National Guidelines on Management of Sexual Violence in Kenya

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Drugs used for STI Prophylaxis Non-pregnant adults male or Norfloxacin 800 mg Stat female Doxycycline 100mg BD one week Pregnant woman Spectinomycin 2g Stat Amoxycillin + 3g Stat Probenicid 1g Stat Erxthromycin 500mg QDS one week Children Amoxycillin 15mg/kg TDS one week Erythromycin 10mg/kg QDS one week 9. Hepatitis B Prevention The generally available Hepatitis B Vaccines do not provide any protection from infection if given after an exposure (e.g.: sexual assault), but they do provide protection from future exposures. It is much less costly to vaccinate all survivors of rape/sexual violence, rather than to test everyone for Hepatitis B antibodies to see who might benefit. Ideally, if Hepatitis B Vaccines is available, it should be considered for survivors of sexual violence according to the revised schedule in the table below. Dosing Schedule Administration Schedule Duration of Immunity Conferred 1 st Hep B dose At first contact Nil 2 nd Hep B dose 1 month after 1 st Hep B dose 1-3 years 3 rd Hep B dose 5 months after 2 nd Hep B dose 10 years 10. Medical Management of Adult Male Survivors of Sexual Violence Men most commonly experience sexual violence in the form of: • Receptive anal intercourse; • Forced masturbation of the perpetrator; • Receptive oral sex; • Forced masturbation of the victim. Male survivors of sexual violence should be triaged in the same manner as female victims. The same procedures for obtaining consent, taking a history, conducting the physical examination (although the genital examination will be different) and ordering diagnostic laboratory tests should be followed, that is: 14
• Perform a top-to-toe examination looking for any signs of injury; • Conduct a thorough examination of the genito-anal area; • Treat any injuries (men also need to be treated for STIs, hepatitis B and tetanus). Men should be informed about, and offered, a HIV test and the option of post-exposure prophylaxis, if available. Men should receive follow-up care for wound healing, any prescribed treatments (including those for STIs), completion of medications and counseling. 11. Medical Management of Perpetrators of Sexual Violence In the event a medical practitioner finds him or herself confronted with a perpetrator in need of medical treatment, the practitioner should accord the perpetrator the necessary treatment as they (perpetrators) too have the right to medical treatment to ensure they access prophylaxis for HIV/AIDS and STIs and management of physical injuries (Sexual Offences Act 2006). The treatment of perpetrators should be the same as for the survivors including collection of forensic specimens and counseling. 15
Page 1: Ministry of Public Health & Sanitat
Page 5: Table of Content Acknowledgements F
Page 8 and 9: The actual writing of the guideline
Page 10 and 11: Acronyms 3TC AZT CCC Cr D4T DCT DNA
Page 12 and 13: Executive Summary Sexual violence i
Page 14 and 15: the policy framework from which spe
Page 16 and 17: Medical Management 1 Introduction M
Page 18 and 19: 3.1.1 Head to Toe Examination for A
Page 20 and 21: • Establish ground rules for the
Page 22 and 23: • Examine the anus. Look for brui
Page 24 and 25: 6. Post Exposure Prophylaxis (PEP)
Page 26 and 27: Weight Band Dose AZT Dose 3ZT 10-20
Page 31 and 32: Psycho-Social Support 1. Introducti
Page 33 and 34: 3. Counseling Different Groups Affe
Page 35 and 36: 7. Types of Counseling • Trauma c
Page 37 and 38: Adherence counseling Effective coun
Page 39 and 40: Forensic Management of Sexual Viole
Page 41 and 42: Crime scene: This is a scene- eithe
Page 43 and 44: Table 3: Possible specimens, method
Page 45: 4.2 Documentation and Reporting In
Page 48 and 49: Humanitarian Issues of Sexual Viole
Page 50 and 51: For effective short and long-term p
Page 52 and 53: Quality Assurance and Quality Impro
Page 54 and 55: 4040
Page 56 and 57: Annex 1: Consent Form Name of Facil
Page 58 and 59: Psychological Assessment (Should be
Page 60 and 61: Does the survivor have any details
Page 62 and 63: o r a tory s a m pl es Blood Pubic
Page 64 and 65: PART 11-MEDICAL DETAILS - (To be co
Page 66 and 67: This P3 Form is free of charge SECT
Page 68 and 69: Annex 4. SV Community Awareness Inf
Page 70 and 71: Remember: you have the right to ask
Page 72 and 73: RAPE TRAUMA COUNSELING DATA FORM Se
Page 74 and 75: Annex 7. Information on Mental Asse
Page 76 and 77: Annex 8. Useful Resources General i
Page 80:
Ministry of Public Health & Sanitat
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National Guidelines on Management of Sexual Violence in Kenya

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