A novel ED-based sexual assault centre in western Kenya: description of patients and analysis of treatment patterns.

BACKGROUND

The aim of this study was to establish the feasibility of a Kenyan emergency department (ED)-based sexual assault centre; and to improve knowledge of the characteristics of sexual assault in the region.

METHODS

The Center for Assault Recovery-Eldoret (CAR-E) was established to provide timely, culturally sensitive treatment of Kenyan sexual assault survivors using a standardised evaluation/treatment protocol. A retrospective review of charts of all sexual assault survivors attending CAR-E from May 2007-May 2008 was performed. Simple descriptive statistics, t tests, and OR were calculated.

RESULTS

CAR-E treated 321 survivors over 13 months. Patients' mean age was 15.9 years; 50% were younger than 14years old. Survivors were predominately female and single. Most knew their assailant. Younger age was associated with increased likelihood of genital trauma. Only 43% of assaults were reported to the police. Sexually transmitted infection prophylaxis was given per protocol to 84% eligible; emergency contraception to 64%; and HIV prophylaxis to 63%. Only 44% received counselling. Survivors were more likely to get sexually transmitted infection and HIV prophylaxis, and emergency contraception if they had genital injury.

CONCLUSIONS

Development of an ED-based sexual assault centre at a referral hospital in Kenya using a standardised history, physical, and treatment protocol was feasible, and high rates of prophylaxis were provided. Based on characteristics of people who have been assaulted, community prevention efforts should concentrate on decreasing the societal acceptability of rape. In conjunction with improvement of protocols at the centre under consideration, development of similar centres in sub-Saharan African ED should be encouraged.