In Mozambique, as in many countries, gender violence remains a guarded secret. Victims face the nightmarish prospect that they may contract HIV or another sexually transmitted infection from an attacker. More than 11 percent of Mozambicans live with HIV.
To address this, a gender-based-violence prevention campaign is under way in Mozambique's capital of Maputo and in four other high HIV-prevalence areas in the country. The campaign received funding from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) and is supported by the U.S. Agency for International Development (USAID). It is implemented by USAID partner Jhpiego, a Baltimore-based international health nonprofit organization.
"This isn't just a societal or cultural problem, this is a health problem. HIV and other sexually transmitted infections, as well as unwanted pregnancy, they all can be prevented,"' said Alicia Jaramillo, deputy director of Jhpiego's Mozambique office.
The program began at Maputo Central Hospital, the 1,000-bed teaching hospital that has a special emergency room for gynecological issues. Since 2010, Jhpiego has worked with health care providers there on preventing infections, including HIV, and on streamlining services for sexual assault victims, regardless of age or gender. Of the more than 2,400 victims who sought services at the hospital between June 2005 and October 2011, 58.6 percent were under 14 years of age and 51 percent were students, according to Ana Baptista, a Jhpiego workplace safety officer.
To help prevent victims of assault from being infected with HIV, health providers provide them with the same prophylaxis that is provided to health care workers who get needle sticks.
"Seeing patients come in to seek care after a sexual assault and having the post-exposure prophylaxis already available to health workers -- it was very natural for the hospital to offer these kits to victims," Jaramillo said.
The regimen consists of four weeks of antiretroviral drugs. The medicine must be administered within 72 hours for it to have the most impact. So part of the awareness campaign is a poster showing a woman with her head down and her face obscured. It appears at the hospital, at police stations and in schools in the metropolitan area and offers a compassionate message to victims of sexual violence: "TU NAO ESTAS SOZINHA" -- "You are not alone!"
Baptista reported that only 31 percent of victims came to Maputo Central within 72 hours of the sexual assault. That led her and her colleagues to develop a community-based aspect of the program to raise awareness about sexual violence in communities and encourage women and families to seek treatment immediately.
The poster encourages women to seek treatment immediately. "We want victims to know that even after the assault happens, it's not over. You have a second chance and you can get help," Baptista said.
She will present the findings of this community-based campaign at the International AIDS Conference in Washington. The conference runs July 22-27.
The campaign also has a message for police officers: Appropriately refer victims of sexual assault to health facilities for care and treatment. According to the Jhpiego conference presentation, 33 percent of sexual assault victims seen at Maputo Central were referred by police.
The campaign drives home a message: Victims of gender violence are not alone and help is available.