Prophylaxis against HIV for rape victims

[Guest guest]

Dear Members.

Recently the Jaipur edition of Hindustan Times had published an article by me in

which I had argueds for a govt policy for prophylactic action against HIV for a

rape victim. I do not know whether this subject has been debated in our country

so far or not. I would like to have your comments. The article is reproduced

below.

RAPE AND THE THREAT OF HIV INFECTION

NEED FOR POST-EXPOSURE PROPHYLAXIS

Dr Sudhir Varma, IAS

The anguished cry of the rape victim has again ricocheted against the walls of

Lutyen’s beautifully-constructed Parliament House and there has been a near

unanimous demand- this time led by the Deputy Prime Minister- for the head of

the rapist. There are more demerits in the demand not only because the rapist is

far better off if he kills the victim and leaves no trace of identification but

also if caught a rape trial with death as a punishment will take much longer and

may see witnesses turning hostile. The fear of retaliation by the perpetrator or

his accomplices will continue to haunt the victim throughout the trial. Even

today the victim is apprehensive of not being believed by the police if the

incident is not exactly within the conventional definition given in the law book

or if the alleged rapist is the kith and kin of the mighty. And what about the

large number of rapes by some one in the family itself? Anyway the purpose of

this article is different.

Internationally, there has been a growing concern for providing anti-retroviral

therapy to reduce the risk of HIV transmission following sexual assault. Such

therapy is being widely used as safe and effective in cases of occupational

exposures like needle prick injuries to health care workers. Studies have shown

that in such cases the viral replication may stop if prophylactic action is

taken immediately. The efficacy of prophylactic treatment in preventing mother

to child transmission is now accepted worldwide. Although there is no scientific

evidence so far to conclusively prove that this may also happen in the case of

sexual assault, especially, if it is a gang rape, when the viral load could be

very high, the doctors can assess individual cases and initiate the measures if

they find them necessary.

Today, the post-rape scenario is rapist-centered and the entire focus shifts to

the crime aspect of the act. The victim is left high and dry. There is an urgent

need for medical care of the victim. A comprehensive line of action which can

take care of the possibility of STD and HIV infection, pregnancy, other injuries

and which also provides counseling should become mandatory to be followed by the

police and the doctors immediately after a victim reports to them.

It is necessary for the government to frame a policy in this regard and come out

with a detailed protocol. Availability of rapid HIV tests should be ensured. The

victim should be counseled to take the test. PEP should start if the possibility

of the rapist being HIV positive is high.

It is far more important to save the victim from death as a result of HIV

infection than to take the rapist to the gallows.

Sudhir Varma, Chairman, Board of Revenue for Rajasthan, Ajmer.

E-mail: shantideep@...>

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