Prevalence and pattern of sexual assault in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Experience-Based Perception of Vulnerability Factors to Child Sexual Abuse by Health Care Professionals in Nigeria: A Qualitative Approach

Child sexual abuse (CSA) remains a major public health concern worldwide. In Africa, particularly, Nigeria, CSA is a silent, but lethal public health menace with prevalence reaching as high as 56% for different child sexual violence. Understanding the vulnerability factors of CSA promotes the creation of strategies toward prevention of CSA. Due to social stigmatization of victims and their families in Nigeria, it is difficult for researchers and policymakers to have access to firsthand information about predisposing factors to CSA, which negatively impacts efforts toward prevention of CSA. Health care professionals are sources of experience-based, anonymous information about various public health issues. This study aims to understand qualitatively health care professionals' perception of vulnerability factors of CSA. The study presents a thematic content analysis of a semi-structured interview of 14 health care professionals working with sexually abused children in Nigeria, on their perception of vulnerability factors of CSA, while aligning the factors with known models of violence. Participants in the study reported several interrelated vulnerability factors involving the individual, sexual abuse perpetrator, family, environment, socioeconomic situations, and the lack or nonimplementation of policies against CSA. The study concludes that identifying these factors can assist health care professionals, parents, and family to better respond to child sexual violence cases and policymakers to create new strategies of preventing CSA, thereby improving the health and safety of children in Nigeria.

The gender-based violence and recovery centre at Coast Provincial General Hospital, Mombasa, Kenya: An integrated care model for survivors of sexual violence

Marleen Temmerman and colleagues describe a model of care for people who have experienced sexual violence, set in Kenya.

HIV Non-Occupational Post Exposure Prophylaxis in Nigeria: A Systematic Review of Research Evidence and Practice

BACKGROUND

Although non-occupational Human Immunodeficiency Virus (HIV) post-exposure prophylaxis (nPEP) has been proven to be efficacious in preventing HIV, it remains an underutilized prevention strategy in Nigeria. We aimed to conduct an overview of research studies on nPEP and practice in Nigeria from 2002 to 2018 examining: sociodemographic characteristics of study sample, awareness, knowledge and prior use of nPEP, reasons for HIV nPEP, timeliness in presenting for PEP, antiretrovirals (ARVs) used for nPEP, side effects and adherence, monitoring and follow-up visits, adherence to guidelines and recommendations for nPEP by healthcare institutions and the strength of evidence of reviewed studies.

METHODS

An electronic search on PubMed, PubMed Central (PMC), cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Embase and Google Scholar for published studies on nPEP from January 2002 to December 2018. We conducted our search using different combinations of the keywords "HIV," "non-occupational," "nonoccupational," "post-exposure," "postexposure," "prophylaxis" and "Nigeria."

RESULTS

Five articles met the inclusion criteria for this study. About 25.4% of college students were aware of PEP.PEP awareness was significantly determined by the following factors ever tested for HIV, nude picture exchanges, sex without condom, and knowledge of partner's HIV status. Across studies, exposed victims who presented for PEP were mostly females (64%-78%). Rape was the most frequently occurring reason for seeking nPEP (25.9%-64.1%). Although most patients presented for nPEP within 72 hours, follow up visits were generally low (0%-2%) across studies assessed, except for one study that reported a high follow up visit of 83.3%. Guidelines adherence by healthcare institutions could not be established due to lack of information on key variables.

CONCLUSION

Our study highlights the paucity of research evidence on nPEP use in Nigeria, the societal and cultural contexts in which non-occupational exposures occur, healthcare providers' roles and the public health and practice implications.

The pattern and characteristics of sexual assault perpetrators and survivors managed at a sexual assault referral centre in Lagos

BACKGROUND

 There has presumably been an increase in cases of sexual assault in Nigeria; however, accurate data on the characteristics of the survivors and perpetrators are not readily available in most cases.

AIM

 To report the pattern and characteristics of sexual assault perpetrators and survivors managed at the Mirabel Centre, Lagos State University Teaching Hospital (LASUTH), Ikeja - a three-year review.

METHODS

 A retrospective audit carried out in the sexual assault referral centre (SARC) - Mirabel Centre, LASUTH, Lagos State, Nigeria. A total of 2160 case files from July 2013 to January 2017 were assessed for age group of survivors and gender, among others.

RESULTS

 A total of 2160 cases were analysed. The mean age of survivors was 13.9 (± 4.4) years with the 11-20 years age group having the highest number of survivors (48.4%) and the 0-10 years age group having 35.9% of survivors. Majority of the survivors (97.7%) were female. The majority of the perpetrators were known to the survivors with 10.3% being family members. Defilement (71.6%) was the most reported type of assault at the centre with rape (20.3%) being the second most common. The majority of the referrals to the centre were from the police (76.7%), while self-referrals made up 8% of referrals.

CONCLUSION

 Minors and adolescents formed the majority of the survivors. Defilement was the most reported form of sexual violence. There needs to be special intervention for better monitoring and protection of minors and youths against sexual assault. The establishment of more sexual assault referral centres in Nigeria will increase reportage and treatment of survivors.