Reported rapes at a hospital rape centre: demographic and clinical profiles.

To the Editor: Figures for the period 2008/2009 indicate a 10% rise in the number of reported sexual offences compared with figures for 2007/2008.1 The increase may be partly attributable to the recent version of the act regulating sexual offences: the Criminal Law (Sexual Offences and Related Matters) Amendment Act, Act 32 of 2007 (Act). In this Act, the definition of rape has been broadened to include the non-consensual vaginal, oral or anal penetration of any person, regardless of gender, with any object.2 South Africa has one of the highest incidences of rape in the world and the most violent types of rape in the world, with gang rape and severe physical injury to rape victims commonly occurring.3,4 Moreover, the consequences of rape potentially include many medical and psychological difficulties, such as unwanted pregnancy, risk of sexually transmitted infections (STIs), genital and physical injury, and psychological disturbance e.g. post-traumatic stress disorder, major depression, increased risk of suicidal ideation, and alcohol and drug abuse problems.5,6 Rape survivors have specific health needs, ideally met by providing integrated and holistic post-rape services, including the provision of pregnancy testing and prevention, termination of pregnancy, testing and treatment of STIs and injuries, and psychosocial counselling.7 Rape survivors strongly value the availability of HIV prophylaxis, an understanding health care provider, access to and receiving counselling, and thorough physical examination, emphasising the need for a holistic approach to post-rape care.8,9 The Act aims to provide certain services to survivors of sexual assault to minimise or prevent further traumatisation, yet the only medical service conditionally provided to rape survivors is the provision of post-exposure prophylaxis (PEP).2