Where the streets have no names : factors predicting the provision of counselling and social work services for child rape survivors in KwaZulu-Natal, South Africa.

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.Despite high prevalence rates for rape in South Africa, little focus has been placed on the rape of children, and even less on the secondary victimization of child rape survivors. Such secondary victimization may manifest in two forms, namely, negative attitudes and behaviours and the non-provision of essential services. This study aimed to explore secondary victimization in child rape as a result of the non-provision of counselling and social work services, to a sample of 200 child rape survivors, who presented for medico-legal assessment at a state hospital in the North Durban area (KwaZulu Natal, South Africa). Data analysis revealed that only 48.5% of the sample did in fact receive such services. In the majority of cases (20%), services were only provided between 2-7 days after the child had presented for medical evaluation. In addition, the study found that in most cases, service provision was limited to a single intake interview. Service provision was found to be less likely in cases where respondents resided in homesteads (informal or ‘traditional’ housing) that had no street address, or where the child presented at the study hospital outside of normal working hours. These findings are discussed in terms of their implications for secondary victimization and secondary prevention programming

Disability and HIV: What drives this relationship in Eastern and Southern Africa?

The Eastern and Southern Africa (ESA) region is the epicentre of the global HIV epidemic and also home to a large number of people with disabilities. Both HIV and Disability are significant public health issues. While they are generally viewed as distinct and unrelated phenomena data seems to suggest that they are particularly closely intertwined in ESA. For the first time in history, by using the same disability indicator consistently, the publication of the World Report on Disability in 2011 has allowed for the comparison of disability data between countries, and across regions. This has the potential to shed some light on the relationship between disability and socio-economic markers and other health conditions in a way that was not possible previously. In the absence of disability and HIV-specific population-based surveys, this paper uses global socio-economic and HIV datasets and compares them to data contained in the most recent World Report on Disability. The analysis suggests that disability prevalence may be related to HIV-prevalence in ESA (Pearson 0.87). It identifies research and policy gaps and seeks to shed light on the relationship between the two phenomena. It concludes that, more than any other region in the world, ESA needs to ensure better data collection on disability and the inclusion of disability throughout its HIV programmes in order to provide a comprehensive and appropriate response to the epidemic

Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study

BACKGROUND: Exposure to disease-modifying therapy (DMT) during early pregnancy in women with relapsing-remitting MS (RRMS) may be increasing. OBJECTIVE: To retrospectively determine incidence of pregnancy, DMT exposure and pregnancy outcomes in women with RRMS. METHODS: We identified all women with RRMS aged 15-45 years in the MSBase Registry between 2005-2016. Annualised pregnancy incidence rates were calculated using Poisson regression models. DMT exposures and pregnancy outcomes were assessed. RESULTS: Of 9,098 women meeting inclusion criteria, 1,178 (13%) women recorded 1,521 pregnancies. The annualised incidence rate of pregnancy was 0.042 (95% CI 0.040, 0.045). A total of 635 (42%) reported pregnancies were conceived on DMT, increasing from 27% in 2006 to 62% in 2016. The median duration of DMT exposure during pregnancy was 30 days (IQR: 9, 50). There were a higher number of induced abortions on FDA pregnancy class C/D drugs compared with pregnancy class B and no DMT (p\u202f=\u202f0.010); but no differences in spontaneous abortions, term or preterm births. CONCLUSIONS: We report low pregnancy incidence rates, with increasing number of pregnancies conceived on DMT over the past 12-years. The median duration of DMT exposure in pregnancy was relatively short at one month