in HIV incident occurred after month 9.

Conclusion: Rape is a long-term risk factor for HIV acquisition. Rape survivors need both immediate and long-term HIV prevention and care.

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Conflict of interest statement

C.G.M. is a staff member of WHO. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of WHO. We declare there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival plot depicting HIV sero-conversion by month of follow-up: comparing recently rape-exposed women with nonexposed control women.
See this image and copyright information in PMC

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