Women's experiences of, and preferences for, services after rape in South Africa: Interview study

Objectives: To describe aspects of delivery of health services after rape, including trade-offs, that would most influence choice of service, and to compare views of patients who had used such services with views of members of the community who may be future users or may have experienced barriers to service use. Design: Discrete choice analysis of stated preferences with interviews. Attributes included travel time to the service, availability of HIV prophylaxis, number of returns to the hospital, medical examination, and counselling skills and attitude of the provider. Setting: One rural and one urban site in South Africa. Participants: 319 women: 155 who had been raped and four carers recruited through health facilities and 160 comparable women recruited from the community. Of these, 156 were from an urban site and 163 from a rural site. Main outcome measures: Strength of preferences over a range of attributes through the estimation of a benefit function through random effects probit modelling. Results: Factors such as the availability of prophylactic treatment for HIV infection and having a sensitive healthcare provider who could provide counselling are more important in women's decisions to seek care after rape than the travel time necessary to access those services. Conclusion: Our findings support the need for holistic rape services.