Sexual violence as a public health issue: the importance of searching for the aggressor

Abstract

Although people believe that sexual violence is practiced by unknown people, most crimes are actually practiced by someone close to the victim. Besides physical and psychological consequences, there is the risk of acquiring the HIV virus. To prevent the latter, in risky situations, the advice is to use antiretroviral chemoprophylaxis during 28 days. This therapy may bring adverse effects. Knowing the aggressor's anti-HIV serology is vital to safely maintain or suspend the therapy indication. This descriptive study, carried out at Conjunto Hospitalar de Sorocaba, aimed to identify the aggressors and their serology. The study was conducted after analyzing notification index cards and charts from July 2003 to December 2005, in 30 months of active search. The researchers found 920 sexual violence victims, with ages ranging from 8 months to 77 years, most of them female (86.5%). Concerning the aggressors, 76% were referred to as identifiable. Antiretroviral prophylaxis was advised to 24.9% of the victims. For 80 (33.2%) aggressors who were found, the search was carried out through telephone calls. Regarding the places where the aggressors were located, 52.5% were found at home, 45% in a prison/police station and 2.5% in the Emergency Room. One aggressor (1.3%) presented positive HIV serology. Most searches were concluded within 6 days (80%), allowing the suspension of chemoprophylaxis in 30.6% of the cases. It was concluded that after finding the aggressors and learning about their anti-HIV serology, the use of antiretroviral chemoprophylaxis could be safely suspended in one third of the victims, therefore reducing the chances of adverse effects.