National Guidelines on Management of Sexual Violence in Kenya

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RAPE TRAUMA COUNSELING DATA FORM Sex Has the client reported to the 0 No 1 Yes 1 Male 2 Female Age (years) Education police? 0 No 1 Yes If not, name reason(s) a) Is the client willing to report to the police? If not, name reason(s) 2 nd Visit a) Disclosure of SV 0 None 0 No 1 Yes 0 No 1 Yes 1 Primary If not, name reason(s) b) Disclosure HIV results 2 Secondary Client referred from? 0 No 1 Yes 3 Post Secondary/Technical 1 VCT services 2 Police stations c) PEP adherence Marital Status 3 Health Facilities 9 Other 0 No 1 Yes 0 Never 1 Married Was the 1 st dose of PEP administered? If not, name reason(s) 2 widowed 3 Separated/Divorced 0 No 1 Yes d) Still taking PEP Type of assault If not, name reason(s) 0 No 1 Yes 1 Penile anal rape 2 Penile vaginal rape 1 Presented after 72 hours 2 Client declined 3 rd Visit 3 Use of objects in vagina 9 Other Is disclosure done so far ? 4 Use of objects in anus Was EC administered? 0 No 1 Yes 9 Other 0 No 1 Yes 2 N/A Comments Client seen If not, name reason(s) 4 th Visit 1 Individual 2 With partner Comments 3 With guardian/parent 4 With friend/relative Did client know HIV status before the assault? 5 th Visit 9 Other 0 No 1 Yes HIV Test done Services required by client If Yes, 0 Negative 1 Positive Was the PRC 1 form filled? 0 Negative 1 Positive Disclosure of SV 0 No 1 Yes If not, name reason(s) Who is the assailant? 1 st Visit 0 No 1 Yes a) HIV test done Disclosure of HIV Results 0 No 1 Yes 2 Declined 0 No 1 Yes If Yes, 0 Negative 1 Positive Pregnancy Test done b)Pregnancy Test done 0 No 1 Yes 2 N/A 0 Known 1 Unknown Results 0 Negative 1 Positive 0 No 1 Yes 2 N/A Results 0 Negative 1 Positive Comments If known, specify relationship c) Disclosed SV 0 No 1 Yes 58
Annex 6 6. Post PRC Rape Register Care Register Name Age Sex Date and Time of alleged assault Seen by (CO) P3 filled Police officer Forensic Examination Date Time Date Time Signature Assault type (Insert card no.) Given 1 st dose of Referred to Signature of person filling the form EC P PEP VCT / DCT PEP Follow up STI LAB Comments 59
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Ministry of Public Health & Sanitat
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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 28 and 29: Drugs used for STI Prophylaxis Non-
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 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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